WorldWideScience

Sample records for assessing cumulative health

  1. Cumulative health risk assessment of co-occurring mycotoxins of deoxynivalenol and its acetyl derivatives in wheat and maize: case study, Shanghai, China.

    Science.gov (United States)

    Han, Zheng; Nie, Dongxia; Ediage, Emmanuel Njumbe; Yang, Xianli; Wang, Jianhua; Chen, Bo; Li, Shuguang; On, Stephen L W; De Saeger, Sarah; Wu, Aibo

    2014-12-01

    Humans are naturally and frequently exposed to a multitude of mycotoxins, but health risk assessments are usually performed on individual mycotoxins, which may underestimate the total risks. In this study, we assessed for the first time the cumulative health risks of concomitant exposure via dietary intake (DI) to multiple mycotoxins, namely deoxynivalenol (DON) and its acetyl derivatives of 3-acetyldeoxynivalenol (3-ADON) and 15-acetyldeoxynivalenol (15-ADON), based on the concentration addition (CA) concept. A cross-sectional study was conducted in seven districts in Shanghai, China with 1269 participants and 330 wheat and maize samples analyzed. After probabilistic analysis using Monte Carlo simulation, the results showed no health risks to the population in Shanghai considering individual mycotoxins. However, if the cumulative health risks were calculated based on the combined consideration of DON with either 3-ADON or 15-ADON or both, the DI values in 95th percentile were up to 1087 ng/kg body weight/day, exceeding the Provisional Maximum Tolerable Daily Intake (PMTDI) of 1000 ng/kg body weight/day and hence representing potential health risks to the population in Shanghai. The integrated study proposed here could be a model strategy for cumulative health risk assessment on the co-occurring hazards in the fields of food safety combined with environmental contaminants.

  2. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    Directory of Open Access Journals (Sweden)

    Margaret M. MacDonell

    2013-01-01

    Full Text Available The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1 planning, scoping, and problem formulation; (2 environmental fate and transport; (3 exposure analysis extending to human factors; (4 toxicity analysis; and (5 risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities.

  3. Addressing cumulative effects in Strategic Environmental Assessment of spatial planning

    Directory of Open Access Journals (Sweden)

    Chiara Bragagnolo

    2012-08-01

    Full Text Available Strategic environmental Assessment (SEA is a decision support instrument for predicting and evaluating the likely environmental effects of implementing a policy, plan or programme. SEA can consider the cumulative impacts of more than one project or activity on the same environmen- tal component. This paper discusses the analysis of cumulative effects in SEA, with reference to spatial planning by: providing a review of key concepts and methods related to cumulative effects literature; presenting a rationale for the inclusion of cumulative effects in SEA of spatial plans; advancing a proposal to address cumulative effects in different SEA stages. The paper concludes that SEA offers the opportunity to support a better management of cumulative effects arising from many local-level spatial planning decisions. Three aspects emerged as critical to ensure good practices: the selection of valued environmental components, the adoption of future-oriented approaches, and the use of spatially-explicit information.

  4. Cumulative assessment : Strategic choices to influence students' study effort

    NARCIS (Netherlands)

    Kerdijk, Wouter; Tio, Rene A.; Mulder, B. Florentine; Cohen-Schotanus, Janke

    2013-01-01

    Background: It has been asserted that assessment can and should be used to drive students' learning. In the current study, we present a cumulative assessment program in which test planning, repeated testing and compensation are combined in order to influence study effort. The program is aimed at hel

  5. Experience of cumulative effects assessment in the UK

    Directory of Open Access Journals (Sweden)

    Piper Jake

    2004-01-01

    Full Text Available Cumulative effects assessment (CEA is a development of environmental impact assessment which attempts to take into account the wider picture of what impacts may affect the environment as a result of either multiple or linear projects, or development plans. CEA is seen as a further valuable tool in promoting sustainable development. The broader canvas upon which the assessment is made leads to a suite of issues such as complexity in methods and assessment of significance, the desirability of co-operation between developers and other parties, new ways of addressing mitigation and monitoring. After outlining the legislative position and the process of CEA, this paper looks at three cases studies in the UK where cumulative assessment has been carried out - the cases concern wind farms, major infrastructure and off-shore developments.

  6. Assessment of cumulative evidence on genetic associations: Interim guidelines

    OpenAIRE

    Ioannidis, John; Boffetta, Paolo; Little, Julian; O'Brien, Thomas; Uitterlinden, André; Vineis, Paolo; Balding, David; Chokkalingam, Anand; Dolan, Siobhan; Flanders, Dana; Higgins, Julian; McCarthy, Mark; McDermott, David; Page, Grier; Rebbeck, Timothy

    2008-01-01

    textabstractEstablished guidelines for causal inference in epidemiological studies may be inappropriate for genetic associations. A consensus process was used to develop guidance criteria for assessing cumulative epidemiologic evidence in genetic associations. A proposed semi-quantitative index assigns three levels for the amount of evidence, extent of replication, and protection from bias, and also generates a composite assessment of 'strong', 'moderate' or 'weak' epidemiological credibility...

  7. The Role of Cumulative Risk Assessment in Decisions about Environmental Justice

    OpenAIRE

    Ken Sexton; Linder, Stephen H.

    2010-01-01

    There is strong presumptive evidence that people living in poverty and certain racial and ethnic groups bear a disproportionate burden of environmental health risk. Many have argued that conducting formal assessments of the health risk experienced by affected communities is both unnecessary and counterproductive—that instead of analyzing the situation our efforts should be devoted to fixing obvious problems and rectifying observable wrongs. We contend that formal assessment of cumulative heal...

  8. Study on the cumulative impact of reclamation activities on ecosystem health in coastal waters.

    Science.gov (United States)

    Shen, Chengcheng; Shi, Honghua; Zheng, Wei; Li, Fen; Peng, Shitao; Ding, Dewen

    2016-02-15

    The purpose of this study is to develop feasible tools to investigate the cumulative impact of reclamations on coastal ecosystem health, so that the strategies of ecosystem-based management can be applied in the coastal zone. An indicator system and model were proposed to assess the cumulative impact synthetically. Two coastal water bodies, namely Laizhou Bay (LZB) and Tianjin coastal waters (TCW), in the Bohai Sea of China were studied and compared, each in a different phase of reclamations. Case studies showed that the indicator scores of coastal ecosystem health in LZB and TCW were 0.75 and 0.68 out of 1.0, respectively. It can be concluded that coastal reclamations have a historically cumulative effect on benthic environment, whose degree is larger than that on aquatic environment. The ecosystem-based management of coastal reclamations should emphasize the spatially and industrially intensive layout.

  9. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    Science.gov (United States)

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  10. U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making

    Directory of Open Access Journals (Sweden)

    Arlene Rosenbaum

    2012-05-01

    Full Text Available Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA’s general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself.

  11. Cumulative Effects Assessment: Linking Social, Ecological, and Governance Dimensions

    Directory of Open Access Journals (Sweden)

    Naomi Krogman

    2012-06-01

    Full Text Available Setting social, economic, and ecological objectives is ultimately a process of social choice informed by science. In this special feature we provide a multidisciplinary framework for the use of cumulative effects assessment in land use planning. Forest ecosystems are facing considerable challenges driven by population growth and increasing demands for resources. In a suite of case studies that span the boreal forest of Western Canada to the interior Atlantic forest of Paraguay we show how transparent and defensible methods for scenario analysis can be applied in data-limited regions and how social dimensions of land use change can be incorporated in these methods, particularly in aboriginal communities that have lived in these ecosystems for generations. The case studies explore how scenario analysis can be used to evaluate various land use options and highlight specific challenges with identifying social and ecological responses, determining thresholds and targets for land use, and integrating local and traditional knowledge in land use planning. Given that land use planning is ultimately a value-laden and often politically charged process we also provide some perspective on various collective and expert-based processes for identifying cumulative impacts and thresholds. The need for good science to inform and be informed by culturally appropriate democratic processes calls for well-planned and multifaceted approaches both to achieve an informed understanding of both residents and governments of the interactive and additive changes caused by development, and to design action agendas to influence such change at the ecological and social level.

  12. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    Science.gov (United States)

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course.

  13. Epigenome: A Biomarker or Screening Tool to Evaluate Health Impact of Cumulative Exposure to Chemical and Non-Chemical Stressors.

    Science.gov (United States)

    Olden, Kenneth; Lin, Yu-Sheng; Bussard, David

    2016-06-01

    Current risk assessment practices and toxicity information are hard to utilize for assessing the health impact of combined or cumulative exposure to multiple chemical and non-chemical stressors encountered in the "real world" environment. Non-chemical stressors such as heat, radiation, noise, humidity, bacterial and viral agents, and social factors, like stress related to violence and socioeconomic position generally cannot be currently incorporated into the risk assessment paradigm. The Science and Decisions report released by the National Research Council (NRC) in 2009 emphasized the need to characterize the effects of multiple stressors, both chemical and non-chemical exposures. One impediment to developing information relating such non-chemical stressors to health effects and incorporating them into cumulative assessment has been the lack of analytical tools to easily and quantitatively monitor the cumulative exposure to combined effects of stressors over the life course. PMID:27534725

  14. Project 6: Cumulative Risk Assessment (CRA) Methods and Applications

    Science.gov (United States)

    Project 6: CRA Methods and Applications addresses the need to move beyond traditional risk assessment practices by developing CRA methods to integrate and evaluate impacts of chemical and nonchemical stressors on the environment and human health. Project 6 has three specific obje...

  15. Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as.

    Science.gov (United States)

    Myers, Hector F; Wyatt, Gail E; Ullman, Jodie B; Loeb, Tamra B; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K; Slavich, George M; Liu, Honghu

    2015-05-01

    This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. PMID:25961869

  16. Deliberative Democracy, Institution Building, and the Pragmatics of Cumulative Effects Assessment

    Directory of Open Access Journals (Sweden)

    John R. Parkins

    2011-09-01

    Full Text Available Cumulative effects assessment is a process of scientific analysis, social choice, and public policy development, yet the linkages among these domains are often less than transparent. Limits to scientific and technical assessment, issues of power and control of information, and episodic forms of civic engagement represent serious challenges to meaningful understanding of cumulative effects assessment and land-use planning. In articulating these challenges, I draw on case studies from Ontario's Lands for Life and Alberta's Land-use Framework to illustrate current limitations to cumulative effects assessment on public lands in Canada. As a partial remedy for these limitations, insights into a pragmatic approach to impact assessment, in contrast to decisionistic and technocratic approaches, offer a way forward through a more robust integration of scientific information, civic engagement, and public policy development. I also identify a need for longer-standing institutions that are dedicated to regional planning and cumulative effects assessment in Canada.

  17. Not so Black and White: environmental justice and cumulative impact assessments

    International Nuclear Information System (INIS)

    not typically identified as meeting EJ criteria (in demographic terms) also face more significant ecological hazards. Thus, the strict bifurcation of communities into categories of Environmental Justice and Non-Environmental Justice is problematic, and poses a serious dilemma for policy makers, public health officials, and community activists. To overcome this challenge requires the adoption of a cumulative environmental justice impact assessment (CEJIA), which in addition to the demographic characteristics of a community, also takes into account the total environmental burden and related health impacts upon residents. Furthermore, through the adoption of the precautionary principle, source reduction, and alternative forms of ''cleaner'' production, environmental justice advocates must work for policies which reduce the environmental threat for the full range of communities, as well as their own

  18. Elaboration of a concept for the cumulative environmental exposure assessment of biocides

    Energy Technology Data Exchange (ETDEWEB)

    Gross, Rita; Bunke, Dirk; Moch, Katja [Oeko-Institut e.V. - Institut fuer Angewandte Oekologie e.V., Freiburg im Breisgau (Germany); Gartiser, Stefan [Hydrotox GmbH, Freiburg im Breisgau (Germany)

    2011-12-15

    Article 10(1) of the EU Biocidal Products Directive 98/8/EC (BPD) requires that for the inclusion of an active substance in Annex I, Annex IA or IB, cumulation effects from the use of biocidal products containing the same active substance shall be taken into account, where relevant. The study proves the feasibility of a technical realisation of Article 10(1) of the BPD and elaborates a first concept for the cumulative environmental exposure assessment of biocides. Existing requirements concerning cumulative assessments in other regulatory frameworks have been evaluated and their applicability for biocides has been examined. Technical terms and definitions used in this context were documented with the aim to harmonise terminology with other frameworks and to set up a precise definition within the BPD. Furthermore, application conditions of biocidal products have been analysed to find out for which cumulative exposure assessments may be relevant. Different parameters were identified which might serve as indicators for the relevance of cumulative exposure assessments. These indicators were then integrated in a flow chart by means of which the relevance of cumulative exposure assessments can be checked. Finally, proposals for the technical performance of cumulative exposure assessments within the Review Programme have been elaborated with the aim to bring the results of the project into the upcoming development and harmonization processes on EU level. (orig.)

  19. The Challenge of Developing Social Indicators for Cumulative Effects Assessment and Land Use Planning

    Directory of Open Access Journals (Sweden)

    John R. Parkins

    2011-06-01

    Full Text Available This paper provides a synopsis on social indicators as relevant to cumulative effects assessment and land use planning. Although much has been done to better understand the social dimensions of environmental assessment, empirical work has been lacking on social indicators that could be used either as measurable inputs or outputs for cumulative effects assessment and land use planning in different kinds of communities and regions. Cumulative effects models currently in practice often fail to address deeper issues of community and regional well-being. Against this gap, social scientists are being asked to make reliable generalizations about functional, measurable relationships between certain social indicators and land use change or scenarios. To address this challenge, the Alberta Research Council held a two-day workshop in 2005 with social scientists. The workshop resulted in a list of prioritized social indicators that could be included in cumulative effects modeling/assessments and land use planning. The top five social indicators included population growth rate, education attainment, self-assessed quality of life, equity, i.e., distribution of benefits, and locus of control. Although consensus on social indicators and social thresholds for cumulative effects models was not reached, the insight gained from the workshop will help inform future cumulative effects assessment and land use planning.

  20. Cumulative Advantage in an Egalitarian Country? Socioeconomic Health Disparities over the Life Course in Sweden.

    Science.gov (United States)

    Leopold, Liliya

    2016-06-01

    According to the cumulative advantage hypothesis, health gaps between socioeconomic groups widen with age. In the United States, studies have supported this hypothesis. Outside this context, evidence remains scarce. The present study tests the cumulative advantage hypothesis in Sweden, a society that contrasts sharply with the United States in terms of policies designed to reduce social disparities in health-related resources. I draw on longitudinal data from the Swedish Level of Living Survey (N = 9,412 person-years), spanning the period between 1991 and 2010. The results show that gaps in self-rated health increase from early to middle adulthood. This applies to differences between educational groups and between occupational classes. In older age, health gaps remain constant. Cross-cohort analyses reveal a rising importance of cumulative advantage between educational groups but not between occupational classes. I conclude that the forces of accumulation prevail even in one of the most egalitarian welfare states. PMID:27284078

  1. Cumulative Risk Assessment and Environmental Equity in Air Permitting: Interpretation, Methods, Community Participation and Implementation of a Unique Statute

    Directory of Open Access Journals (Sweden)

    Gregory C. Pratt

    2011-11-01

    Full Text Available In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA to issue air permits was amended to include a unique requirement to analyze and consider “cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited.” Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase ‘environmental equity’. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the “cumulative levels and effects analysis”.

  2. Cumulative risk assessment and environmental equity in air permitting: interpretation, methods, community participation and implementation of a unique statute.

    Science.gov (United States)

    Ellickson, Kristie M; Sevcik, Sarah M; Burman, Shelley; Pak, Steven; Kohlasch, Frank; Pratt, Gregory C

    2011-11-01

    In 2008, the statute authorizing the Minnesota Pollution Control Agency (MPCA) to issue air permits was amended to include a unique requirement to analyze and consider "cumulative levels and effects of past and current environmental pollution from all sources on the environment and residents of the geographic area within which the facility's emissions are likely to be deposited." Data describing the Statute Area suggest it is challenged by environmental and socioeconomic concerns, i.e., concerns which are often described by the phrase 'environmental equity'. With input from diverse stakeholders, the MPCA developed a methodology for implementing a cumulative levels and effects analysis when issuing air permits in the designated geographic area. A Process Document was created defining explicit steps a project proposer must complete in the analysis. An accompanying Reference Document compiles all available environmental health data relevant to the Statute Area that could be identified. The final cumulative levels and effects methodology is organized by health endpoint and identifies hazard, exposure and health indices that require further evaluation. The resulting assessment is summarized and presented to decision makers for consideration in the regulatory permitting process. We present a description of the methodology followed by a case study summary of the first air permit processed through the "cumulative levels and effects analysis".

  3. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    Directory of Open Access Journals (Sweden)

    Lauren Zeise

    2012-08-01

    Full Text Available Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure.

  4. Methodological Considerations in Screening for Cumulative Environmental Health Impacts: Lessons Learned from a Pilot Study in California

    Science.gov (United States)

    August, Laura Meehan; Faust, John B.; Cushing, Lara; Zeise, Lauren; Alexeeff, George V.

    2012-01-01

    Polluting facilities and hazardous sites are often concentrated in low-income communities of color already facing additional stressors to their health. The influence of socioeconomic status is not considered in traditional models of risk assessment. We describe a pilot study of a screening method that considers both pollution burden and population characteristics in assessing the potential for cumulative impacts. The goal is to identify communities that warrant further attention and to thereby provide actionable guidance to decision- and policy-makers in achieving environmental justice. The method uses indicators related to five components to develop a relative cumulative impact score for use in comparing communities: exposures, public health effects, environmental effects, sensitive populations and socioeconomic factors. Here, we describe several methodological considerations in combining disparate data sources and report on the results of sensitivity analyses meant to guide future improvements in cumulative impact assessments. We discuss criteria for the selection of appropriate indicators, correlations between them, and consider data quality and the influence of choices regarding model structure. We conclude that the results of this model are largely robust to changes in model structure. PMID:23202671

  5. Cumulative assessment of persistent organic pollutant toxicity in vivo

    OpenAIRE

    Westerholm, Emma

    2011-01-01

    Humans are continuously exposed to a multitude of compounds present in the environment and in food. A major challenge in risk assessment is to determine the degree of exposure to multiple chemicals and the hazards associated with such combined exposure. The simultaneous exposure to persistent organic pollutants (POPs), such as dioxins and dioxin-like (DL) compounds, polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs), is one example of a complex group of chemicals whic...

  6. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    DEFF Research Database (Denmark)

    Müller, Anne Kirstine; Nielsen, Elsa

    2008-01-01

    A cumulative risk assessment of three anti-androgenic pesticides vinclozolin, procymidone and prochloraz in combination has been carried out using an Integrated Probabilistic Risk Assessment (IPRA) model. In the model, variability in both exposure and sensitivity between individuals were combined...

  7. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food.

    NARCIS (Netherlands)

    Müller, A.K.; Bosgra, S.; Boon, P.E.; van der Voet, H.; Nielsen, E.; Ladefoged, O.

    2009-01-01

    In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three reprodu

  8. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    NARCIS (Netherlands)

    Muller, A.K.; Bosgra, S.; Boon, P.E.; Voet, van der H.; Nielsen, E.; Ladefoged, O.

    2009-01-01

    In this paper, we present a cumulative risk assessment of three anti-androgenic pesticides (vinclozolin, procymidone and prochloraz) using the relative potency factor (RPF) approach and an integrated probabilistic risk assessment (IPRA) model. RPFs for each substance were estimated for three reprodu

  9. Using Cumulative Risk to Screen for Mental Health Problems in Child Welfare

    Science.gov (United States)

    McCrae, Julie S.; Barth, Richard P.

    2008-01-01

    Objective: This study tests the hypothesis that information typically collected during a maltreatment investigation can be used to screen children for mental health problems. Method: Data are from the National Survey of Child and Adolescent Well-Being. Cumulative risk scores were created for 3,022 children and compared to reports of clinical-level…

  10. A method proposal for cumulative environmental impact assessment based on the landscape vulnerability evaluation

    International Nuclear Information System (INIS)

    Cumulative environmental impact assessment deals with the occasional use in practical application of environmental impact assessment process. The main reasons are the difficulty of cumulative impact identification caused by lack of data, inability to measure the intensity and spatial effect of all types of impacts and the uncertainty of their future evolution. This work presents a method proposal to predict cumulative impacts on the basis of landscape vulnerability evaluation. For this purpose, qualitative assessment of landscape ecological stability is conducted and major vulnerability indicators of environmental and socio-economic receptors are specified and valuated. Potential cumulative impacts and the overall impact significance are predicted quantitatively in modified Argonne multiple matrixes while considering the vulnerability of affected landscape receptors and the significance of impacts identified individually. The method was employed in the concrete environmental impact assessment process conducted in Slovakia. The results obtained in this case study reflect that this methodology is simple to apply, valid for all types of impacts and projects, inexpensive and not time-consuming. The objectivity of the partial methods used in this procedure is improved by quantitative landscape ecological stability evaluation, assignment of weights to vulnerability indicators based on the detailed characteristics of affected factors, and grading impact significance. - Highlights: • This paper suggests a method proposal for cumulative impact prediction. • The method includes landscape vulnerability evaluation. • The vulnerability of affected receptors is determined by their sensitivity. • This method can increase the objectivity of impact prediction in the EIA process

  11. Cumulative risk assessment of the intake of organophosphorus and carbamate pesticides in the Danish diet

    DEFF Research Database (Denmark)

    Jensen, A. F.; Petersen, Annette; Granby, Kit

    2003-01-01

    in the Danish nation-wide food consumption survey in 1995. The pesticide data are based on the Danish pesticide residue-monitoring programme from 1996-2001. The amount of 35 organophosphorus pesticides and carbamates were included in the cumulative risk assessment. Processing factors, such as reduction......The aim of the study is to evaluate the potential cumulative effects of organophosphorus and carbamate pesticides that act through a common mechanism of toxicity, and to assess the long- and short-term risks for the Danish population. The intake estimates are based on dietary intake data collected...... of pesticide levels by rinsing and peeling, were applied in the exposure assessment. The "Toxicity Equivalence Factor" (TEF) approach was used to normalise the toxicity of the different organophosphorus and carbamate pesticides. Cumulative chronic exposure of organophosphorus and carbamates pesticides via...

  12. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    Directory of Open Access Journals (Sweden)

    Timothy M. Barzyk

    2015-04-01

    Full Text Available Community, state, and federal approaches to conventional and cumulative risk assessment (CRA were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific methodology, including partnership formation and solution development as necessary practices. Community, state, and federal examples were described and then summarized based on their adherence to CRA principles of: (1 planning, scoping, and problem formulation; (2 risk analysis and ranking, and (3 risk characterization, interpretation, and management. While each application shared the common goal of protecting human health and the environment, they adopted different approaches to achieve this. For a specific project-level analysis of a particular place or instance, this may be acceptable, but to ensure long-term applicability and transferability to other projects, recommendations for developing a consistent approach to CRA are provided. This approach would draw from best practices, risk assessment and decision analysis sciences, and historical lessons learned to provide results in an understandable and accepted manner by all entities. This approach is intended to provide a common ground around which to develop CRA methods and approaches that can be followed at all levels.

  13. [Recommendations for the analysis of cumulated data in antimicrobial susceptibility in health institutions].

    Science.gov (United States)

    2010-04-01

    Due to the great variability in antimicrobial resistance patterns, local reports of cumulative antimicrobial susceptibility data are necessary in every health center. The purpose is to guide clinical decisions and the early detection of patterns that allow preventive measures to avoid dissemination of resistant strains. The main objective of this guide is to provide recommendations for the analysis of antimicrobial susceptibility data and elaboration of a local report. Recommendations provided in this guide are based on the Clinical and Laboratory Standards Institute (CLSI) document "Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data" (3). Key aspects related to information gathering and data processing, analysis and presentation are described.

  14. Cumulative violence exposure, emotional nonacceptance, and mental health symptoms in a community sample of women.

    Science.gov (United States)

    Sundermann, Jane M; Chu, Ann T; DePrince, Anne P

    2013-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence)--referred to here as cumulative violence exposure--are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims' emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of 3 types of symptoms central to complex trauma responses: depression, dissociation, and posttraumatic stress disorder (PTSD) symptoms. A non-treatment-seeking community sample of women (N = 89; M age = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test 3 mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women's cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations.

  15. Cumulative impact assessments and bird/wind farm interactions: Developing a conceptual framework

    International Nuclear Information System (INIS)

    The wind power industry has grown rapidly in the UK to meet EU targets of sourcing 20% of energy from renewable sources by 2020. Although wind power is a renewable energy source, there are environmental concerns over increasing numbers of wind farm proposals and associated cumulative impacts. Individually, a wind farm, or indeed any action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. EU and UK legislation requires a cumulative impact assessment (CIA) as part of Environmental Impact Assessments (EIA). However, in the absence of detailed guidance and definitions, such assessments within EIA are rarely adequate, restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Here we propose a conceptual framework to promote transparency in CIA through the explicit definition of impacts, actions and scales within an assessment. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development EIAs. We propose that benefits would be gained from elevating CIA to a strategic level, as a component of spatially explicit planning.

  16. Health risks of children's cumulative and aggregative exposure to metals and metalloids in a typical urban environment in China.

    Science.gov (United States)

    Cao, Suzhen; Duan, Xiaoli; Zhao, Xiuge; Chen, Yiting; Wang, Beibei; Sun, Chengye; Zheng, Binghui; Wei, Fusheng

    2016-03-01

    Rapid development of industrialization and urbanization results in serious environmental contamination by metal(loid)s, which would consequently cause deleterious health effects to the exposed people through multi-pathways. Therefore, total health risk assessment for the population in urban environment is very important. Unfortunately, few studies to date investigate the cumulative health risks of metal(loid)s through aggregative pathways in Children who are often susceptible population. 12 metal(loid)s including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), Zinc(Zn), Copper(Cu), Nickel(Ni), Manganese(Mn), Cobalt(Co), Selenium(Se), Antimony(Se) and Vanadium(V), were analyzed in PM10, drinking water, food, soil and indoor dust in this study. The cumulative and aggregative risks of these metal(loid)s among the local children were then evaluated on a field sampling and questionnaire-survey basis. The results showed that the environments were heavily polluted by metal(loid)s. For most metal(loid)s, food ingestion accounted for more than 80% of the total daily exposure dose. The non-cancer risks were up to 30 times higher than the acceptable level due to the food ingestion via Pb, Cr, Cu, Zn, As, Se, Cd and Sb, and the PM10 inhalation via Cr and Mn. While, the cancer risks were mainly attributed to Cr via food ingestion and As via food and dust ingestion, and approximately 100 times of the maximum acceptable level of 1.0 × 10(-4). The study highlights the cumulative and aggregative exposure assessment, instead of pollutant investigation to evaluate the potential health risks and emphasizes concerns to improve indoor hygienic and environmental quality and to decrease the potential harmful health effects of children living in urban area. PMID:26774306

  17. A prospective study of cumulative job stress in relation to mental health

    Directory of Open Access Journals (Sweden)

    Coppieters Yves

    2005-06-01

    Full Text Available Abstract Background This study tests associations between psychosocial stress at work measured by the effort-reward imbalance model in a dynamic perspective, and multiple indicators of poor mental health, in a prospective design. Methods 1986 male and female employees from four Belgian enterprises were followed-up over one year within the framework of the Somstress study. Based on two consecutive measurements, an index of cumulative job stress was constructed and its associations with five indicators of mental health were studied, excluding caseness at entry (for depression, anxiety, somatisation, chronic fatigue and psychotropic drug consumption respectively. Taking into account the longitudinal design, four categories of job stress are defined: 1 employees free from stress at both measures, 2 job stress present at first measure but not at the second one, 3 recent onset of job stress as evidenced by second measure 4 workers exposed to stress at both measures. Multivariate logistic regression with appropriate adjustments was applied. Results In bivariate analysis, a clear graded association of cumulative job stress with all five mental health indicators is observed, both in men and women. In multivariate logistic regression analysis, recent onset of stress is strongly associated with poor mental health among men (odds ratios ranging from 1.8 to 4.6, while cumulative stress shows strongest effects on mental health in women (odds ratios ranging from 1.4 to 7.1. Conclusion Cumulative experience and recent onset of job stress in terms of high effort spent and low reward received is associated with elevated risk of all five indicators of poor mental health at follow-up in a large cohort of employees.

  18. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach

    International Nuclear Information System (INIS)

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0–6-yr-old children accounted for 91% (79–107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0–3-yr-old children and 4–6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods. - Graphical abstract: In seven phthalates, the 95th percentile of the average daily dose (ADD) for ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) in 0–3-yr-old male (0–3 M) and female (0–3 F) children accounted for 97% and 84% of TDIs, respectively. For 4–6-yr-old and 7–12-yr-old males and 7–12-yr-old females, ADDs for ΣDBP(i + n) accounted for 79%, 72%, and 65% of TDIs, respectively. - Highlights: • A cumulative risk assessment of PAEs was used in a severe plasticizer-contaminated food episode. • ΣDBP(i + n) posed the highest risk potential of all the dietary phthalates. • Females 4–6 yr old had the highest risk for anti-androgenic effects. • Beverages, milk and dairy products were the major contributors to average daily dose of phthalate esters. - The health of young Taiwanese may be adversely affected by overexposure of plasticizer-contaminated food

  19. Weak self-directed learning skills hamper performance in cumulative assessment

    NARCIS (Netherlands)

    Tio, Rene A.; Stegmann, Mariken E.; Koerts, Janke; van Os, Titus W. D. P.; Cohen-Schotanus, Janke

    2016-01-01

    Background: Self-regulated learning is an important determinant of academic performance. Previous research has shown that cumulative assessment encourages students to work harder and improve their results. However, not all students seem to respond as intended. We investigated the influence of studen

  20. Why cumulative impacts assessments of hydrocarbon activities in the Arctic fail to meet their purpose

    DEFF Research Database (Denmark)

    Kirkfeldt, Trine Skovgaard; Hansen, Anne Merrild; Olsen, Pernille;

    2016-01-01

    The Arctic Region is characterised by vulnerable ecosystems and residing indigenous people, dependent on nature for fishing and hunting. The Arctic also contains a wealth of non-living natural resources such as minerals and hydrocarbons. Synergies between increased access and growing global demand...... of methodology for assessment of cumulative impacts, knowledge gap of Arctic ecosystems and other....

  1. Optimization of the cumulative risk assessment of pesticides and biocides using computational techniques: Pilot project

    DEFF Research Database (Denmark)

    Jonsdottir, Svava Osk; Reffstrup, Trine Klein; Petersen, Annette;

    This pilot project is intended as the first step in developing a computational strategy to assist in refining methods for higher tier cumulative and aggregate risk assessment of exposure to mixture of pesticides and biocides. For this purpose, physiologically based toxicokinetic (PBTK) models were...

  2. Cumulative versus end-of-course assessment : effects on self-study time and test performance

    NARCIS (Netherlands)

    Kerdijk, Wouter; Cohen-Schotanus, Janke; Mulder, B. Florentine; Muntinghe, Friso L. H.; Tio, Rene A.

    2015-01-01

    ContextStudents tend to postpone preparation for a test until the test is imminent, which raises various risks associated with cramming' behaviours, including that for suboptimal learning. Cumulative assessment utilises spaced testing to stimulate students to study more frequently and to prevent pro

  3. Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach

    DEFF Research Database (Denmark)

    Søeborg, T; Frederiksen, H; Andersson, Anna-Maria

    2012-01-01

    and adolescents and resulting estimated daily intakes of four different phthalates. These daily intake estimates are used for a cumulative risk assessment with anti-androgenic effects as the endpoint using Tolerable Daily Intake (TDI) values determined by the European Food Safety Authorities (EFSA) or Reference...... endpoint for the phthalates included in this article. Using the EFSA TDI values, 12 children exceeded the hazard quotient for the sum of di-n-butyl phthalate and di-iso-butyl phthalate (∑DBP((i+n)) ) and one child exceeded the hazard quotient for di-(2-ethylhexyl)phthalate (DEHP). Nineteen children...... exceeded the cumulated hazard index for three phthalates. Using the RfD AA values, one child exceeded the hazard quotient for DEHP and the same child exceeded the cumulated hazard index for four phthalates. The EFSA TDI approach thus is more restrictive and identifies ∑DBP((i+n)) as the compound...

  4. Cumulative Violence Exposure, Emotional Nonacceptance, and Mental Health Symptoms in a Community Sample of Women

    OpenAIRE

    Sundermann, Jane M.; Chu, Ann T.; DePrince, Anne P.

    2013-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence) – referred to here as cumulative violence exposure – are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cogniti...

  5. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach.

    Science.gov (United States)

    Chang, J W; Chen, C Y; Yan, B R; Chang, M H; Tseng, S H; Kao, Y M; Chen, J C; Lee, C C

    2014-06-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.

  6. Conceptual and methodological challenges to integrating SEA and cumulative effects assessment

    International Nuclear Information System (INIS)

    The constraints to assessing and managing cumulative environmental effects in the context of project-based environmental assessment are well documented, and the potential benefits of a more strategic approach to cumulative effects assessment (CEA) are well argued; however, such benefits have yet to be clearly demonstrated in practice. While it is widely assumed that cumulative effects are best addressed in a strategic context, there has been little investigation as to whether CEA and strategic environmental assessment (SEA) are a 'good fit' - conceptually or methodologically. This paper identifies a number of conceptual and methodological challenges to the integration of CEA and SEA. Based on results of interviews with international experts and practitioners, this paper demonstrates that: definitions and conceptualizations of CEA are typically weak in practice; approaches to effects aggregation vary widely; a systems perspective lacks in both SEA and CEA; the multifarious nature of SEA complicates CEA; tiering arrangements between SEA and project-based assessment are limited to non-existing; and the relationship of SEA to regional planning remains unclear.

  7. Application of a Novel Method for Assessing Cumulative Risk Burden by County

    Directory of Open Access Journals (Sweden)

    Ken Sexton

    2012-05-01

    Full Text Available The purpose of this study is to apply the Human Security Index (HSI as a tool to detect social and economic cumulative risk burden at a county-level in the state of Texas. The HSI is an index comprising a network of three sub-components or “fabrics”; the Economic, Environmental, and Social Fabrics. We hypothesized that the HSI will be a useful instrument for identifying and analyzing socioeconomic conditions that contribute to cumulative risk burden in vulnerable counties. We expected to identify statistical associations between cumulative risk burden and (a ethnic concentration and (b geographic proximity to the Texas-Mexico border. Findings from this study indicate that the Texas-Mexico border region did not have consistently higher total or individual fabric scores as would be suggested by the high disease burden and low income in this region. While the Economic, Environmental, Social Fabrics (including the Health subfabric were highly associated with Hispanic ethnic concentration, the overall HSI and the Crime subfabric were not. In addition, the Education, Health and Crime subfabrics were associated with African American racial composition, while Environment, Economic and Social Fabrics were not. Application of the HSI to Texas counties provides a fuller and more nuanced understanding of socioeconomic and environmental conditions, and increases awareness of the role played by environmental, economic, and social factors in observed health disparities by race/ethnicity and geographic region.

  8. DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PESTICIDES

    Science.gov (United States)

    The US EPAs N-Methyl Carbamate Cumulative Risk Assessment (NMCRA) assesses the effect on acetylcholine esterase (AChE) activity of exposure to 10 N-methyl carbamate (NMC) pesticides through dietary, drinking water, and residential exposures.

  9. Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models

    Directory of Open Access Journals (Sweden)

    Heather L. White

    2013-03-01

    Full Text Available The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI models to gauge the negative health effects of one social exposure: socioeconomic position (SEP. We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.

  10. Application of the ELDO approach to assess cumulative eye lens doses for interventional cardiologists

    International Nuclear Information System (INIS)

    In preparation of a large European epidemiological study on the relation between eye lens dose and the occurrence of lens opacities, the European ELDO project focused on the development of practical methods to estimate retrospectively cumulative eye lens dose for interventional medical professionals exposed to radiation. The present paper applies one of the ELDO approaches, correlating eye lens dose to whole-body doses, to assess cumulative eye lens dose for 14 different Finnish interventional cardiologists for whom annual whole-body dose records were available for their entire working period. The estimated cumulative left and right eye lens dose ranged from 8 to 264 mSv and 6 to 225 mSv, respectively. In addition, calculations showed annual eye lens doses sometimes exceeding the new ICRP annual limit of 20 mSv. The work also highlights the large uncertainties associated with the application of such an approach proving the need for dedicated dosimetry systems in the routine monitoring of the eye lens dose. (authors)

  11. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    Science.gov (United States)

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children.

  12. Framework tool for a rapid cumulative effects assessment: case of a prominent wetland in Myanmar.

    Science.gov (United States)

    Pradhan, N; Habib, H; Venkatappa, M; Ebbers, T; Duboz, R; Shipin, O

    2015-06-01

    The wetland of focus, Inle Lake, located in central Myanmar, is well known for its unique biodiversity and culture, as well as for ingenious floating garden agriculture. During the last decades, the lake area has seen extensive degradation in terms of water quality, erosion, deforestation, and biodiversity concomitant with a major shift to unsustainable land use. The study was conducted, with an emphasis on water quality, to analyze environmental impacts (effects) changing the ecosystem and to comprehensively evaluate the environmental state of the ecosystem through an innovative Rapid Cumulative Effects Assessment framework tool. The assessment started with a framework-forming Participatory Rural Appraisal (PRA), which quantified and prioritized impacts over space and time. Critically important impacts were assessed for "intra-inter interactions" using the loop analysis simulation. Water samples were analyzed while geographic information system (GIS) and remote sensing were used to identify water pollution hotspots. It was concluded that out of a plethora of impacts, pollution from municipal sources, sedimentation, and effects exerted by floating gardens had the most detrimental impacts, which cumulatively affected the entire ecosystem. The framework tool was designed in a broad sense with a reference to highly needed assessments of poorly studied wetlands where degradation is evident, but scarcely quantified, and where long-term field studies are fraught with security issues and resource unavailability (post-conflict, poor and remote regions, e.g., Afghanistan, Laos, Sudan, etc.). PMID:25963760

  13. Probabilistic cumulative risk assessment of anti-androgenic pesticides in food

    DEFF Research Database (Denmark)

    Müller, Anne Kirstine; Bosgra, Sieto; Boon, Polly E.;

    2009-01-01

    reproductive endpoints (ano-genital distance, and weights of the seminal vesicles and the musculus levator ani/bulbocavernosus) in male rat foetuses exposed in utero. The cumulative dietary intake was estimated based on consumption data and residue data from the Netherlands. The IPRA model combines variability...... in both exposure and sensitivity between individuals into a distribution of individual margins of exposures (IMoEs) and IMoEs of 1 or less indicate a possible concern. The assessment did not result in IMoEs ≤ 1. The endpoint ‘weight of seminal vesicles’ resulted in the lowest IMoEs (0.1th percentile: 198...

  14. Current Status of Development of Methods to Assess Effects of Cumulative or Aggregated Underwater Sounds on Marine Mammals.

    Science.gov (United States)

    Fleishman, Erica; Streever, Bill; Angliss, Robyn; Clark, Christopher W; Ellison, William T; Frankel, Adam; Gedamke, Jason; Leu, Matthias; McKenna, Megan; Racca, Roberto; Simmons, Samantha; Suydam, Robert

    2016-01-01

    There are no standards for assessment of the cumulative effects of underwater sound. Quantitative assessments typically consider a single source, whereas qualitative assessments may include multiple sources but rarely identify response variables. As a step toward understanding the cumulative effects of underwater sound, we assessed the aggregated sounds of multiple sources received by migrating bowhead whales (Balaena mysticetus). The quantitative method models the sound field from multiple sources and simulates movement of a population through it. The qualitative method uses experts to assess the responses of individuals and populations to sound sources and identify the potential mechanisms. These methods increase the transparency of assessments. PMID:26610973

  15. Phthalates in Commercial Chinese Rice Wines: Concentrations and the Cumulative Risk Assessment to Adult Males in Shanghai.

    Science.gov (United States)

    Huang, Yue; Lu, Wen Wei; Chen, Bo; You, Jie; Wu, Min; Li, Shu Guang

    2014-10-01

    The concentrations of 16 phthalates in 164 commercial Chinese rice wines (CRW) were detected by GC-MS, and consumption data on CRW in different packaging types was investigated from 634 adult males in Shanghai using a food frequency questionnaire. Based on the principles of probabilistic modelling and cumulative risk assessment, the exposure and health risk of phthalates from CRW to adult males in Shanghai was evaluated. DMP, DEP, DIBP, DnBP, BBP, and DEHP were detected in the samples, the range of detection frequency of individual phthalates varied from 6.10% for BBP to 15.24% for DIBP, and the detected concentrations were 51.06-200.34 ng/mL. All the respondents consumed CRW, 90.69% of them consumed CRW 0.01-49.9 mL/d, the minimum value of the average daily intake of CRW was 6.25 mL/d, the median was 13.72 mL/d and the maximum was 300 mL/d. The median exposure level of the 6 detected Phthalates to adult males in Shanghai were 6.58-7.10 ng/(d•kg), and the maximum exposure level were 137.38-540.47 ng/(d•kg). The cumulative exposure health risk index (HI) based on the median and maximum exposure level of the 6 Phthalates (DMP, DEP, DIBP, DnBP, BBP, and DEHP) were 0.001147 and 0.063396, both were far less than 1. In conclusion, CRW were generally consumed by the adult males in Shanghai, although multiple phthalates were detected in commercial CRW, health risk of such exposure levels from commercial CRW to the target adult males in Shanghai was very low.

  16. Collaboration, Participation and Technology: The San Joaquin Valley Cumulative Health Impacts Project

    Directory of Open Access Journals (Sweden)

    Jonathan K. London

    2011-11-01

    Full Text Available Community-university partnerships have been shown to produce significant value for both sets of partners by providing reciprocal learning opportunities, (rebuilding bonds of trust, and creating unique venues to formulate and apply research that responds to community interests and informs collaborative solutions to community problems. For such partnerships to be mutually empowering, certain design characteristics are necessary. These include mutual respect for different modes and expressions of knowledge, capacity-building for all parties, and an environment that promotes honest and constructive dialogue about the inevitable tensions associated with the interplay of power/knowledge. This article explores an innovative case of community-university partnerships through participatory action research involving a coalition of environmental justice and health advocates, the San Joaquin Valley Cumulative Health Impacts Project, and researchers affiliated with the University of California, Davis. In particular, we examine how participatory GIS and community mapping can promote co-learning and interdependent science. Keywords Community-based participatory research, environmental justice, Public Participation Geographic Information System

  17. Assessing Cumulative Thermal Stress in Fish During Chronic Exposure to High Temperature

    Energy Technology Data Exchange (ETDEWEB)

    Bevelhimer, M.S.; Bennett, W.R.

    1999-11-14

    As environmental laws become increasingly protective, and with possible future changes in global climate, thermal effects on aquatic resources are likely to receive increasing attention. Lethal temperatures for a variety of species have been determined for situations where temperatures rise rapidly resulting in lethal effects. However, less is known about the effects of chronic exposure to high (but not immediately lethal) temperatures and even less about stress accumulation during periods of fluctuating temperatures. In this paper we present a modeling framework for assessing cumulative thermal stress in fish. The model assumes that stress accumulation occurs above a threshold temperature at a rate depending on the degree to which the threshold is exceeded. The model also includes stress recovery (or alleviation) when temperatures drop below the threshold temperature as in systems with large daily variation. In addition to non-specific physiological stress, the model also simulates thermal effects on growth.

  18. Alchemy to reason: Effective use of Cumulative Effects Assessment in resource management

    International Nuclear Information System (INIS)

    Cumulative Effects Assessment (CEA) is a tool that can be useful in making decisions about natural resource management and allocation. The decisions to be made include those (i) necessary to construct planning and regulatory frameworks to control development activity so that societal goals will be achieved and (ii) whether or not to approve individual development projects, with or without conditions. The evolution of CEA into a more successful tool cannot occur independently of the evolution of decision making processes. Currently progress is painfully slow on both fronts. This paper explores some opportunities to accelerate improvements in decision making in natural resource management and in the utility of CEA as a tool to assist in making such decisions. The focus of the paper is on how to define the public interest by determining what is acceptable.

  19. Probability, conditional probability and complementary cumulative distribution functions in performance assessment for radioactive waste disposal

    International Nuclear Information System (INIS)

    A formal description of the structure of several recent performance assessments (PAs) for the Waste Isolation Pilot Plant (WIPP) is given in terms of the following three components: a probability space (Sst, Sst, pst) for stochastic uncertainty, a probability space (Ssu, Ssu, psu) for subjective uncertainty and a function (i.e., a random variable) defined on the product space associated with (Sst, Sst, pst) and (Ssu, Ssu, psu). The explicit recognition of the existence of these three components allows a careful description of the use of probability, conditional probability and complementary cumulative distribution functions within the WIPP PA. This usage is illustrated in the context of the U.S. Environmental Protection Agency's standard for the geologic disposal of radioactive waste (40 CFR 191, Subpart B). The paradigm described in this presentation can also be used to impose a logically consistent structure on PAs for other complex systems

  20. IDENTIFYING CHEMICALS FOR CUMULATIVE RISK ASSESSMENT USING COMMON MECHANISMS OF ACTION AND TOXICITY

    Science.gov (United States)

    Traditionally, potential health risk assessments from exposure to contaminated food, drinking water, or environmental media have been conducted on individual pesticides or chemicals in each medium of concern. However, humans are generally exposed to multiple chemicals and stress...

  1. (BOSC) DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PRESTICIDES

    Science.gov (United States)

    THE US EPA'S N-METHYL CARBAMATE CUMULATIVE RISK ASSESSMENT (NMCRA) ASSESSES THE EFFECT ON ACETYLCHOLINE ESTERASE (AChE) ACTIVITY OF EXPOSURE TO 10 N-METHLY CARBAMATE (NMC)PESTICIDES THROUGH DIETARY, DRINKING WATER, AND RESIDENTIAL EXPOSURES. THESE DATA THUS INFORM, BUT DO NOT COM...

  2. Suriname: Health Sector Assessment

    OpenAIRE

    Rena Eichler

    1999-01-01

    This study assesses the health sector in Suriname, with the goal of assisting policy makers to develop a better understanding of problems and to propose a range of solutions. This study presents the analytical framework used to assess the health sector, reviews the major findings, and presents key recommendations. The focus is on the complex inter-relationships between the major actors in the health sector: policy leaders, consumers, providers, and payers. This market-oriented framework was c...

  3. Using Physiologically-Based Pharmacokinetic Models to Incorporate Chemical and Non-Chemical Stressors into Cumulative Risk Assessment: A Case Study of Pesticide Exposures

    Directory of Open Access Journals (Sweden)

    Jonathan I. Levy

    2012-05-01

    Full Text Available Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids and non-chemical stressors that may modify the effects of these exposures (including diet. We developed a methodological framework to evaluate chemical and non-chemical stressor impacts on OPs, utilizing an existing PBPK/PD model for chlorpyrifos. We evaluated population-specific stressors that would influence OP doses or acetylcholinesterase (AChE inhibition, the relevant PD outcome. We incorporated the impact of simultaneous exposure to pyrethroids and dietary factors on OP dose through the compartments of metabolism and PD outcome within the PBPK model, and simulated combinations of stressors across multiple exposure ranges and potential body weights. Our analyses demonstrated that both chemical and non-chemical stressors can influence the health implications of OP exposures, with up to 5-fold variability in AChE inhibition across combinations of stressor values for a given OP dose. We demonstrate an approach for modeling OP risks in the presence of other population-specific environmental stressors, providing insight about co-exposures and variability factors that most impact OP health risks and contribute to children’s cumulative health risk from pesticides. More generally, this framework can be used to inform cumulative risk assessment for any compound impacted by

  4. Cumulative Burden of Lifetime Adversities: Trauma and Mental Health in Low-SES African Americans and Latino/as

    OpenAIRE

    Myers, HF; Wyatt, GE; Ullman, JB; Loeb, TB; Chin, D.; Prause, N.; Zhang, M.; Williams, JK; Slavich, GM; H. Liu

    2015-01-01

    © 2014 American Psychological Association. All rights reserved. This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men...

  5. Methodologies for Assessing the Cumulative Environmental Effects of Hydroelectric Development of Fish and Wildlife in the Columbia River Basin, Volume 1, Recommendations, 1987 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Stull, Elizabeth Ann

    1987-07-01

    This volume is the first of a two-part set addressing methods for assessing the cumulative effects of hydropower development on fish and wildlife in the Columbia River Basin. Species and habitats potentially affected by cumulative impacts are identified for the basin, and the most significant effects of hydropower development are presented. Then, current methods for measuring and assessing single-project effects are reviewed, followed by a review of methodologies with potential for use in assessing the cumulative effects associated with multiple projects. Finally, two new approaches for cumulative effects assessment are discussed in detail. Overall, this report identifies and reviews the concepts, factors, and methods necessary for understanding and conducting a cumulative effects assessment in the Columbia River Basin. Volume 2 will present a detailed procedural handbook for performing a cumulative assessment using the integrated tabular methodology introduced in this volume. 308 refs., 18 figs., 10 tabs.

  6. Probability, conditional probability and complementary cumulative distribution functions in performance assessment for radioactive waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Helton, J.C. [Arizona State Univ., Tempe, AZ (United States)

    1996-03-01

    A formal description of the structure of several recent performance assessments (PAs) for the Waste Isolation Pilot Plant (WIPP) is given in terms of the following three components: a probability space (S{sub st}, S{sub st}, p{sub st}) for stochastic uncertainty, a probability space (S{sub su}, S{sub su}, p{sub su}) for subjective uncertainty and a function (i.e., a random variable) defined on the product space associated with (S{sub st}, S{sub st}, p{sub st}) and (S{sub su}, S{sub su}, p{sub su}). The explicit recognition of the existence of these three components allows a careful description of the use of probability, conditional probability and complementary cumulative distribution functions within the WIPP PA. This usage is illustrated in the context of the U.S. Environmental Protection Agency`s standard for the geologic disposal of radioactive waste (40 CFR 191, Subpart B). The paradigm described in this presentation can also be used to impose a logically consistent structure on PAs for other complex systems.

  7. Benchmark Dose Analysis from Multiple Datasets: The Cumulative Risk Assessment for the N-Methyl Carbamate Pesticides

    Science.gov (United States)

    The US EPA’s N-Methyl Carbamate (NMC) Cumulative Risk assessment was based on the effect on acetylcholine esterase (AChE) activity of exposure to 10 NMC pesticides through dietary, drinking water, and residential exposures, assuming the effects of joint exposure to NMCs is dose-...

  8. Probabilistic assessment of the cumulative dietary acute exposure of the population of Denmark to organophosphorus and carbamate pesticides

    DEFF Research Database (Denmark)

    Jensen, Bodil Hamborg; Petersen, Annette; Christensen, Tue

    2009-01-01

    the nationwide dietary survey conducted in 2000-2002. Contributions from 43 commodities were included in the calculations. We used the relative potency factor (RPF) approach to normalize the toxicity of the various organophosphorus and carbamate pesticides to the two index compounds chlorpyriphos......Organophosphorus and carbamate pesticides are acetylcholinesterase-inhibiting pesticides and as such have a common mode of action. We assessed the cumulative acute exposure of the population of Denmark to 25 organophosphorus and carbamate pesticide residues from the consumption of fruit, vegetables...... exposure was apple. The results show that there is no cumulative acute risk for Danish consumers to acetylcholinesterase- inhibiting pesticides....

  9. Towards a cumulative collision risk assessment of local and migrating birds in North Sea offshore wind farms

    OpenAIRE

    Brabant, Robin; Vanermen, Nicolas; Stienen,Eric; Degraer, Steven

    2015-01-01

    Bird collision assessments are generally made at the scale of a single wind farm. While especially in offshore situations such assessments already hold several assumptions, even bigger challenges exist on estimating the cumulative impact ofmultiple wind farms and the impacts at population level. In this paper, the number of collision victims at Belgian offshore wind farms was estimated with a(theoretical) collision risk model based on technical turbine specifications, bird-related parameters ...

  10. An Assessment of Cumulative Axial and Torsional Fatigue in a Cobalt-Base Superalloy

    Science.gov (United States)

    Kalluri, Sreeramesh; Bonacuse, Peter J.

    2010-01-01

    Cumulative fatigue under axial and torsional loading conditions can include both load-order (higMow and low/high) as well as load-type sequence (axial/torsional and torsional/axial) effects. Previously reported experimental studies on a cobalt-base superalloy, Haynes 188 at 538 C, addressed these effects. These studies characterized the cumulative axial and torsional fatigue behavior under high amplitude followed by low amplitude (Kalluri, S. and Bonacuse, P. J., "Cumulative Axial and Torsional Fatigue: An Investigation of Load-Type Sequance Effects," in Multiaxial Fatigue and Deformation: Testing and Prediction, ASTM STP 1387, S. Kalluri, and P. J. Bonacuse, Eds., American Society for Testing and Materials, West Conshohocken, PA, 2000, pp. 281-301) and low amplitude followed by high amplitude (Bonacuse, P. and Kalluri, S. "Sequenced Axial and Torsional Cumulative Fatigue: Low Amplitude Followed by High Amplitude Loading," Biaxial/Multiaxial Fatigue and Fracture, ESIS Publication 31, A. Carpinteri, M. De Freitas, and A. Spagnoli, Eds., Elsevier, New York, 2003, pp. 165-182) conditions. In both studies, experiments with the following four load-type sequences were performed: (a) axial/axial, (b) torsional/torsional, (c) axial/torsional, and (d) torsional/axial. In this paper, the cumulative axial and torsional fatigue data generated in the two previous studies are combined to generate a comprehensive cumulative fatigue database on both the load-order and load-type sequence effects. This comprehensive database is used to examine applicability of the Palmgren-langer-Miner linear damage rule and a nonlinear damage curve approach for Haynes 188 subjected to the load-order and load-type sequencing described above. Summations of life fractions from the experiments are compared to the predictions from both the linear and nonlinear cumulative fatigue damage approaches. The significance of load-order versus load-type sequence effects for axial and torsional loading conditions

  11. Health needs assessment

    Directory of Open Access Journals (Sweden)

    Ibrahim A Bani

    2008-01-01

    The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools.

  12. Playing It Safe: Assessing Cumulative Impact and Social Vulnerability through an Environmental Justice Screening Method in the South Coast Air Basin, California

    Directory of Open Access Journals (Sweden)

    Justin Scoggins

    2011-05-01

    Full Text Available Regulatory agencies, including the U.S. Environmental Protection Agency (US EPA and state authorities like the California Air Resources Board (CARB, have sought to address the concerns of environmental justice (EJ advocates who argue that chemical-by-chemical and source-specific assessments of potential health risks of environmental hazards do not reflect the multiple environmental and social stressors faced by vulnerable communities. We propose an Environmental Justice Screening Method (EJSM as a relatively simple, flexible and transparent way to examine the relative rank of cumulative impacts and social vulnerability within metropolitan regions and determine environmental justice areas based on more than simply the demographics of income and race. We specifically organize 23 indicator metrics into three categories: (1 hazard proximity and land use; (2 air pollution exposure and estimated health risk; and (3 social and health vulnerability. For hazard proximity, the EJSM uses GIS analysis to create a base map by intersecting land use data with census block polygons, and calculates hazard proximity measures based on locations within various buffer distances. These proximity metrics are then summarized to the census tract level where they are combined with tract centroid-based estimates of pollution exposure and health risk and socio-economic status (SES measures. The result is a cumulative impacts (CI score for ranking neighborhoods within regions that can inform diverse stakeholders seeking to identify local areas that might need targeted regulatory strategies to address environmental justice concerns.

  13. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  14. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  15. Assessing the implications of human land-use change for the transient climate response to cumulative carbon emissions

    International Nuclear Information System (INIS)

    Recent research has shown evidence of a linear climate response to cumulative CO2 emissions, which implies that the source, timing, and amount of emissions does not significantly influence the climate response per unit emission. Furthermore, these analyses have generally assumed that the climate response to land-use CO2 emissions is equivalent to that of fossil fuels under the assumption that, once in the atmosphere, the radiative forcing induced by CO2 is not sensitive to the emissions source. However, land-cover change also affects surface albedo and the strength of terrestrial carbon sinks, both of which have an additional climate effect. In this study, we use a coupled climate-carbon cycle model to assess the climate response to historical and future cumulative land-use CO2 emissions, in order to compare it to the response to fossil fuel CO2. We find that when we isolate the CO2-induced (biogeochemical) temperature changes associated with land-use change, then the climate response to cumulative land-use emissions is equivalent to that of fossil fuel CO2. We show further that the globally-averaged albedo-induced biophysical cooling from land-use change is non-negligible and may be of comparable magnitude to the biogeochemical warming, with the result that the net climate response to land-use change is substantially different from a linear response to cumulative emissions. However, our new simulations suggest that the biophysical cooling from land-use change follows its own independent (negative) linear response to cumulative net land-use CO2 emissions, which may provide a useful scaling factor for certain applications when evaluating the full transient climate response to emissions. (letter)

  16. Cumulative human impacts on Mediterranean and Black Sea marine ecosystems: assessing current pressures and opportunities.

    Directory of Open Access Journals (Sweden)

    Fiorenza Micheli

    Full Text Available Management of marine ecosystems requires spatial information on current impacts. In several marine regions, including the Mediterranean and Black Sea, legal mandates and agreements to implement ecosystem-based management and spatial plans provide new opportunities to balance uses and protection of marine ecosystems. Analyses of the intensity and distribution of cumulative impacts of human activities directly connected to the ecological goals of these policy efforts are critically needed. Quantification and mapping of the cumulative impact of 22 drivers to 17 marine ecosystems reveals that 20% of the entire basin and 60-99% of the territorial waters of EU member states are heavily impacted, with high human impact occurring in all ecoregions and territorial waters. Less than 1% of these regions are relatively unaffected. This high impact results from multiple drivers, rather than one individual use or stressor, with climatic drivers (increasing temperature and UV, and acidification, demersal fishing, ship traffic, and, in coastal areas, pollution from land accounting for a majority of cumulative impacts. These results show that coordinated management of key areas and activities could significantly improve the condition of these marine ecosystems.

  17. [Assessment on the ecological suitability in Zhuhai City, Guangdong, China, based on minimum cumulative resistance model].

    Science.gov (United States)

    Li, Jian-fei; Li, Lin; Guo, Luo; Du, Shi-hong

    2016-01-01

    Urban landscape has the characteristics of spatial heterogeneity. Because the expansion process of urban constructive or ecological land has different resistance values, the land unit stimulates and promotes the expansion of ecological land with different intensity. To compare the effect of promoting and hindering functions in the same land unit, we firstly compared the minimum cumulative resistance value of promoting and hindering functions, and then looked for the balance of two landscape processes under the same standard. According to the ecology principle of minimum limit factor, taking the minimum cumulative resistance analysis method under two expansion processes as the evaluation method of urban land ecological suitability, this research took Zhuhai City as the study area to estimate urban ecological suitability by relative evaluation method with remote sensing image, field survey, and statistics data. With the support of ArcGIS, five types of indicators on landscape types, ecological value, soil erosion sensitivity, sensitivity of geological disasters, and ecological function were selected as input parameters in the minimum cumulative resistance model to compute urban ecological suitability. The results showed that the ecological suitability of the whole Zhuhai City was divided into five levels: constructive expansion prohibited zone (10.1%), constructive expansion restricted zone (32.9%), key construction zone (36.3%), priority development zone (2.3%), and basic cropland (18.4%). Ecological suitability of the central area of Zhuhai City was divided into four levels: constructive expansion prohibited zone (11.6%), constructive expansion restricted zone (25.6%), key construction zone (52.4%), priority development zone (10.4%). Finally, we put forward the sustainable development framework of Zhuhai City according to the research conclusion. On one hand, the government should strictly control the development of the urban center area. On the other hand, the

  18. [Assessment on the ecological suitability in Zhuhai City, Guangdong, China, based on minimum cumulative resistance model].

    Science.gov (United States)

    Li, Jian-fei; Li, Lin; Guo, Luo; Du, Shi-hong

    2016-01-01

    Urban landscape has the characteristics of spatial heterogeneity. Because the expansion process of urban constructive or ecological land has different resistance values, the land unit stimulates and promotes the expansion of ecological land with different intensity. To compare the effect of promoting and hindering functions in the same land unit, we firstly compared the minimum cumulative resistance value of promoting and hindering functions, and then looked for the balance of two landscape processes under the same standard. According to the ecology principle of minimum limit factor, taking the minimum cumulative resistance analysis method under two expansion processes as the evaluation method of urban land ecological suitability, this research took Zhuhai City as the study area to estimate urban ecological suitability by relative evaluation method with remote sensing image, field survey, and statistics data. With the support of ArcGIS, five types of indicators on landscape types, ecological value, soil erosion sensitivity, sensitivity of geological disasters, and ecological function were selected as input parameters in the minimum cumulative resistance model to compute urban ecological suitability. The results showed that the ecological suitability of the whole Zhuhai City was divided into five levels: constructive expansion prohibited zone (10.1%), constructive expansion restricted zone (32.9%), key construction zone (36.3%), priority development zone (2.3%), and basic cropland (18.4%). Ecological suitability of the central area of Zhuhai City was divided into four levels: constructive expansion prohibited zone (11.6%), constructive expansion restricted zone (25.6%), key construction zone (52.4%), priority development zone (10.4%). Finally, we put forward the sustainable development framework of Zhuhai City according to the research conclusion. On one hand, the government should strictly control the development of the urban center area. On the other hand, the

  19. Cumulative risk assessment of chemicals in food%食品中化学物累积风险评估方法及应用

    Institute of Scientific and Technical Information of China (English)

    张磊; 李凤琴; 刘兆平

    2011-01-01

    Food chemicals, such as contaminants, pesticides and food additives, may cause cumulative exposure of human beings through four types of combined effect or interaction, but traditional risk assessment methodologies were mainly based on single-chemical scenarios.In the past decades, more attention has been paid to health risks caused by cumulative exposure to chemicals, and some cumulative risk assessment methods including group tolerable daily intake (TDI) , hazard index (HI) , relative potency factor (RPF) and physiologically based toxicokinetics (PBTK) models have been developed.The characteristics and application of these methods are discussed in this paper.%食品中存在的各种污染物、农药和添加剂等化学物可能会通过多种机制的联合作用对人体形成累积暴露,但传统的风险评估方法多以单一化学物暴露为基础.近年来,化学物累积暴露形成的健康风险受到越来越多的重视,一些累积风险评估方法,如类别每日可耐受摄入量(TDI)、危害指数(HI)、相对效能因子(RPF)、生理毒代动力学(PBTK)模型等也逐渐发展起来.本文对这些方法的特点及其应用进行了讨论.

  20. A Levels-of-Evidence Approach for Assessing Cumulative Ecosystem Response to Estuary and River Restoration Programs

    Energy Technology Data Exchange (ETDEWEB)

    Diefenderfer, Heida L.; Thom, Ronald M.; Johnson, Gary E.; Skalski, J. R.; Vogt, Kristiina A.; Ebberts, Blaine D.; Roegner, G. Curtis; Dawley, Earl

    2011-03-01

    Even though large-scale ecological restoration programs are beginning to supplement isolated projects implemented on rivers and tidal waterways, the effects of restoration success often continue to be evaluated at project scales or by integration in an additive manner. Today our scientific understanding is sufficient that we can begin to apply lessons learnt from assessing cumulative impacts of anthropogenic stressors on ecosystems to the assessment of ecological restoration. Integration of this knowledge has the potential to increase the efficacy of restoration projects conducted at several locations but co-managed within the confines of a larger integrative program. We introduce here a framework based on a levels-of-evidence approach that facilitates assessment of the cumulative landscape effects of individual restoration actions taken at many different locations. It incorporates data collection at restoration and reference sites, hydrodynamic modeling, geographic information systems, and meta-analyses in a five-stage process: design, data, analysis, synthesis and evaluation, and application. This framework evolved from the need to evaluate the efficacy of restoration projects designed to increase rearing habitat for outmigrating juvenile salmonids, which are being implemented in numerous wetlands on the 235-km tidal portion of the Columbia River, U.S.A.

  1. Modeling cumulative effects in life cycle assessment: the case of fertilizer in wheat production contributing to the global warming potential.

    Science.gov (United States)

    Laratte, Bertrand; Guillaume, Bertrand; Kim, Junbeum; Birregah, Babiga

    2014-05-15

    This paper aims at presenting a dynamic indicator for life cycle assessment (LCA) measuring cumulative impacts over time of greenhouse gas (GHG) emissions from fertilizers used for wheat cultivation and production. Our approach offers a dynamic indicator of global warming potential (GWP), one of the most used indicator of environmental impacts (e.g. in the Kyoto Protocol). For a case study, the wheat production in France was selected and considered by using data from official sources about fertilizer consumption and production of wheat. We propose to assess GWP environmental impact based on LCA method. The system boundary is limited to the fertilizer production for 1 ton of wheat produced (functional unit) from 1910 to 2010. As applied to wheat production in France, traditional LCA shows a maximum GWP impact of 500 kg CO2-eq for 1 ton of wheat production, whereas the GWP impact of wheat production over time with our approach to dynamic LCA and its cumulative effects increases to 18,000 kg CO2-eq for 1 ton of wheat production. In this paper, only one substance and one impact assessment indicator are presented. However, the methodology can be generalized and improved by using different substances and indicators.

  2. In vivo measurements of lead-210 for assessing cumulative radon exposure in uranium miners

    Energy Technology Data Exchange (ETDEWEB)

    Guilmette, R.A.; Laurer, G.R. [New York Univ. Inst. of Environmental Medicine, Tuxedo, NY (United States); Lambert, W.E.; Gilliland, F.D. [Univ. of New Mexico, Albuquerque, NM (United States)] [and others

    1995-12-01

    It has long been recognized that a major contributor to the uncertainty in risk analysis of lung cancer in uranium and other hard rock miners is the estimation of total radon progeny exposure of individual miners under study. These uncertainties arise from the fact that only a limited number of measurements of airborne {sup 222}Rn progeny concentrations were made in the mines during the times that the miners were being exposed, and that dosimeters capable of integrating the Rn progeny exposures of the miners did not exist. Historically, the cumulative exposures for individual uranium and other hard rock miners have been calculated by combining the employee`s work history, which may or may not have included time spent at different jobs within the mines and at different locations within the mines, with whatever periodic measurements of Rn and Rn progeny were available. The amount and quality of the measurement data varied enormously from mine to mine and from population to population. Because the quality of the exposure data collected during the period of active mining in the United STates cannot now be altered substantially, significant improvement in individual miner exposure estimates is only likely to be achieved if a new cumulative exposure metric is developed and implemented. The decay chain of Rn includes the production of {sup 210}Pb, which can accumulate in the skeleton in amounts proportional to the intake of Rn progeny. We hypothesize that the in vivo measurement of {sup 210}Pb in the skulls of miners will provide such a metric. In summary, the primary purpose of this pilot study to demonstrate the feasibility of measuring {sup 210}Pb in the heads of former uranium miners has been accomplished.

  3. Scientific Opinion on the identification of pesticides to be included in cumulative assessment groups on the basis of their toxicological profile

    OpenAIRE

    EFSA Panel on Plant Protection Products and their Residues

    2013-01-01

    The European Food Safety Authority asked the Panel on Plant Protection Products and their Residues to develop an Opinion on the identification of pesticides to be included in cumulative assessment groups (CAGs) on the basis of their toxicological profile. In 2008, the PPR Panel adopted an Opinion on the suitability of existing methodologies for cumulative risk assessment of pesticides and a tiered approach was proposed, which was applied to a selected group of triazole pesticides in 2009. The...

  4. A geographic model to assess and limit cumulative ecological degradation from Marcellus Shale exploitation in New York, USA

    Science.gov (United States)

    Davis, John B.; Robinson, George R.

    2012-01-01

    When natural resources are exploited, environmental costs and economic benefits are often asymmetric. An example is apparent in the environmental impacts from fossil fuel extraction by hydraulic fracturing. So far, most scrutiny has been focused on water quality in affected aquifers, with less attention paid to broader ecological impacts beyond individual drilling operations. Marcellus Shale methane exploitation in New York State, USA, has been delayed because of a regulatory moratorium, pending evaluation that has been directed primarily at localized impacts. We developed a GIS-based model, built on a hexagonal grid underlay nested within the U.S. Environmental Protection Agency’s EMAP system, to examine potential cumulative ecological impacts. In a two-step process, we characterized > 19,000 hexagons, each sized to approximate the footprint of one drilling site (2.57 km²), using ecological attributes; we then developed a method for apportioning resource access that includes assessments of cumulative ecological costs. Over one-quarter of the hexagons were excluded as off-limits on the basis of six criteria: slope suitability, regulated wetland cover, protected-land cover, length of high-quality streams, mapped road density, and open water cover. Three additional criteria were applied to assess the estimated conservation vulnerability of the remaining sites: density of grassland birds (North American Breeding Bird Survey), percent core forest (Coastal Change Analysis Program), and total density of all state-mapped streams; these were determined and used in combination to rank the 14,000 potentially accessible sites. In a second step, an iterative process was used to distribute potential site access among all towns (sub-county governments) within the Marcellus Shale Formation. At each iteration, one site was selected per town, either randomly or in rank order of increasing vulnerability. Results were computed as percent cumulative impact versus the number of

  5. A Geographic Model to Assess and Limit Cumulative Ecological Degradation from Marcellus Shale Exploitation in New York, USA

    Directory of Open Access Journals (Sweden)

    George R. Robinson

    2012-06-01

    Full Text Available When natural resources are exploited, environmental costs and economic benefits are often asymmetric. An example is apparent in the environmental impacts from fossil fuel extraction by hydraulic fracturing. So far, most scrutiny has been focused on water quality in affected aquifers, with less attention paid to broader ecological impacts beyond individual drilling operations. Marcellus Shale methane exploitation in New York State, USA, has been delayed because of a regulatory moratorium, pending evaluation that has been directed primarily at localized impacts. We developed a GIS-based model, built on a hexagonal grid underlay nested within the U.S. Environmental Protection Agency’s EMAP system, to examine potential cumulative ecological impacts. In a two-step process, we characterized > 19,000 hexagons, each sized to approximate the footprint of one drilling site (2.57 km², using ecological attributes; we then developed a method for apportioning resource access that includes assessments of cumulative ecological costs. Over one-quarter of the hexagons were excluded as off-limits on the basis of six criteria: slope suitability, regulated wetland cover, protected-land cover, length of high-quality streams, mapped road density, and open water cover. Three additional criteria were applied to assess the estimated conservation vulnerability of the remaining sites: density of grassland birds (North American Breeding Bird Survey, percent core forest (Coastal Change Analysis Program, and total density of all state-mapped streams; these were determined and used in combination to rank the 14,000 potentially accessible sites. In a second step, an iterative process was used to distribute potential site access among all towns (sub-county governments within the Marcellus Shale Formation. At each iteration, one site was selected per town, either randomly or in rank order of increasing vulnerability. Results were computed as percent cumulative impact versus

  6. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Science.gov (United States)

    2013-05-01

    ... Scoping in a memo dated July 3, 1997. Administrator Browner wrote: ``Today, we are providing guidance for... study data from epidemiology, toxicology, ecology, health economics, chemical mixtures risk...

  7. Reprint of "Acquisition of choice in concurrent chains: Assessing the cumulative decision model".

    Science.gov (United States)

    Grace, Randolph C

    2016-06-01

    Concurrent chains is widely used to study pigeons' choice between terminal links that can vary in delay, magnitude, or probability of reinforcement. We review research on the acquisition of choice in this procedure. Acquisition has been studied with a variety of research designs, and some studies have incorporated no-food trials to allow for timing and choice to be observed concurrently. Results show that: Choice can be acquired rapidly within sessions when terminal links change unpredictably; under steady-state conditions, acquisition depends on both initial- and terminal-link schedules; and initial-link responding is mediated by learning about the terminal-link stimulus-reinforcer relations. The cumulative decision model (CDM) proposed by Christensen and Grace (2010) and Grace and McLean (2006, 2015) provides a good description of within-session acquisition, and correctly predicts the effects of initial and terminal-link schedules in steady-state designs (Grace, 2002a). Questions for future research include how abrupt shifts in preference within individual sessions and temporal control of terminal-link responding can be modeled. PMID:27150444

  8. Experimental assessment of cumulative temperature and UV-B radiation effects on Mediterranean plankton metabolism

    KAUST Repository

    Garcia-Corral, Lara S.

    2015-07-07

    The Mediterranean Sea is a vulnerable region for climate change, warming at higher rates compare to the global ocean. Warming leads to increased stratification of the water column and enhanced the oligotrophic nature of the Mediterranean Sea. The oligotrophic waters are already highly transparent, however, exposure of Mediterranean plankton to ultraviolet radiation (UV-B and UV-A) may increase further if the waters become more oligotrophic, thereby, allowing a deeper UV radiation penetration and likely enhancing impacts to biota. Here we experimentally elucidate the cumulative effects of warming and natural UV-B radiation on the net community production (NCP) of plankton communities. We conducted five experiments at monthly intervals, from June to October 2013, and evaluated the responses of NCP to ambient UV-B radiation and warming (+3°C), alone and in combination, in a coastal area of the northwest Mediterranean Sea. UV-B radiation and warming lead to reduced NCP and resulted in a heterotrophic (NCP < 0) metabolic balance. Both UV-B radiation and temperature, showed a significant individual effect in NCP across treatments and time. However, their joint effect showed to be synergistic as the interaction between them (UV × Temp) was statistically significant in most of the experiments performed. Our results showed that both drivers, would affect the gas exchange of CO2−O2 from and to the atmosphere and the role of plankton communities in the Mediterranean carbon cycle.

  9. Experimental assessment of cumulative temperature and UV-B radiation effects on Mediterranean plankton metabolism

    Directory of Open Access Journals (Sweden)

    Lara S. eGarcia-Corral

    2015-07-01

    Full Text Available The Mediterranean Sea is a vulnerable region for climate change, warming at higher rates compare to the global ocean. Warming leads to increased stratification of the water column and enhanced the oligotrophic nature of the Mediterranean Sea. The oligotrophic waters are already highly transparent, however, exposure of Mediterranean plankton to ultraviolet radiation (UV-B and UV-A may increase further if the waters become more oligotrophic, thereby, allowing a deeper UV radiation penetration and likely enhancing impacts to biota.Here we experimentally elucidate the cumulative effects of warming and natural UV-B radiation on the net community production (NCP of plankton communities. We conducted five experiments at monthly intervals, from June to October 2013, and evaluated the responses of NCP to ambient UV-B radiation and warming (+3ºC, alone and in combination, in a coastal area of the northwest Mediterranean Sea. UV-B radiation and warming lead to reduced net community production and resulted in a heterotrophic (NCP<0 metabolic balance. Both UV-B radiation and temperature, showed a significant individual effect in NCP across treatments and time. However, their joint effect showed to be synergistic as the interaction between them (UV x Temp was statistically significant in most of the experiments performed. Our results showed that both drivers, would affect the gas exchange of CO2-O2 from and to the atmosphere and the role of plankton communities in the Mediterranean carbon cycle

  10. Using Marginal Structural Modeling to Estimate the Cumulative Impact of an Unconditional Tax Credit on Self-Rated Health.

    Science.gov (United States)

    Pega, Frank; Blakely, Tony; Glymour, M Maria; Carter, Kristie N; Kawachi, Ichiro

    2016-02-15

    In previous studies, researchers estimated short-term relationships between financial credits and health outcomes using conventional regression analyses, but they did not account for time-varying confounders affected by prior treatment (CAPTs) or the credits' cumulative impacts over time. In this study, we examined the association between total number of years of receiving New Zealand's Family Tax Credit (FTC) and self-rated health (SRH) in 6,900 working-age parents using 7 waves of New Zealand longitudinal data (2002-2009). We conducted conventional linear regression analyses, both unadjusted and adjusted for time-invariant and time-varying confounders measured at baseline, and fitted marginal structural models (MSMs) that more fully adjusted for confounders, including CAPTs. Of all participants, 5.1%-6.8% received the FTC for 1-3 years and 1.8%-3.6% for 4-7 years. In unadjusted and adjusted conventional regression analyses, each additional year of receiving the FTC was associated with 0.033 (95% confidence interval (CI): -0.047, -0.019) and 0.026 (95% CI: -0.041, -0.010) units worse SRH (on a 5-unit scale). In the MSMs, the average causal treatment effect also reflected a small decrease in SRH (unstabilized weights: β = -0.039 unit, 95% CI: -0.058, -0.020; stabilized weights: β = -0.031 unit, 95% CI: -0.050, -0.007). Cumulatively receiving the FTC marginally reduced SRH. Conventional regression analyses and MSMs produced similar estimates, suggesting little bias from CAPTs.

  11. Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

    Science.gov (United States)

    Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

    2014-01-01

    Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

  12. CUMEX: a cumulative hazard index for assessing limiting exposures to environmental pollutants

    International Nuclear Information System (INIS)

    A hazard index methodology called CUMEX has been developed for limiting human exposure to environmental pollutants. Hazard index is defined as Q/Q/sub L/ where Q is exposure or dose to total-body, organ or tissue from all environmental pathways and Q/sub L/ is a limit which should not be exceeded because of health risk to humans. Mathematical formulations for hazard indices are developed for each sampling medium corresponding to each effluent type. These hazard indices are accumulated into composite indices such that total human intake or dose would not exceed the health risk limit. Mathematical formulation for composite hazard indices or CUMEX indices for multiple pollutants are presented. An example CUMEX application to cadmium release from a smelter complex in East Helena, Montana demonstrates details of the methodology for a single pollutant where human intake occurs through inhalation and ingestion

  13. CUMEX: a cumulative hazard index for assessing limiting exposures to environmental pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, P.J.; Killough, G.G.; Parzyck, D.C.; Rohwer, P.S.; Rupp, e.M.; Whitfield, B.L.; Booth, R.S.; Raridon, R.J.

    1977-04-01

    A hazard index methodology called CUMEX has been developed for limiting human exposure to environmental pollutants. Hazard index is defined as Q/Q/sub L/ where Q is exposure or dose to total-body, organ or tissue from all environmental pathways and Q/sub L/ is a limit which should not be exceeded because of health risk to humans. Mathematical formulations for hazard indices are developed for each sampling medium corresponding to each effluent type. These hazard indices are accumulated into composite indices such that total human intake or dose would not exceed the health risk limit. Mathematical formulation for composite hazard indices or CUMEX indices for multiple pollutants are presented. An example CUMEX application to cadmium release from a smelter complex in East Helena, Montana demonstrates details of the methodology for a single pollutant where human intake occurs through inhalation and ingestion.

  14. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...

  15. Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes

    Directory of Open Access Journals (Sweden)

    Béatrice Nikiéma

    2012-09-01

    longitudinal research is warranted to disentangle time-specific from cumulative effects of poverty on child health.

  16. Procedure and assessment of cumulative environmental effects Sameiginlegt mat á umhverfisáhrifum

    Directory of Open Access Journals (Sweden)

    Margrét Vala Kristjánsdóttir

    2011-12-01

    Full Text Available This paper deals with a provision in Article 5.2 of the Icelandic Act on Environmental Impact Assessment (EIA, No. 106/2000 that allows for a special procedure of joint EIA of two or more associated projects. Its main aim is to ensure that the overall assessment of environmental effects is taken into account before decisions are made. This provision has raised questions in relation to its scope and applicability. The provision´s origin, substance and application are analysed as well as its conformity to Directive 85/337/EEC as it has been introduced into the EEA Agreement. The paper concludes that administrative implementation has clarified certain aspects, including the legal conditions for its application. However, the application of the provision raises questions as to whether its aim may be achieved by a less onerous procedure; in line with Directive 85/337/EEC as interpreted by the European Commission.Í greininni er fjallað um ákvæði um sameiginlegt mat á umhverfisáhrifum í 2. mgr. 5. gr. laga nr. 106/2000 um mat á umhverfisáhrifum. Meginmarkmið ákvæðisins er að upplýsa um heildaráhrif framkvæmda á umhverfið áður en ákvarðanir um þær eru teknar. Vegna álitaefna sem upp hafa komið í tengslum við framkvæmd ákvæðisins er í greininni leitast við að skýra tilurð þess og efni með hliðsjón af lögskýringargögnum, framkvæmd þess og reglum tilskipunar 85/337/EBE eins og hún hefur verið tekin upp í EES-samninginn. Í greininni er komist að þeirri niðurstöðu að skilyrði fyrir beitingu ákvæðisins hafi skýrst í framkvæmd. Framkvæmdin veki jafnframt spurningar um hvort ná megi markmiðum ákvæðisins jafn vel, með einfaldari leiðum sem samræmast tilskipun 85/337/EBE eins og hún hefur verið skýrð af framkvæmdastjórn Evrópusambandsins.

  17. Health technology assessment in Singapore.

    Science.gov (United States)

    Pwee, Keng Ho

    2009-07-01

    The Republic of Singapore is an island city-state in Southeast Asia. Its population enjoys good health and the Singapore Ministry of Health's mission is to promote good health and reduce illness, ensure access to good and affordable health care, and pursue medical excellence. This is achieved through a healthcare system that includes both private and public sector elements. The financing philosophy of Singapore's healthcare delivery system is based on individual responsibility and community support. Health care in Singapore is financed by a combination of taxes, employee medical benefits, compulsory health savings, insurance, and out-of-pocket payment. The capability for health technology assessment in Singapore was developed concurrently with its medical device regulation system in the 1990s. The first formal unit with health technology assessment (HTA) functions was established in September 1995. Today, HTA features in decision making for the Standard Drug List, licensing of medical clinics, the Health Service Development Programme, healthcare subsidies, and policy development. The public sector healthcare delivery clusters have also recently started health services research units with HTA functions. Singapore is organizing the 6th Health Technology Assessment International (HTAi) Annual Meeting in June 2009. Bringing this prestigious international conference to Asia for the first time will help raise awareness of HTA in the region.

  18. VA telemental health: suicide assessment.

    Science.gov (United States)

    Godleski, Linda; Nieves, J Edwin; Darkins, Adam; Lehmann, Laurent

    2008-01-01

    The Department of Veterans Affairs (VA) encompasses one of the largest telemental health networks in the world, with over 45,000 videoconferencing and over 5,000 home telemental health encounters annually. Recently, the VA designated suicide prevention as a major priority, with telehealth modalities providing opportunities for remote interventions. Suicide risk assessments, using videoconferencing, are now documented in the literature, as are current studies that find telemental health to be equivalent to face-to-face treatment. Remote assessment of suicidality, however, involves complex legal issues: licensing requirements for remote delivery of care, legal procedures for involuntary detainment and commitment of potentially harmful patients, and liability questions related to the remote nature of the mental health service. VA best practices for remote suicide risk assessment include paradigms for establishing procedures in the context of legal challenges (licensing and involuntary detainment/commitment), for utilizing clinical assessment and triage decision protocols, and for contingency planning to optimize patient care and reduce liability.

  19. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

    Mannheimer, L N; Gulis, G; Lehto, J;

    2007-01-01

    health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief...

  20. Quantifying Chronic Stress Exposure for Cumulative Risk Assessment: Lessons Learned from a Case Study of Allostatic Load

    Science.gov (United States)

    Although multiple methods of quantifying environmental chemical exposures have been validated for use in human health risk assessment, quantifying chronic stress exposure is more challenging. Stress is a consequence of perceiving an “exposure” (e.g., violence, poverty) as more th...

  1. Ground-Truthing Validation to Assess the Effect of Facility Locational Error on Cumulative Impacts Screening Tools

    Directory of Open Access Journals (Sweden)

    J. L. Sadd

    2015-01-01

    Full Text Available Researchers and government regulators have developed numerous tools to screen areas and populations for cumulative impacts and vulnerability to environmental hazards and risk. These tools all rely on secondary data maintained by government agencies as part of the regulatory and permitting process. Stakeholders interested in cumulative impacts screening results have consistently questioned the accuracy and completeness of some of these datasets. In this study, three cumulative impacts screening tools used in California were compared, and ground-truth validation was used to determine the effect database inaccuracy. Ground-truthing showed substantial locational inaccuracy and error in hazardous facility databases and statewide air toxics emission inventories of up to 10 kilometers. These errors resulted in significant differences in cumulative impact screening scores generated by one screening tool, the Environmental Justice Screening Method.

  2. Physiotherapy students’ mental health assessment

    OpenAIRE

    Gesouli-Voltyraki –E.; Charisi E.; Papastergiou D.; Κostopoulou S.; Borou A.; Alverti V.; Avlakiotis K.; Spanos S.

    2012-01-01

    Introduction: Educational environment has a serious impact on students’ mental health. Few data are available on mental health of Physiotherapy students. Aim: The purpose of this study was to assess the mental heath of students in a tertiary Physiotherapy Department during the 3rd years of studies. Material and methods: 80 males and females physiotherapy students of the 5th and 6th semester of a tertiary Physiotherapy Department filled in the GHQ-28 questionnaire. Comparisons between groups w...

  3. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    , with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries....

  4. Sensor based soil health assessment

    Science.gov (United States)

    Quantification and assessment of soil health involves determining how well a soil is performing its biological, chemical, and physical functions relative to its inherent potential. Due to high cost, labor requirements, and soil disturbance, traditional laboratory analyses cannot provide high resolut...

  5. Assessing the Role of Current and "Cumulative" Exposure in Simultaneous Bilingual Acquisition: The Case of Dutch Gender

    Science.gov (United States)

    Unsworth, Sharon

    2013-01-01

    This paper investigates the role of amount of current and "cumulative" exposure in bilingual development and ultimate attainment by exploring the extent to which simultaneous bilingual children's knowledge of grammatical gender is affected by current and previous amount of exposure, including in the early years. Elicited production and…

  6. Correlation of cumulative corticosteroid treatment with magnetic resonance imaging assessment of avascular femoral head necrosis in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Nilufer Kale

    2010-10-01

    Full Text Available Increased risk of osteoporosis, fractures, and avascular necrosis (AVN has been suggested in multiple sclerosis (MS. Patients with MS are often exposed to corticosteroid treatment (CST during the disease course and conflicting reports exist regarding complications of CST. Our study aims to investigate the association between cumulative doses of CST and radiographic evaluation of AVN of the femoral head in MS. Twenty-six MS patients (mean age, 38.4±10 yr were enrolled and prospectively evaluated for AVN by magnetic resonance imaging (MRI. The mean disease duration was 11.5±8.5 years and mean expanded disability status scale (EDSS score was 3±2. The cumulative dosage of CST varied between 20 g and 60 g; patients were grouped into two categories: 1 CST between 20-40 g, 17 (65% patients; 2 CST ≥40 g; 9 (35% patients. The relationship between cumulative CST dosage and MRI diagnosis of AVN was stat­istically insignificant (P>0.9. Clarification of the cumulative effect of CST in the development of AVN is of great importance for future long-term steroid treatment strategies.

  7. Setting the Stage for Chronic Health Problems: Cumulative Childhood Adversity among Homeless Adults with Mental Illness in Vancouver, British Columbia

    OpenAIRE

    Patterson, Michelle; Moniruzzaman, Akm; Somers, Julian

    2014-01-01

    Background It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and ...

  8. Scientific Opinion on the identification of pesticides to be included in cumulative assessment groups on the basis of their toxicological profile

    Directory of Open Access Journals (Sweden)

    EFSA Panel on Plant Protection Products and their Residues (PPR

    2013-07-01

    Full Text Available The European Food Safety Authority asked the Panel on Plant Protection Products and their Residues to develop an Opinion on the identification of pesticides to be included in cumulative assessment groups (CAGs on the basis of their toxicological profile. In 2008, the PPR Panel adopted an Opinion on the suitability of existing methodologies for cumulative risk assessment of pesticides and a tiered approach was proposed, which was applied to a selected group of triazole pesticides in 2009. The present Opinion suggests a methodology for grouping of pesticides based on phenomenological effects and provides CAGs for the thyroid and nervous system. This approach can be applied even when the underlying biochemical events mediating the effects are not understood, and is based on a standardised and thorough review of Draft Assessment Reports (DARs supporting the approval of all pesticides in Europe, and on recommendations from the European Commission. Pesticidal active substances exhibiting neurotoxic properties were allocated to CAGs for acute effects on motor, sensory and autonomic divisions of the nervous system and neurochemical endpoints. Chronic effects across the same divisions/endpoints and neuropathological effects were collated. Active substances having adverse effects on the thyroid system were allocated to CAGs for effects either on C-cells/the calcitonin system or on follicular cells/the T3/T4 system. The PPR Panel notes that the resulting groups encompass many pesticides and also that individual pesticides could appear in several groups and therefore the data entries for performing cumulative risk assessment (CRA are of considerable magnitude. Although some CAGs contain a large number of pesticides, little indication of cumulative risk may be inferred from the size of CAGs per se. The PPR Panel recommends that the methodology is implemented for all major organ/systems but the approach used should be considered specific for pesticides.

  9. 国内外累积性环境风险评估研究进展%Research Progress of Cumulative Environmental Risk Assessment at Home and Abroad

    Institute of Scientific and Technical Information of China (English)

    袁鹏; 李文秀; 彭剑峰; 宋永会; 许伟宁

    2015-01-01

    随着环境风险评估的重点由单一源、单一传播途径、单受体转向多来源、多传播途径、多受体的评估,累积性环境风险评估逐渐成为当前研究热点。通过概念辨析和文献调研的方法,综述了美国累积性环境风险评估的发展历史、评估流程,并对国内外累积性环境风险评估方法、应用研究进展进行了评述。指出了目前国内开展累积性环境风险评估存在的方法不完善、基础科研工作不足、宏观环境管理政策亟待加强等问题。建议应尽快明确累积性环境风险评估概念与管理要求,制订累积性环境风险评估的流程、框架与技术指南,加强基础数据库建立和实践探索,为长效的环境风险管理提供决策依据。%With the focuses of environmental risk assessment gradually evolving from assessment of single source or stressor, single exposure route and single risk receptor toward integrated assessment involving several sources or stressors, multiple exposure routes and multiple receptors in recent years, the cumulative risk assessment has become a study hot spot.Through concepts discrimination and literatures search, the development history and assessment procedure in the US, and the methods and practices of cumulative risk assessment both at home and abroad were reviewed.It was pointed out that there were several problems in conducting cumulative risk assessment in China, such as lack of assessment methods, lack of basic scientific data and urgent need of reinforcement of macro-environmental management policy and so on.It was suggests that the concept and management requirements of cumulative environmental risk assessment should be defined, the evaluation process, framework and technical guide be formulated, and the construction of foundational databases and practical explorations be reinforced as soon as possible,which can provide the decision support for the long-term effective environmental

  10. Issues in health technology assessment

    International Nuclear Information System (INIS)

    Full text: In general, the main justification for the provision of health services is to improve the health of individuals and populations. Some experts focus on other goals for the health care systems, such as promoting health care innovation and increasing employment. Information on the efficacy of a diagnostic or therapeutic procedure has become more widely available during the last 25 years, both through increased research and increased availability of data based on, e.g. the Cochrane Collaboration and the Health Technology Assessment Database (INAHTA). At the same time, the most relevant information is often in proprietary hands, that is, in private organizations such as the manufacturing industry or in organizations that collect health information. The American Food and Drug Administration routinely assesses efficacy of devices and makes this information openly accessible. Unfortunately, the European Union focuses on trade issues, including innovation, and does not have a strong focus on public health. Competition for health care resources is a major concern even in segments of the population living in the richest countries. The problem of limited resources is, of course, much more pronounced in poor countries, in particular in the poorest countries. Although cost effectiveness of health care is very important conceptually, data are often not available. Cost effectiveness is often developed within the context of national needs and is very difficult to transfer to other jurisdictions. In addition, data on cost effectiveness are often not available to compare different options in health care. There is thus enormous scope for such studies in the future. Broader issues, such as health care organization and morals and ethics are also important. For example, is it ethical to promote advanced technology in poor countries that cannot provide even basic health care services? Is it ethical for researchers to overlook the basic needs of poor countries when working on

  11. Physiotherapy students’ mental health assessment

    Directory of Open Access Journals (Sweden)

    Gesouli-Voltyraki –E.

    2012-04-01

    Full Text Available Introduction: Educational environment has a serious impact on students’ mental health. Few data are available on mental health of Physiotherapy students. Aim: The purpose of this study was to assess the mental heath of students in a tertiary Physiotherapy Department during the 3rd years of studies. Material and methods: 80 males and females physiotherapy students of the 5th and 6th semester of a tertiary Physiotherapy Department filled in the GHQ-28 questionnaire. Comparisons between groups were performed using the non parametric Mann-Whitney-U test at significance level of p=0.05. Results: Physiotherapy students’ mean age was 21.77±2.42 years old. The majority of the sample were women (47 participants, 58.7%. 50% of students had a total GHQ -28 score >5, indicating high levels of distress, with anxiety and insomnia being major problems. No statistically significant differences were traced between men and women, although women had a higher total score in comparison with men (median values: 5 vs 3 respectively. Conclusions: Physiotherapy students’ mental health and especially female physiotherapy students’ mental health appears substantially burdened. Anxiety and insomnia are major problem for students of Physiotherapy.

  12. Impaired assessment of cumulative lifetime familiarity for object concepts after left anterior temporal-lobe resection that includes perirhinal cortex but spares the hippocampus.

    Science.gov (United States)

    Bowles, Ben; Duke, Devin; Rosenbaum, R Shayna; McRae, Ken; Köhler, Stefan

    2016-09-01

    The ability to recognize the prior occurrence of objects can operate effectively even in the absence of successful recollection of episodic contextual detail about a relevant past object encounter. The pertinent process, familiarity assessment, is typically probed in humans with recognition-memory tasks that include an experimentally controlled study phase for a list of items. When meaningful stimuli such as words or pictures of common objects are employed, participants must judge familiarity with reference to the recent experimental encounter rather than their lifetime of autobiographical experience, which may have involved hundreds or thousands of exposures across numerous episodic contexts. Humans can, however, also judge the cumulative familiarity of objects concepts they have encountered over their lifetime. At present, little is known about the cognitive and neural mechanisms that support this ability. Here, we tested an individual (NB) with a rare left anterior temporal-lobe lesion that included perirhinal cortex but spared the hippocampus, who had previously been found to exhibit selective impairments in familiarity assessment on verbal recognition-memory tasks. As NB exhibits normal recollection abilities, her case presents a unique opportunity to examine potential links between both types of familiarity. In Experiment 1, we demonstrated that NB's impairment in making recognition judgments affects cumulative frequency judgments for exposure to concept names in a recent study episode. Experiments 2 and 3 revealed, with a task borrowed from the semantic-memory literature, that NB's impairments do indeed extend to abnormalities in judging cumulative lifetime familiarity for object concepts. These abnormalities were not limited to verbal processing, and were present even when pictures were offered as additional cues. Moreover, they showed sensitivity to concept structure as reflected in semantic feature norms; we only observed them for judgments on object

  13. Assessing cumulative impacts of forest development on the distribution of furbearers using expert-based habitat modeling.

    Science.gov (United States)

    Bridger, M C; Johnson, C J; Gillingham, M P

    2016-03-01

    Cumulative impacts of anthropogenic landscape change must be considered when managing and conserving wildlife habitat. Across the central-interior of British Columbia, Canada, industrial activities are altering the habitat of furbearer species. This region has witnessed unprecedented levels of anthropogenic landscape change following rapid development in a number of resource sectors, particularly forestry. Our objective was to create expert-based habitat models for three furbearer species: fisher (Pekania pennanti), Canada lynx (Lynx canadensis), and American marten (Martes americana) and quantify habitat change for those species. We recruited 10 biologist and 10 trapper experts and then used the analytical hierarchy process to elicit expert knowledge of habitat variables important to each species. We applied the models to reference landscapes (i.e., registered traplines) in two distinct study areas and then quantified the change in habitat availability from 1990 to 2013. There was strong agreement between expert groups in the choice of habitat variables and associated scores. Where anthropogenic impacts had increased considerably over the study period, the habitat models showed substantial declines in habitat availability for each focal species (78% decline in optimal fisher habitat, 83% decline in optimal lynx habitat, and 79% decline in optimal marten habitat). For those traplines with relatively little forest harvesting, the habitat models showed no substantial change in the availability of habitat over time. The results suggest that habitat for these three furbearer species declined significantly as a result of the cumulative impacts of forest harvesting. Results of this study illustrate the utility of expert knowledge for understanding large-scale patterns of habitat change over long time periods. PMID:27209791

  14. The Soft Cumulative Constraint

    CERN Document Server

    Petit, Thierry

    2009-01-01

    This research report presents an extension of Cumulative of Choco constraint solver, which is useful to encode over-constrained cumulative problems. This new global constraint uses sweep and task interval violation-based algorithms.

  15. Community Health Needs Assessment: Potential for Population Health Improvement.

    Science.gov (United States)

    Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

    2016-06-01

    Derived from various health care policies and initiatives, the concept of population health has been newly adopted by health care and medicine. In particular, it has been suggested that the Patient Protection and Affordable Care Act provision that requires nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address health priorities has the potential to improve population health. A mixed methods study design was used to examine the potential for population health improvements to occur through the Internal Revenue Service (IRS)-mandated nonprofit hospital CHNA and planning processes. Methods involved a 2-phased approach composed of (1) content analysis of 95 CHNA/implementation strategies reports and (2) interviews with key informants, consultants, and community stakeholders involved in CHNA and planning processes. Although this is a great opportunity for the nonprofit hospital assessment and planning processes to influence population health outcomes, the findings from the first 3-year assessment and planning cycle (2011-2013) suggest this is unlikely. As nonprofit hospitals begin the second 3-year assessment and planning cycle, this article offers recommendations to increase the potential for nonprofit hospitals to improve population health. These recommendations include clarifying the purpose of IRS CHNA regulations, engaging community stakeholders in collaborative assessment and planning, understanding disease etiology and identifying and addressing broader determinants of health, adopting a public health assessment and planning model, and emphasizing population health improvement. (Population Health Management 2016;19:178-186). PMID:26440370

  16. Assessing Cumulative Impacts of Coal Bed Methane Development on Surface Water Quality and its Suitability for Irrigation in the Powder River Basin

    Science.gov (United States)

    Dawson, H. E.

    2003-12-01

    This paper presents a mass balance approach to assessing the cumulative impacts of discharge from Coal Bed Methane (CBM) wells on surface water quality and its suitability for irrigation in the Powder River Basin. Key water quality parameters for predicting potential effects of CBM development on irrigated agriculture are sodicity, expressed as sodium adsorption ratio (SAR) and salinity, expressed as electrical conductivity (EC). The assessment was performed with the aid of a spreadsheet model, which was designed to estimate steady-state SAR and EC at gauged stream locations after mixing with CBM produced water. Model input included ambient stream water quality and flow, CBM produced water quality and discharge rates, conveyance loss (quantity of water loss that may occur between the discharge point and the receiving streams), beneficial uses, regulatory thresholds, and discharge allocation at state-line boundaries. Historical USGS data were used to establish ambient stream water quality and flow conditions. The resultant water quality predicted for each stream station included the cumulative discharge of CBM produced water in all reaches upstream of the station. Model output was presented in both tabular and graphical formats, and indicated the suitability of pre- and post-mixing water quality for irrigation. Advantages and disadvantages of the spreadsheet model are discussed. This approach was used by federal agencies to support the development of the January 2003 Environmental Impact Statements (EIS) for the Wyoming and Montana portions of the Powder River Basin.

  17. Exposure to phthalates in 5-6 years old primary school starters in Germany--a human biomonitoring study and a cumulative risk assessment.

    Science.gov (United States)

    Koch, Holger M; Wittassek, Matthias; Brüning, Thomas; Angerer, Jürgen; Heudorf, Ursel

    2011-06-01

    We determined the internal exposure of 111 German primary school starters by analyzing urinary metabolites of six phthalates: butyl benzyl phthalate (BBzP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di (2-ethylhexyl) phthalate (DEHP), di-iso-nonyl phthalate (DiNP) and di-iso-decylphthalate (DiDP). From the urinary metabolite levels, we calculated daily intakes and related these values to Tolerable Daily Intake (TDI) values. By introducing the concept of a relative cumulative Tolerable Daily Intake (TDI(cum)) value, we tried to account for the cumulative exposure to several of the above-mentioned phthalates. The TDI(cum) was derived as follows: the daily intake (DI) calculated from the metabolite level was divided by the TDI for each phthalate; this ratio was multiplied by 100% indicating the TDI percentage for which the DI accounted. Finally the % TDIs of the different phthalates were totalled to get the TDI(cum). A TDI(cum) above 100% is a potential cause for concern. We confirmed the ubiquitous exposure of the children to all phthalates investigated. Exposures were within range of levels previously reported for GerES, albeit slightly lower. Regarding daily intakes, two children exceeded the TDI for DnBP, whereas one child closely approached the TDI for DEHP. 24% of the children exceeded the TDI(cum) for the three most critical phthalates: DEHP, DnBP and DiBP. Furthermore, 54% of the children had total exposures that used up more than 50% the TDI(cum). Therefore, the overall exposure to a number of phthalates, and the knowledge that these phthalates (and other anti-androgens) act in a dose-additive manner, urgently warrants a cumulative risk assessment approach.

  18. Model-based tolerance intervals derived from cumulative historical composition data: application for substantial equivalence assessment of a genetically modified crop.

    Science.gov (United States)

    Hong, Bonnie; Fisher, Tracey L; Sult, Theresa S; Maxwell, Carl A; Mickelson, James A; Kishino, Hirohisa; Locke, Mary E H

    2014-10-01

    Compositional analysis is a requisite component of the substantial equivalence framework utilized to assess genetically modified (GM) crop safety. Statistical differences in composition data between GM and non-GM crops require a context in which to determine biological relevance. This context is provided by surveying the natural variation of key nutrient and antinutrient levels within the crop population with a history of safe use. Data accumulated from various genotypes with a history of safe use cultivated in relevant commercial crop-growing environments over multiple seasons are discussed as the appropriate data representative of this natural variation. A model-based parametric tolerance interval approach, which accounts for the correlated and unbalanced data structure of cumulative historical data collected from multisite field studies conducted over multiple seasons, is presented. This paper promotes the application of this tolerance interval approach to generate reference ranges for evaluation of the biological relevance of statistical differences identified during substantial equivalence assessment of a GM crop.

  19. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  20. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research

  1. Cumulative environmental effects. Summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  2. Cumulative environmental effects. Summary

    International Nuclear Information System (INIS)

    This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

  3. Establishment of Health Technology Assessment in Iran

    Directory of Open Access Journals (Sweden)

    Shila Doaee

    2012-06-01

    Full Text Available Objective: Health Technology Assessment (HTA aims at informing healthcare policymakers, managers and practitioners of the "clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice". So considering the policy-oriented nature of HTA that calls for a close integration into the functioning and governance of health systems the present study focuses on executive processes and function of the HTA office of Iran.Materials and methods: Data of this review study were collected through documented sources and observations from 2007 to 2010.Results: Health Technology Assessment began its activities as a secretariat in the Deputy of Health in 2007 and it continues as a Health Technology Assessment Office at the Management of Health Technology Assessment, Standardization, and Tariff at the Deputy of curative affairs of MOHME in the beginning of 2010.14 Technology of modern medical equipment and 8 pharmaceutical medicine are assessed, Now many of measures for HTA establishment  such as cooperation National Institute of Health Research (NIHR, Holding scientific committee meetings, Establishing  the  Master's degree of  health technology assessment ,Building capacities for health technology assessment through education in major universities of the country.Conclusion: pay attention to health technology assessment, selection and application of proper technologies in the frameworks of policy-making and managerial strategies and make efforts to develop it with the support of the governmental in Iran is necessary.

  4. Cumulative human impacts on marine predators

    DEFF Research Database (Denmark)

    Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J;

    2013-01-01

    Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact...... in planning the use of marine resources.......Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact...... Sanctuaries. High variation in underlying species and cumulative impact distributions means that neither alone is sufficient for effective spatial management. Instead, comprehensive management approaches accounting for both cumulative human impacts and trade-offs among multiple stressors must be applied...

  5. The use of a Cumulative Needs for Care Monitor for individual treatment v. care as usual for patients diagnosed with severe mental illness, a cost-effectiveness analysis from the health care perspective

    NARCIS (Netherlands)

    Drukker, M.; Joore, M.; van Os, J.; Sytema, S.; Driessen, G.; Bak, M.; Delespaul, Ph.

    2012-01-01

    Aims. To study the systematic assessment of need for care and clinical parameters for use in treatment plans in patients diagnosed with severe mental illness. Methods. The Cumulative Needs for Care Monitor (CNCM) includes various validated instruments, such as the Camberwell Assessment of Need. A Ma

  6. Direct releases to the surface and associated complementary cumulative distribution functions in the 1996 performance assessments for the Waste Isolation Pilot Plant: Direct brine release

    Energy Technology Data Exchange (ETDEWEB)

    STOELZEL,D.M.; O' BRIEN,D.G.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,J.D.; SCOTT,L.N.

    2000-05-19

    The following topics related to the treatment of direct brine releases to the surface environment in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented (1) mathematical description of models, (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented analyses indicate that direct brine releases do not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for direct brine releases fall substantially to the left of the boundary line specified in the US Environmental Protection Agency's standard for the geologic disposal of radioactive waste (4O CFR 191.40 CFR 194).

  7. Direct releases to the surface and associated complementary cumulative distribution functions in the 1996 performance assessment for the Waste Isolation Pilot Plant: Cuttings, cavings and spallings

    Energy Technology Data Exchange (ETDEWEB)

    BERGLUND,J.W.; GARNER,J.W.; HELTON,JON CRAIG; JOHNSON,J.D.; SMITH,L.N.; ANDERSON,R.P.

    2000-05-22

    The following topics related to the treatment of cuttings, cavings and spallings releases to the surface environment in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented: (1) mathematical description of models. (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented results indicate that direct releases due to cuttings, cavings and spallings do not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for cuttings, cavings and spallings releases fall substantially to the left of the boundary line specified in the US Environmental Protection Agency standard for the geologic disposal of radioactive waste (40 CFR 191, 40 CFR 194).

  8. Direct releases to the surface and associated complementary cumulative distribution functions in the 1996 performance assessment for the Waste Isolation Pilot Plant: Cuttings, cavings and spallings

    International Nuclear Information System (INIS)

    The following topics related to the treatment of cuttings, cavings and spallings releases to the surface environment in the 1996 performance assessment for the Waste Isolation Pilot Plant (WIPP) are presented: (1) mathematical description of models. (2) uncertainty and sensitivity analysis results arising from subjective (i.e., epistemic) uncertainty for individual releases, (3) construction of complementary cumulative distribution functions (CCDFs) arising from stochastic (i.e., aleatory) uncertainty, and (4) uncertainty and sensitivity analysis results for CCDFs. The presented results indicate that direct releases due to cuttings, cavings and spallings do not constitute a serious threat to the effectiveness of the WIPP as a disposal facility for transuranic waste. Even when the effects of uncertain analysis inputs are taken into account, the CCDFs for cuttings, cavings and spallings releases fall substantially to the left of the boundary line specified in the US Environmental Protection Agency standard for the geologic disposal of radioactive waste (40 CFR 191, 40 CFR 194)

  9. The internationalization of health technology assessment.

    Science.gov (United States)

    Menon, D; Marshall, D

    1996-01-01

    Health technology assessment as a formalized set of activities has a relatively short history. At its current stage of development, it is clear that it has global dimensions and impact. In this paper we review the history of health technology assessment, its development as a form of health services research, and its "institutionalization." We then identify the reasons for its internationalization, review current international initiatives, and propose actions to be taken to improve cooperation among countries.

  10. The Relationship between Cumulative Credits and Student Learning Outcomes: A Cross-Sectional Assessment of Information Literacy and Communication Skills

    Science.gov (United States)

    Thonney, Teresa; Montgomery, Joe C.

    2015-01-01

    This article relates the efforts of faculty at one community college to define standards for achievement of two SLOs (critical thinking and effective communication) and to gather and analyze evidence of how well students meet those standards. Faculty from 13 disciplines assessed writing samples from 265 students. We found that, in general,…

  11. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    Science.gov (United States)

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful. PMID:26455783

  12. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies.

    Science.gov (United States)

    Hernández-Delgado, E A

    2015-12-15

    Climate change has significantly impacted tropical ecosystems critical for sustaining local economies and community livelihoods at global scales. Coastal ecosystems have largely declined, threatening the principal source of protein, building materials, tourism-based revenue, and the first line of defense against storm swells and sea level rise (SLR) for small tropical islands. Climate change has also impacted public health (i.e., altered distribution and increased prevalence of allergies, water-borne, and vector-borne diseases). Rapid human population growth has exacerbated pressure over coupled social-ecological systems, with concomitant non-sustainable impacts on natural resources, water availability, food security and sovereignty, public health, and quality of life, which should increase vulnerability and erode adaptation and mitigation capacity. This paper examines cumulative and synergistic impacts of climate change in the challenging context of highly vulnerable small tropical islands. Multiple adaptive strategies of coupled social-ecological ecosystems are discussed. Multi-level, multi-sectorial responses are necessary for adaptation to be successful.

  13. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...... as a powerful tool for the evaluation of potential health consequences of planned measures. It is often discussed whether HIA is not just another term or form of risk assessment and what is their relation. Our aim is to discuss similarities and differences between the two methods so as to clarify...

  14. Direct assessment of cumulative aryl hydrocarbon receptor agonist activity in sera from experimentally exposed mice and environmentally exposed humans

    DEFF Research Database (Denmark)

    Schlezinger, Jennifer J; Bernard, Pamela L; Haas, Amelia;

    2010-01-01

    readouts to provide a broader context for estimating human risk than that obtained with serum extraction and gas chromatography/mass spectroscopy (GC/MS)-based assays alone. METHODS: AhR agonist activity was quantified in sera from dioxin-treated mice, commercial human sources, and polychlorinated biphenyl......BACKGROUND: Aryl hydrocarbon receptor (AhR) ligands adversely affect many biological processes. However, assessment of the significance of human exposures is hampered by an incomplete understanding of how complex mixtures affect AhR activation/inactivation. OBJECTIVES: These studies used biological...

  15. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  16. Assessment of health risks of policies

    International Nuclear Information System (INIS)

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

  17. Binary Cumulant Varieties

    CERN Document Server

    Sturmfels, Bernd

    2011-01-01

    Algebraic statistics for binary random variables is concerned with highly structured algebraic varieties in the space of 2x2x...x2-tensors. We demonstrate the advantages of representing such varieties in the coordinate system of binary cumulants. Our primary focus lies on hidden subset models. Parametrizations and implicit equations in cumulants are derived for hyperdeterminants, for secant and tangential varieties of Segre varieties, and for certain context-specific independence models. Extending work of Rota and collaborators, we explore the polynomial inequalities satisfied by cumulants.

  18. Cumulative radiation effect

    International Nuclear Information System (INIS)

    In five previous papers, the concept of Cumulative Radiation Effect (CRE) has been presented as a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Simple nomographic and tabular methods for the solution of practical problems in radiotherapy are now described. An essential feature of solving a CRE problem is firstly to present it in a concise and readily appreciated form, and, to do this, nomenclature has been introduced to describe schedules and regimes as compactly as possible. Simple algebraic equations have been derived to describe the CRE achieved by multi-schedule regimes. In these equations, the equivalence conditions existing at the junctions between schedules are not explicit and the equations are based on the CREs of the constituent schedules assessed individually without reference to their context in the regime as a whole. This independent evaluation of CREs for each schedule has resulted in a considerable simplification in the calculation of complex problems. The calculations are further simplified by the use of suitable tables and nomograms, so that the mathematics involved is reduced to simple arithmetical operations which require at the most the use of a slide rule but can be done by hand. The order of procedure in the presentation and calculation of CRE problems can be summarised in an evaluation procedure sheet. The resulting simple methods for solving practical problems of any complexity on the CRE-system are demonstrated by a number of examples. (author)

  19. Model-based tolerance intervals derived from cumulative historical composition data: application for substantial equivalence assessment of a genetically modified crop.

    Science.gov (United States)

    Hong, Bonnie; Fisher, Tracey L; Sult, Theresa S; Maxwell, Carl A; Mickelson, James A; Kishino, Hirohisa; Locke, Mary E H

    2014-10-01

    Compositional analysis is a requisite component of the substantial equivalence framework utilized to assess genetically modified (GM) crop safety. Statistical differences in composition data between GM and non-GM crops require a context in which to determine biological relevance. This context is provided by surveying the natural variation of key nutrient and antinutrient levels within the crop population with a history of safe use. Data accumulated from various genotypes with a history of safe use cultivated in relevant commercial crop-growing environments over multiple seasons are discussed as the appropriate data representative of this natural variation. A model-based parametric tolerance interval approach, which accounts for the correlated and unbalanced data structure of cumulative historical data collected from multisite field studies conducted over multiple seasons, is presented. This paper promotes the application of this tolerance interval approach to generate reference ranges for evaluation of the biological relevance of statistical differences identified during substantial equivalence assessment of a GM crop. PMID:25208038

  20. A Stochastic Approach To Human Health Risk Assessment Due To Groundwater Contamination

    Science.gov (United States)

    de Barros, F. P.; Rubin, Y.

    2006-12-01

    We present a probabilistic framework to addressing adverse human health effects due to groundwater contamination. One of the main challenges in health risk assessment is in relating it to subsurface data acquisition and to improvement in our understanding of human physiological responses to contamination. In this paper we propose to investigate this problem through an approach that integrates flow, transport and human health risk models with hydrogeological characterization. A human health risk cumulative distribution function is analytically developed to account for both uncertainty and variability in hydrogeological as well as human physiological parameters. With our proposed approach, we investigate under which conditions the reduction of uncertainties from flow physics, human physiology and exposure related parameters might contribute to a better understanding of human health risk assessment. Results indicate that the human health risk cumulative distribution function is sensitive to physiological parameters at low risk values associated with longer travel times. The results show that the worth of hydrogeological characterization in human health risk is dependent on the residence time of the contaminant plume in the aquifer and on the exposure duration of the population to certain chemicals.

  1. Private Health Sector Assessment in Kenya

    OpenAIRE

    Barnes, Jeff; O'Hanlon, Barbara; Feeley, Frank III; McKeon, Kimberly; Gitonga, Nelson; Decker, Caytie

    2010-01-01

    Kenya private sector is one of the most developed and dynamic in Sub Saharan Africa. In this context, USAID/Kenya requested that the Private Sector Partnerships-One project (PSP One) conduct an assessment of the private health sector in Kenya. The scope of work involved assessing the role of the private sector in the overall health system, considering the potential of the private sector to...

  2. Integrating Sexual Minority Health Issues into a Health Assessment Class.

    Science.gov (United States)

    Bosse, Jordon D; Nesteby, J Aleah; Randall, Carla E

    2015-01-01

    The health needs of the lesbian, gay, bisexual, and transgender (LGBT) population are traditionally overlooked by the health care community and are rendered invisible by most nursing school curricula. Initial contact with a nurse during a health history and assessment can have an impact on whether the person will feel comfortable disclosing his or her identity, returning for services, or following plans of care. Because the first interaction with a nurse can be critical, the health assessment course is an appropriate place in the curriculum to discuss the needs of the LGBT community. This article includes a discussion of unique health risks to the LGBT population, benefits, and challenges of incorporating these issues into the classroom and recommendations for including the care of this population into a health assessment nursing course. Specific communication techniques are provided that may be helpful during history taking and physical examination with a patient who is LGBT. Guidance regarding physical examination of the transgender patient is also included. These suggestions will be helpful to nurse faculty who teach health assessment, nursing students, educators who design and implement professional development and continuing education for established nurses, preceptors in the clinical setting, and any nurse who is unfamiliar with the needs and concerns specific to the LGBT population. PMID:26653044

  3. Risk assessment in support of plant health

    DEFF Research Database (Denmark)

    Jeger, Michael; Schans, Jan; Lövei, Gabor L.;

    2012-01-01

    types and plants in the environment. There has been an increasing trend towards producing scientific opinions which are full pest risk assessments for the whole EU territory. In its work, and as a contribution to the wider development of risk assessment methodology, the Panel has developed a series......With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU). Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop...... of guidance documents. These deal with the peer review of existing pest risk assessments, a framework for conducting risk assessments which harmonise standards set by the International Plant Protection Convention and the legislative requirements of the EU, and extension of this framework to include...

  4. An Assessment of Environmental Health Needs

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

  5. Ethical perspectives on health technology assessment.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2004-01-01

    This study analyses why ethical aspects play a minor role in health technology assessment (HTA) studies, even when comprehensive approaches of technology assessment are advocated. Technology is often regarded as a value-neutral tool. At the same time, bioethics is dominated by an engineering model.

  6. [Health research and health technology assessment in Chile].

    Science.gov (United States)

    Espinoza, Manuel Antonio; Cabieses, Báltica; Paraje, Guillermo

    2014-01-01

    Health research is considered an essential element for the improvement of population health and it has been recommended that a share of the national health budget should be allocated to develop this field. Chile has undertaken efforts in the last decades in order to improve the governmental structure created to promote the development of health research, which has increased human resources and funding opportunities. On the other hand, the sustained economic growth of Chile in the last decades suggests that the health expenditure will maintain its increasing trend in the following years. This additional funding could be used to improve coverage of current activities performed in the health system, but also to address the incorporation of new strategies. More recently, health technology assessment (HTA) has been proposed as a process to support decisions about allocation of resources based on scientific evidence. This paper examines the relationship between the development of health research and the HTA process. First, it presents a brief diagnosis of the situation of health research in Chile. Second, it reviews the conceptual basis and the methods that account for the relationship between a HTA process and the development of health research. In particular, it emphasizes the relevance of identifying information gaps where funding additional research can be considered a good use of public resources. Finally, it discusses the challenges and possible courses of action that Chile could take in order to guarantee the continuous improvement of an articulated structure for health research and HTA.

  7. Smart Sensors Assess Structural Health

    Science.gov (United States)

    2010-01-01

    NASA frequently inspects launch vehicles, fuel tanks, and other components for structural damage. To perform quick evaluation and monitoring, the Agency pursues the development of structural health monitoring systems. In 2001, Acellent Technologies Inc., of Sunnyvale, California, received Small Business Innovation Research (SBIR) funding from Marshall Space Flight Center to develop a hybrid Stanford Multi-Actuator Receiver Transduction (SMART) Layer for aerospace vehicles and structures. As a result, Acellent expanded the technology's capability and now sells it to aerospace and automotive companies; construction, energy, and utility companies; and the defense, space, transportation, and energy industries for structural condition monitoring, damage detection, crack growth monitoring, and other applications.

  8. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES ampersand H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ''more focused, concentrating on ES ampersand H management, ES ampersand H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES ampersand H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES ampersand H areas. This manual documents the processes to be used to perform the ES ampersand H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy

  9. Bearing Health Assessment Based on Chaotic Characteristics

    Directory of Open Access Journals (Sweden)

    Chen Lu

    2013-01-01

    Full Text Available Vibration signals extracted from rotating parts of machinery carry a lot of useful information about the condition of operating machine. Due to the strong non-linear, complex and non-stationary characteristics of vibration signals from working bearings, an accurate and reliable health assessment method for bearing is necessary. This paper proposes to utilize the selected chaotic characteristics of vibration signal for health assessment of a bearing by using self-organizing map (SOM. Both Grassberger-Procaccia algorithm and Takens' theory are employed to calculate the characteristic vector which includes three chaotic characteristics, such as correlation dimension, largest Lyapunov exponent and Kolmogorov entropy. After that, SOM is used to map the three corresponding characteristics into a confidence value (CV which represents the health state of the bearing. Finally, a case study based on vibration datasets of a group of testing bearings was conducted to demonstrate that the proposed method can reliably assess the health state of bearing.

  10. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES ampersand H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are ''more focused, concentrating on ES ampersand H management, ES ampersand H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES ampersand H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES ampersand H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual

  11. Spatial and temporal assessment of cumulative disturbance impacts due to military training, burning, haying, and their interactions on land condition of Fort Riley.

    Science.gov (United States)

    Wang, Guangxing; Murphy, Dana; Oller, Adam; Howard, Heidi R; Anderson, Alan B; Rijal, Santosh; Myers, Natalie R; Woodford, Philip

    2014-07-01

    The effects of military training activities on the land condition of Army installations vary spatially and temporally. Training activities observably degrade land condition while also increasing biodiversity and stabilizing ecosystems. Moreover, other anthropogenic activities regularly occur on military lands such as prescribed burns and agricultural haying-adding to the dynamics of land condition. Thus, spatially and temporally assessing the impacts of military training, prescribed burning, agricultural haying, and their interactions is critical to the management of military lands. In this study, the spatial distributions and patterns of military training-induced disturbance frequency were derived using plot observation and point observation-based method, at Fort Riley, Kansas from 1989 to 2001. Moreover, spatial and variance analysis of cumulative impacts due to military training, burning, haying, and their interactions on the land condition of Fort Riley were conducted. The results showed that: (1) low disturbance intensity dominated the majority of the study area with exception of concentrated training within centralized areas; (2) high and low values of disturbance frequency were spatially clustered and had spatial patterns that differed significantly from a random distribution; and (3) interactions between prescribed burning and agricultural haying were not significant in terms of either soil erosion or disturbance intensity although their means and variances differed significantly between the burned and non-burned areas and between the hayed and non-hayed areas.

  12. Psychophysiological assessment of stress and screening of health risk in peacekeeping operations.

    Science.gov (United States)

    Nikolova, Rouja; Aleksiev, Lyubomir; Vukov, Mircho

    2007-01-01

    Medical surveillance for military personnel participating in peacekeeping missions (PKMs) is required to define the effect of stress on health status. The aim of this study was to determine the effect of stress on the autonomic cardiovascular control and health risk of 72 Bulgarian peacekeepers participating in a PKM in Kosovo. The assessment of psychophysiological stress and determination of stress characteristics were implemented with analysis of heart rate variability and personal interviews. As a response to the cumulative exposure to the effect of stress on cognitive function, we observed reductions in parasympathetic function and baroreceptor modulation of heart rhythm. The alteration in cardiovascular control was registered as decreases in short-term variability and spectral powers of cardiointervals in the respiratory sinus arrhythmia and Traube-Hering-Mayer bands. The advantage of psychophysiological stress assessment and screening of health risk in PKMs is that results indicate the mechanisms of the effects of stress on cognitive function and health status. PMID:17274265

  13. Risk assessment in support of plant health

    Directory of Open Access Journals (Sweden)

    Jeger M

    2012-10-01

    Full Text Available

    With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU. Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop types and plants in the environment. There has been an increasing trend towards producing scientific opinions which are full pest risk assessments for the whole EU territory. In its work, and as a contribution to the wider development of risk assessment methodology, the Panel has developed a series of guidance documents. These deal with the peer review of existing pest risk assessments, a framework for conducting risk assessments which harmonise standards set by the International Plant Protection Convention and the legislative requirements of the EU, and extension of this framework to include environmental risk assessment and the evaluation of risk reducing options. Quantitative approaches have become increasingly important during this time. The Panel has developed such methods in climatic mapping (in association with the Joint Research Councils, application of spatial spread models, re-evaluation of quantitative pathway analyses, and in statistical modelling of experimental data. A Plant Health Network has been established to facilitate interaction with EU Member States, especially in relation to data collection and co-ordination of risk assessment activities. At the current time a revision of the EU Plant Health Regime is being formulated. The legislative consequences of the revision will be of considerable significance for the work of the Plant Health Panel.

  14. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    DEFF Research Database (Denmark)

    Rosenkotter, N.; Vondeling, H.; Blancquaert, I.;

    2011-01-01

    contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health......The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the...

  15. Health Technology Assessment and patient safety

    OpenAIRE

    Andrew Mulcahy; Tom Walley

    2005-01-01

    Health Technology Assessment (HTA) is a process used to evaluate the clinical effectiveness and costeffectiveness of health technologies by a systematic review of clinical, economic, and utilization research.

    Despite widespread investment in patient safety technologies in the U.K., U.S., and elsewhere, little HTA has been done to establish the clinical or cost-effectiveness of these technologies. The HTA and patient safety literature suggests there are four categori...

  16. Community health assessment. The first step in community health planning.

    Science.gov (United States)

    Rice, J A

    1993-01-01

    Hospitals face a paradigm shift: from planning service delivery to population-based community health planning. Comprehensive community health planning is a two-step process: assessment and action, in that order. Assessment identifies community problems and resources; action follows planning, which determines which of those problems should be addressed with which resources. This paper provides an overview of the community assessment process. The first challenge in launching a community health initiative is to identify and recruit partners drawn from the ranks of prominent community organizations, such as school boards, public health agencies, and elected officials. The best enlistment strategies are those that empower persons outside the hospital to take visible control. Defining the community is the first step in analyzing the community. It is important that everyone involved in the assessment process agree on the definition, which should take in those characteristics that make the community unique, including its social systems, environmental factors, and demographics. The next step in the process is developing a community health profile, a set of key community indicators or measures that will help you set priorities, document successes and failures, and monitor trends. There are a number of models available to consult in developing indicators, whether traditional, medically oriented determinants of health or broader parameters, such as housing and public safety. Criteria for selecting indicators include validity, stability and reliability, and responsiveness. Most indicators will be developed using secondary, or already existing, sources of data, such as census data, Medicare and Medicaid files, police records, and hospital admission and exit records. Conducting the community assessment involves putting together a list of problems to be solved and a list of available resources, both of which can be compiled using the same four-step process of gathering and

  17. Identification and Quantification of Cumulative Factors that Increase Environmental Exposures and Impacts

    Science.gov (United States)

    Evaluating the combined adverse effects of multiple stressors upon human health is an imperative component of cumulative risk assessment (CRA)1. In addition to chemical stressors, other non-chemical factors are also considered. For examples, smoking will elevate the risks of havi...

  18. Shift work, health, the working time regulations and health assessments.

    Science.gov (United States)

    Nicholson, P J; D'Auria, D A

    1999-04-01

    Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value. PMID:10451593

  19. Dose-Response Relationship between Cumulative Occupational Lead Exposure and the Associated Health Damages: A 20-Year Cohort Study of a Smelter in China

    Directory of Open Access Journals (Sweden)

    Yue Wu

    2016-03-01

    Full Text Available Long-term airborne lead exposure, even below official occupational limits, has been found to cause lead poisoning at higher frequencies than expected, which suggests that China’s existing occupational exposure limits should be reexamined. A retrospective cohort study was conducted on 1832 smelting workers from 1988 to 2008 in China. These were individuals who entered the plant and came into continuous contact with lead at work for longer than 3 months. The dose-response relationship between occupational cumulative lead exposure and lead poisoning, abnormal blood lead, urinary lead and erythrocyte zinc protoporphyrin (ZPP were analyzed and the benchmark dose lower bound confidence limits (BMDLs were calculated. Statistically significant positive correlations were found between cumulative lead dust and lead fumes exposures and workplace seniority, blood lead, urinary lead and ZPP values. A dose-response relationship was observed between cumulative lead dust or lead fumes exposure and lead poisoning (p < 0.01. The BMDLs of the cumulative occupational lead dust and fumes doses were 0.68 mg-year/m3 and 0.30 mg-year/m3 for lead poisoning, respectively. The BMDLs of workplace airborne lead concentrations associated with lead poisoning were 0.02 mg/m3 and 0.01 mg/m3 for occupational exposure lead dust and lead fume, respectively. In conclusion, BMDLs for airborne lead were lower than occupational exposure limits, suggesting that the occupational lead exposure limits need re-examination and adjustment. Occupational cumulative exposure limits (OCELs should be established to better prevent occupational lead poisoning.

  20. Remote Sensing of Bioindicators for Forest Health Assessment

    Science.gov (United States)

    Kefauver, Shawn Carlisle

    The impacts of tropospheric ozone on forest health in Mediterranean type climates in California, USA and Catalonia, Spain were investigated using a combination of remote sensing, Geographic Information System (GIS), and field studies focused on sensitive bioindicator conifer species and ambient ozone monitoring. For the field validation of impacts of tropospheric ozone on conifer health, the Ozone Injury Index (OII) was applied to the bioindicator species Pinus ponderosa, Pinus jeffreyi, and Pinus uncinata. Combining these three tools, it was possible to build meaningful ecological models covering large areas to enhance our understanding of the biotic and abiotic interactions which affect forest health. Regression models predicting ozone injury improved considerably when incorporating ozone exposure with GIS related to plant water status, including water availability and water usage, as a proxies for estimating the stomatal conductance and ozone uptake R2=0.35, p = 0.016 in Catalonia, R2=0.36, p visual chlorotic mottling component of the OII was the most strongly correlated to remote sensing indices, in particular the photochemical reflectance index (PRI; R2=0.28, p=0.0044 for OIIVI-amount and R 2=0.33 and p=0.0016 for OIIVI -severity). Regression models assessing ozone injury to conifers using imaging spectroscopy techniques also improved when incorporating the GIS proxies of stomatal conductance (R 2=0.59, pozone monitoring in Catalonia, it was found that all models improved when incorporating the cumulative exposure to ozone over a period of three years (R2=0.56, pozone using a modified version of the OII (P<0.0001, R2=0.53, RMSE=2.73 with only the OII subcomponents VI-Severity and FWHORL and P<0.0001, R2 = 0.90, RMSE = 1.35 with GIS).

  1. Managing cumulative impacts: A key to sustainability?

    Energy Technology Data Exchange (ETDEWEB)

    Hunsaker, C.T.

    1994-12-31

    This paper addresses how science can be more effectively used in creating policy to manage cumulative effects on ecosystems. The paper focuses on the scientific techniques that we have to identify and to assess cumulative impacts on ecosystems. The term ``sustainable development`` was brought into common use by the World Commission on Environment and Development (The Brundtland Commission) in 1987. The Brundtland Commission report highlighted the need to simultaneously address developmental and environmental imperatives simultaneously by calling for development that ``meets the needs of the present generation without compromising the needs of future generations.`` We cannot claim to be working toward sustainable development until we can quantitatively assess cumulative impacts on the environment: The two concepts are inextricibally linked in that the elusiveness of cumulative effects likely has the greatest potential of keeping us from achieving sustainability. In this paper, assessment and management frameworks relevant to cumulative impacts are discussed along with recent literature on how to improve such assessments. When possible, examples are given for marine ecosystems.

  2. Assessment of the health impact of an environmental pollution and quantitative assessment of health risks

    International Nuclear Information System (INIS)

    The report made by a working group is written for experts in health risk assessment or for professionals involved in risk management. It proposes a methodological and conceptual framework which could build a unified approach to a quantitative assessment of health risks. In the first part, under the form of questions and answers, it defines the health impact, describes how to assess the excess of individual risk and the related hypothesis, how to pass from the excess of individual risk to the health impact, how to express the results of an health impact calculation, how to take the lack of knowledge into account at the different steps of this calculation, what is the significance of the result of such a calculation, and how useful an health impact assessment can be. The second part proposes a more detailed presentation of the scientific background for the health impact calculation with its indicators, its uncertainties, its practice in other countries, its relevance, and its fields of application. Then, after a comment of the dose-response relationship, it reports the scientific validity of the assessment of a number of cases

  3. Ecosystem Health Assessment in Wuli Lake

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Using the method of trophic state-composite index (TSI-CI ) and the 12 months of monitoring data in 2010,we carry out initial exploration of the status of ecosystem health in Wuli Lake. First,we select four indicators,Chla,SD,TP and TN,to conduct trophic state assessment using weighted index method; then after selecting physical,chemical and biological indicators to conduct nondimensionalization processing,we calculate the composite index and conduct comprehensive assessment. The results show that in 2010,the status of ecosystem health in Wuli Lake was the best in July,worst in August; when the composite trophic state indicators with Chla as the representative increase or decrease significantly and cross different nutritional grades,TSI will significantly deviate from CI,and the relationship between the two in the other time is not prominent.

  4. Teaching health assessment in the virtual classroom.

    Science.gov (United States)

    Lashley, Mary

    2005-08-01

    Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online. PMID:16130340

  5. Prospect theory in the health domain: A quantitative assessment

    OpenAIRE

    Attema, Arthur; Brouwer, Werner; L'Haridon, Olivier

    2013-01-01

    International audience It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect, theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full, function had not yet been quantified in the health domain. This paper is therefore the first to, simultaneously measure utility of life duration, probability weighting, and loss aversion in this domain., We observe loss aversion and risk aversion for gains and losses, which for g...

  6. Assessing the performance of health technology assessment organizations: a framework.

    Science.gov (United States)

    Lafortune, Louise; Farand, Lambert; Mondou, Isabelle; Sicotte, Claude; Battista, Renaldo

    2008-01-01

    In light of growing demands for public accountability, the broadening scope of health technology assessment organizations (HTAOs) activities and their increasing role in decision-making underscore the importance for them to demonstrate their performance. Based on Parson's social action theory, we propose a conceptual model that includes four functions an organization needs to balance to perform well: (i) goal attainment, (ii) production, (iii) adaptation to the environment, and (iv) culture and values maintenance. From a review of the HTA literature, we identify specific dimensions pertaining to the four functions and show how they relate to performance. We compare our model with evaluations reported in the scientific and gray literature to confirm its capacity to accommodate various evaluation designs, contexts of evaluation, and organizational models and perspectives. Our findings reveal the dimensions of performance most often assessed and other important ones that, hitherto, remain unexplored. The model provides a flexible and theoretically grounded tool to assess the performance of HTAOs.

  7. Joint cumulants for natural independence

    OpenAIRE

    Hasebe, Takahiro; Saigo, Hayato

    2011-01-01

    Many kinds of independence have been defined in non-commutative probability theory. Natural independence is an important class of independence; this class consists of five independences (tensor, free, Boolean, monotone and anti-monotone ones). In the present paper, a unified treatment of joint cumulants is introduced for natural independence. The way we define joint cumulants enables us not only to find the monotone joint cumulants but also to give a new characterization of joint cumulants fo...

  8. Cumulative Timers for Microprocessors

    Science.gov (United States)

    Battle, John O.

    2007-01-01

    It has been proposed to equip future microprocessors with electronic cumulative timers, for essentially the same reasons for which land vehicles are equipped with odometers (total-distance-traveled meters) and aircraft are equipped with Hobbs meters (total-engine-operating time meters). Heretofore, there has been no way to determine the amount of use to which a microprocessor (or a product containing a microprocessor) has been subjected. The proposed timers would count all microprocessor clock cycles and could only be read by means of microprocessor instructions but, like odometers and Hobbs meters, could never be reset to zero without physically damaging the chip.

  9. Risk assessment and toxicology databases for health effects assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lu, P.Y.; Wassom, J.S. [Oak Ridge National Laboratory, TN (United States)

    1990-12-31

    Scientific and technological developments bring unprecedented stress to our environment. Society has to predict the results of potential health risks from technologically based actions that may have serious, far-reaching consequences. The potential for error in making such predictions or assessment is great and multiplies with the increasing size and complexity of the problem being studied. Because of this, the availability and use of reliable data is the key to any successful forecasting effort. Scientific research and development generate new data and information. Much of the scientific data being produced daily is stored in computers for subsequent analysis. This situation provides both an invaluable resource and an enormous challenge. With large amounts of government funds being devoted to health and environmental research programs and with maintenance of our living environment at stake, we must make maximum use of the resulting data to forecast and avert catastrophic effects. Along with the readily available. The most efficient means of obtaining the data necessary for assessing the health effects of chemicals is to utilize applications include the toxicology databases and information files developed at ORNL. To make most efficient use of the data/information that has already been prepared, attention and resources should be directed toward projects that meticulously evaluate the available data/information and create specialized peer-reviewed value-added databases. Such projects include the National Library of Medicine`s Hazardous Substances Data Bank, and the U.S. Air Force Installation Restoration Toxicology Guide. These and similar value-added toxicology databases were developed at ORNL and are being maintained and updated. These databases and supporting information files, as well as some data evaluation techniques are discussed in this paper with special focus on how they are used to assess potential health effects of environmental agents. 19 refs., 5 tabs.

  10. Assessment methods of cumulative exposure to pesticide residues in food%食品中农药残留的累积性暴露评估方法研究

    Institute of Scientific and Technical Information of China (English)

    姜官鑫; 沈国清; 唐雯佳

    2011-01-01

    The potential cumulative effect of pesticide residues has been drawn more and more attention by many national governments and consumers. A lot of research work on assessments of cumulative exposure to pesticide residues which have a common mechanism such as organophosphate and carbamate has been done by US,The Netherlands,Brazil,Denmark and other countries. The main assessment methods of cumulative exposure such as Hazard Index, Cumulative Risk Index, Reference Point Index, Margin of Exposure, Toxicity Equivalence Factors were reviewed ,and the influence of uncertain factors were analyzed.%食品中农药残留潜在的累积效应已受到许多国家政府部门以及消费者越来越多的关注.美国、荷兰、巴西、丹麦等国家都已分别对具有共同作用机制的有机磷类和氨基甲酸酯类农药残留的累积性暴露评估做了大量的研究工作.本文对危险指数(HI)、累积风险指数(CRI)、参考点指数(RPI)、暴露边界(MOE)以及毒性当量因子(TEF)等国外目前研究累积性暴露评估的主要方法进行了综述,并对不确定因素的影响进行了分析.

  11. Microbiological risk assessment and public health

    International Nuclear Information System (INIS)

    Despite the advances made in risk assessment i the past twenty years, in areas as diverse as toxicology and offshore engineering, the risk assessment approach has made little impact on those addressing the microbiological aspects of public health. In this paper the advances which have been made are discussed and the difficulties preventing the wider application of microbiological risk assessment (MRA) to public health are considered. The term microbiological risk is used here to mean the probability of contracting a disease caused by a microorganism. I intend to demonstrate that the dynamic nature of microorganisms and the unique nature of the relationship between a pathogen (a microorganism which causes disease) and its host create special challenges for those involved in MRA. Although these problems are difficult they are not intractable. Indeed in some cases partial solutions have already been found and applied. It is hoped that this paper will help stimulate further thought and consideration in a variety of disciplines so that these challenges can be met, thereby allowing MRA to fulfil its potential

  12. Assessing Hmong farmers' safety and health.

    Science.gov (United States)

    de Castro, A B; Krenz, Jennifer; Neitzel, Richard L

    2014-05-01

    This pilot project investigated agricultural-related safety and health issues among Hmong refugees working on family-operated farms. Novel approaches, namely participatory rural appraisal and photovoice, were used to conduct a qualitative occupational hazard assessment with a group of Hmong farmers in Washington State. These two methods were useful in gathering participants' own perspectives about priority concerns. Several identified problems were related to musculoskeletal disorders, handling and operating heavy machinery, heat and cold stress, respiratory exposures, pest management, and socioeconomic and language concerns. Findings from this study provide insight into the work-related challenges that Hmong refugee farmers encounter and can serve as a basis for occupational health professionals to develop interventions to assist this underserved group.

  13. Environmental, health and safety assessment of photovoltaics

    Science.gov (United States)

    Rose, E. C.

    1983-01-01

    The environmental, health, and safety (E, H and S) concerns associated with the fabrication, deployment, and decommissioning of photovoltaic (PV) systems in terrestial applications are identified and assessed. Discussion is limited to crystalline silicon technologies. The primary E, H, and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.

  14. An assessment of cumulative external doses from Chernobyl fallout for a forested area in Russia using the optically stimulated luminescence from quartz inclusions in bricks

    DEFF Research Database (Denmark)

    Ramzaev, V.; Bøtter-Jensen, Lars; Thomsen, Kristina Jørkov;

    2008-01-01

    Optically stimulated luminescence (OSL) has been used for estimation of the accumulated doses in quartz inclusions obtained from two fired bricks, extracted in July 2004 from a building located in the forested surroundings of the recreational area Novie Bobovichi, the Bryansk Region, Russia...... starting on 27 April 1986 and ending on 31 July 2004. This result is in good agreement with the result of deterministic modelling of the cumulative gamma-ray dose in free air above undisturbed ground from the Chernobyl source in the Bryansk Region. Over the same time period, the external Chernobyl...

  15. Is cumulated pyrethroid exposure associated with prediabetes?

    DEFF Research Database (Denmark)

    Hansen, Martin Rune; Jørs, Erik; Lander, Flemming;

    2014-01-01

    , cumulative exposure) was assessed from questionnaire data. Participants were asked about symptoms of diabetes. Blood samples were analyzed for glycosylated hemoglobin (HbA1c), a measure of glucose regulation. No association was found between pyrethroid exposure and diabetes symptoms. The prevalence...

  16. Health Technology Assessment and patient safety

    Directory of Open Access Journals (Sweden)

    Andrew Mulcahy

    2005-12-01

    Full Text Available

    Health Technology Assessment (HTA is a process used to evaluate the clinical effectiveness and costeffectiveness of health technologies by a systematic review of clinical, economic, and utilization research.

    Despite widespread investment in patient safety technologies in the U.K., U.S., and elsewhere, little HTA has been done to establish the clinical or cost-effectiveness of these technologies. The HTA and patient safety literature suggests there are four categories of patient safety HTA, including HTA for existing safety technologies, underutilized safety technologies, emerging safety technologies, as well as safety aspects of technologies with a non-safety primary purpose.

    Recent HTA and other research, including a 2002 evidencebased evaluation of patient safety technologies from the U.S. Agency for Health Research and Quality, provide an important foundation for a more comprehensive approach to patient safety HTA. However, HTA programs must address prioritization, methodology, and dissemination challenges introduced by patient safety technologies before significant progress can Te made.

  17. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p process of developing cases and patient scenarios that were used in this study. Construct validity was obtained from the survey results analyzed from the experts and students. Future studies should examine the effect of rater training upon the reliability. Criterion or predictive validity could be further studied by comparing students' performances on the ISPE with other independent estimates of students' competence. The unique integration questions of the ISPE were judged to have good content validity from experts and students, suggestive that integration, a most crucial element of clinical competence, while done in the mind of the

  18. Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

    Science.gov (United States)

    Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

    2015-01-01

    The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

  19. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning.

  20. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  1. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners

    Science.gov (United States)

    Springer, Andrew E.; Evans, Alexandra E.

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  2. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

    Background: Health impact assessment (HIA prospectively judges the potential health impacts of pending decisions and feeds the assessment back into the decision making process. HIA is considered as a key tool for intersectoral collaboration. This article presents selected results of a mapping exercise on HIA in Europe. The mapping exercise is complemented by the presentation of a conceptual framework on the effectiveness of HIA and illustrative examples.

    Method: Two methodologies are employed in this article: First, the use of HIA across Europe is based on a survey conducted by 21 teams in 19 countries. A semi standardized questionnaire was employed, using a wide variety of sources. Second, for the discussion on the effectiveness of HIA, a conceptual framework using four types of effectiveness was employed. Results: HIA is a common practice only in a handful of European countries. In most of Europe, HIA is at an early developmental stage. The mapping exercise, however, provides evidence that HIA can work across all sectors and at all political level, although there is currently a focus on the local level. HIA is conducted in different countries by different sets of actors and organizations, reflecting the existing setup. The evidence on the effectiveness of HIA is still inconclusive. However, single case studies and upcoming evidence suggests that HIA has the capacity to inform and influence the decision making process.

    Conclusions: HIA can work and deliver. The variations in context across European countries have resulted in different forms of implementation and different dynamics of developing HIA.

  3. An Assessment of Integrated Health Management Frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Lybeck, Nancy; Coble, Jamie B.; Tawfik, Magdy; Bond, Leonard J.

    2012-05-18

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of an NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of an NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures

  4. Study of occupation health risk assessment on Chinese coal mine

    Institute of Scientific and Technical Information of China (English)

    XIAO Guo-qing; YAN Xiang-nong

    2007-01-01

    Factors of occupation health hazard were identified and analyzed, and indexes system of occupation health risk assessment were established by applying fuzzy theory and system safety technique, the weights of index system were obtained by AHP, finally a reasonable mathematics model of occupation health risk assessment was accomplished by an example.

  5. Assessing the Strengths of Mental Health Consumers: A Systematic Review

    Science.gov (United States)

    Bird, Victoria J.; Le Boutillier, Clair; Leamy, Mary; Larsen, John; Oades, Lindsay G.; Williams, Julie; Slade, Mike

    2012-01-01

    Strengths assessments focus on the individual's talents, abilities, resources, and strengths. No systematic review of strengths assessments for use within mental health populations has been published. The aims of this study were to describe and evaluate strengths assessments for use within mental health services. A systematic review identified 12…

  6. Self-assessed dental health, oral health practices, and general health behaviors in Chinese urban adolescents

    DEFF Research Database (Denmark)

    Jiang, Han; Petersen, Poul Erik; Peng, Bin;

    2005-01-01

    The objectives of this study were: to describe perceived dental health status and oral health-related knowledge, attitudes, and behavior in Chinese urban adolescents; to assess the associations of oral health variables with socio-economic status and school performance; and to analyse the relative...... effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage...... cigarette smoking at least once, while 41% reported having tasted alcohol drinks. Multivariate regression analyses showed that perceived dental health status and needs were associated with gender, age, unhealthy lifestyles, poor school performance, and socio-economic status. The establishment of school...

  7. Assessing Your Weight and Health Risk

    Science.gov (United States)

    ... 1 Health Topics 2 News & Resources 3 Intramural Research 4 Health Topics Educational Campaigns and Programs Resources Contact the Health ... BMI and Waist Circumference provides you with an idea of whether your BMI ... for Health Topics Associated With Obesity Along with being overweight or ...

  8. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: ► A more objective approach to health risk assessment is provided. ► An objective set of criteria for the consequences for chronic and acute impacts. ► An objective set of criteria for the consequences on the health care system. ► An objective set of criteria for event frequency that could impact on health. ► The approach presented is currently being trialled in Australia.

  9. An evaluation paradigm for cumulative impact analysis

    Science.gov (United States)

    Stakhiv, Eugene Z.

    1988-09-01

    Cumulative impact analysis is examined from a conceptual decision-making perspective, focusing on its implicit and explicit purposes as suggested within the policy and procedures for environmental impact analysis of the National Environmental Policy Act of 1969 (NEPA) and its implementing regulations. In this article it is also linked to different evaluation and decision-making conventions, contrasting a regulatory context with a comprehensive planning framework. The specific problems that make the application of cumulative impact analysis a virtually intractable evaluation requirement are discussed in connection with the federal regulation of wetlands uses. The relatively familiar US Army Corps of Engineers' (the Corps) permit program, in conjunction with the Environmental Protection Agency's (EPA) responsibilities in managing its share of the Section 404 regulatory program requirements, is used throughout as the realistic context for highlighting certain pragmatic evaluation aspects of cumulative impact assessment. To understand the purposes of cumulative impact analysis (CIA), a key distinction must be made between the implied comprehensive and multiobjective evaluation purposes of CIA, promoted through the principles and policies contained in NEPA, and the more commonly conducted and limited assessment of cumulative effects (ACE), which focuses largely on the ecological effects of human actions. Based on current evaluation practices within the Corps' and EPA's permit programs, it is shown that the commonly used screening approach to regulating wetlands uses is not compatible with the purposes of CIA, nor is the environmental impact statement (EIS) an appropriate vehicle for evaluating the variety of objectives and trade-offs needed as part of CIA. A heuristic model that incorporates the basic elements of CIA is developed, including the idea of trade-offs among social, economic, and environmental protection goals carried out within the context of environmental

  10. Simulation-based assessments in health professional education: a systematic review

    Directory of Open Access Journals (Sweden)

    Ryall T

    2016-02-01

    Full Text Available Tayne Ryall,1 Belinda K Judd,2,3 Christopher J Gordon3 1Physiotherapy Department, Canberra Hospital, ACT Health, Canberra, ACT, 2Faculty of Health Sciences, 3Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia Introduction: The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education.Methods: A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL, Education Resources Information Center (ERIC, Medical Literature Analysis and Retrieval System Online (Medline, and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included.Results: A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the

  11. Assessing the oral health literacy: A review

    Directory of Open Access Journals (Sweden)

    Sudhir Hongal

    2013-10-01

    Full Text Available Oral health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate oral health decisions. The current review is based on some of the extensive literature in health literacy, much of it focused on the intersection of low literacy and the understanding of basic health care information. Health literacy is a non-pharmacological method of managing and preventing diseases. There are three distinct levels in oral health literacy, i.e. functional, interactive and critical. Health literacy is important for all adults, who must be able to read articles and magazines about oral and general health prevention, interpret instructions on prescription bottles and over-the-counter medications, manage the healthcare needs of their children and ageing parents and interpret insurance and Medicare rules, regulations and benefits. There are several factors which impact on low health literacy level in the community. Poor health literacy is considered as a contributor of poor oral health status in an individual, poor heath outcome in a community and health inequalities. The dental profession is indeed changing the tide and now recognizes that several solutions can be implemented to ensure effective communication becomes a national organizational priority to improve oral healthcare.

  12. Assessment of the Health Impacts of Climate Change in Kiribati

    OpenAIRE

    Lachlan McIver; Alistair Woodward; Seren Davies; Tebikau Tibwe; Steven Iddings

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest prior...

  13. Urban Ecosystem Health Assessment: Perspectives and Chinese Practice

    Directory of Open Access Journals (Sweden)

    Lixiao Zhang

    2013-11-01

    Full Text Available The concept of ecosystem health is a way to assess the holistic operations and development potential of urban ecosystems. Accelerated by the practical need for integrated ecosystem management, assessment of urban ecosystem health has been greatly developed and extensively applied in urban planning and management. Development is aimed at comprehensively evaluating the performance of urban ecosystems, identifying the limiting factors, and providing suggestions for urban regulation. The time has come for reviewing and establishing an instructional framework for urban ecosystem health assessment to shed light on certain essential issues of urban ecosystem health. Based on literature reviews and series of practice, a holistic framework of urban ecosystem health assessment is proposed. The framework covers the essential elements of urban ecosystem health and integrates three dimensions: theoretical foundation, assessment method, and practical application. Concrete assessment methods are also established, focusing on both external performance and internal metabolic processes. The practice of urban ecosystem health assessment in China is illustrated to briefly demonstrate the application of the established framework and methods. Some prospects are discussed for urban ecosystem health assessment and its application in urban planning and management.

  14. The public health dimension of disasters: health outcome assessment of disasters.

    NARCIS (Netherlands)

    Berg, B. van den; Grievink, L.; Gutschmidt, K.; Lang, T.; Palmer, S.; Ruijten, M.; Stumpel, R.; Yzermans, J.

    2008-01-01

    A broad range of health problems are related to disasters. Insight into these health problems is needed for targeted disaster management. Disaster health outcome assessment can provide insight into the health effects of disasters. During the 15th World Congress on Disaster and Emergency Medicine in

  15. Private Health Sector Assessment in Tanzania

    OpenAIRE

    White, James; O’Hanlon, Barbara; Chee, Grace; Malangalila, Emmanuel; Kimambo, Adeline; Coarasa, Jorge; Callahan, Sean; Levey, Ilana Ron; McKeon, Kim

    2013-01-01

    Tanzania exemplifies the developing world's struggle to achieve 'middle-income' country status while confronting widespread poverty and substantial health challenges-such as persistently high child and maternal mortality, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria. In this context, Tanzania's National Public Private Partnership (PPP) policy and second Health Sector Strategic Plan (HSSP) included a call for a private health secto...

  16. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  17. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  18. Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

    OpenAIRE

    Princess Christina Campbell; Patrick Chukwuemeka Korie; Feziechukwu Collins Nnaji

    2014-01-01

    Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme a...

  19. Guide to Assessing Health Care Organizations

    OpenAIRE

    International Finance Corporation

    2015-01-01

    In recent years, International Finance Corporation (IFC) has become increasingly active in the private health sector in developing countries. We are now the largest multi-lateral investor in the private health sector, worldwide. Since 2000 the author have provided over US$1.5 billion of financial support (mainly through debt and equity financing) to over 80 projects in more than 30 countri...

  20. [Health impact assessment of building and investment projects].

    Science.gov (United States)

    Thriene, B

    2003-02-01

    For regional planning and approval procedures for building projects of a certain order of magnitude and power rating according to the German Federal Act on the Prevention of Emissions with Integrated Environmental Impact Assessment (EIA), the German public health departments, acting as public authorities, increasingly perform health impact assessments (HIA). The amended Act on Environmental Impact Assessment, the Decree on industrial plants which require approval (4th Federal Decree on Emission Prevention) and the Health Service Acts of the Federal States of Germany form the legal basis for the assessment of health issues with regard to approval procedures for building and investment projects. In the framework of the "Action Programme for the Environment and Health", the present article aims at making this process binding and to ensure responsibility and general involvement of the Public Health departments in all German Federal States. Future criteria, basic principles and procedures for single-case testing as well as assessment standards should meet these requirements. The Federal Ministry for the Environment and the Federal Ministry for Health should agree on Health Impact Assessment (HIA ) as well as on the relaxant stipulations in their procedures and general administrative regulations for implementing the Environmental Impact Assessment Act (EIA). Current EIA procedures focus on urban development and road construction, industrial investment projects, intensive animal husbandry plants, waste incineration plants, and wind energy farms. This paper illustrates examples meeting with varying degrees of public acceptance. However, being involved in the regional planning procedure for the project "Extension of the federal motorway A 14 from Magdeburg to Schwerin", the Public Health Service also shares global responsibility for health and climate protection. Demands for shortest routing conflict with objectives of environmental protection which should be given long

  1. The effect evaluation of the cumulative assessment model in nursing safety control%累计考核管理模式在护理安全管理中应用的效果评价

    Institute of Scientific and Technical Information of China (English)

    谢惠兰; 罗敏; 欧阳庆; 刘玉娥; 成放群; 周利华; 胡碧波; 周扬飞; 张晓玲

    2014-01-01

    目的 探索累计考核管理模式在护理安全管理中的应用及效果评价.方法 在原有“累计扣分制”被动处罚式的管理模式的基础上逐步建立主动预防式的安全管理模式.以5个试点病房为研究对象,比较实施前后护士安全意识及患者安全文化的认知、不良事件主动报告、护理质量及患者满意度的变化情况.结果 5个试点病房的护理人员安全意识及患者安全文化的认知度提高,不良事件主动呈报率较前增多,护理质量及患者满意度提高.结论 通过建立累计考核管理模式改变了以前“扣分、批评、通报、处罚”的管理模式,强化了护士的安全认知和安全行为,构建了积极的患者安全文化氛围,采用“不惩罚”及“保密”的原则,系统地收集、分析、梳理、总结、共享不良事件信息,并着重分析系统层面、管理因素、环境因素的综合成因,逐步实现从系统的角度处理安全隐患的风险管理策略,达到前馈控制安全事件的发生,形成一个利用差错信息来提高护理质量和患者安全的主动预防式管理模式.%Objective To explore the application and the effect evaluation of cumulative assessment management model in nursing safety control.Methods The original passive punishment management such as "cumulative deduction model" was gradually transformed into active precaution safety management model.The objects of research were 5 wards that the cumulative assessment model was applied to.The results were used to compare the changes of the nurses' safety consciousness,patients' safety culture cognition,spontaneous reporting of the adverse events,nursing quality and patients satisfaction before and after the implementation of active precaution safety management.Results In the 5 wards,nurses' safety consciousness and patients' safety culture cognition were improved; the spontaneous reporting of the adverse events increased and the nursing

  2. Human health risks analysis: assessment of health costs of energy related pollutants

    International Nuclear Information System (INIS)

    This section contains a summary of research on the assessment of health costs of energy related pollutants. It includes the development of new statistical methodology, mathematical models, and data bases relevant to the assessment

  3. The differential impacts of episodic, chronic, and cumulative physical bullying and cyberbullying: the effects of victimization on the school experiences, social support, and mental health of rural adolescents.

    Science.gov (United States)

    Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L

    2014-01-01

    Few studies have examined the impacts of past, current, and chronic physical bullying and cyberbullying on youth, especially in rural settings. This study augments this scant literature by exploring the school experiences, social support, and mental health outcomes for rural, middle school youth. The participants for this 2-year longitudinal study were 3,127 youth from 28 middle schools. Participants were classified as nonvictims, past victims (i.e., victimized during Year 1 but not Year 2), current victims (i.e., victimized during Year 2 but not Year 1), and chronic victims (i.e., victimized during both Year 1 and Year 2). Findings illustrated that chronic victimization resulted in the lowest levels of school satisfaction, social support, future optimism, and self-esteem. Chronic victims also reported the highest levels of school hassles, perceived discrimination, peer rejection, anxiety, depression, and externalizing behaviors. In terms of episodic victimization, current year victimization was associated with worse outcomes than past year victimization. Implications and limitations were discussed.

  4. Cumulative dietary exposure of the population of Denmark to pesticides.

    Science.gov (United States)

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa; Christensen, Tue; Poulsen, Mette Erecius; Andersen, Jens Hinge

    2015-09-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme during the period 2004-2011. Food consumption data were obtained from DANSDA (the DAnish National Survey of Diet and physical Activity) for the period 2005-2008. The calculations were made using three different models to cope with residues below the limit of reporting (LOR). We concluded that a model that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI by a factor of 2.

  5. Defining and Assessing Public Health Functions: A Global Analysis.

    Science.gov (United States)

    Martin-Moreno, Jose M; Harris, Meggan; Jakubowski, Elke; Kluge, Hans

    2016-01-01

    Given the broad scope and intersectoral nature of public health structures and practices, there are inherent difficulties in defining which services fall under the public health remit and in assessing their capacity and performance. The aim of this study is to analyze how public health functions and practice have been defined and operationalized in different countries and regions around the world, with a specific focus on assessment tools that have been developed to evaluate the performance of essential public health functions, services, and operations. Our review has identified nearly 100 countries that have carried out assessments, using diverse analytical and methodological approaches. The assessment processes have evolved quite differently according to administrative arrangements and resource availability, but some key contextual factors emerge that seem to favor policy-oriented follow-up. These include local ownership of the assessment process, policymakers' commitment to reform, and expert technical advice for implementation. PMID:26789385

  6. The relationship between perceived own health state and health assessments of anchoring vignettes

    OpenAIRE

    Hinz, Andreas; Häuser, Winfried; Glaesmer, Heide; Brähler, Elmar

    2016-01-01

    Self-reported health depends on the internal frame of reference and on response styles. One way of studying this dependency is using anchoring vignettes. Response shift effects are assumed to induce a negative correlation between self-reported health and the health assessments attributed to the vignettes. Method: A representative sample of the German adult population (N = 2,409) was selected. Participants were asked to rate their health state and the health states of two rather complex vignet...

  7. Prospect theory in the health domain: a quantitative assessment.

    Science.gov (United States)

    Attema, Arthur E; Brouwer, Werner B F; I'Haridon, Olivier

    2013-12-01

    It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full function had not yet been quantified in the health domain. This paper is therefore the first to simultaneously measure utility of life duration, probability weighting, and loss aversion in this domain. We observe loss aversion and risk aversion for gains and losses, which for gains can be explained by probabilistic pessimism. Utility for gains is almost linear. For losses, we find less weighting of probability 1/2 and concave utility. This contrasts with the common finding of convex utility for monetary losses. However, CPT was proposed to explain choices among lotteries involving monetary outcomes. Life years are arguably very different from monetary outcomes and need not generate convex utility for losses. Moreover, utility of life duration reflects discounting, causing concave utility. PMID:24103499

  8. Prospect theory in the health domain: a quantitative assessment.

    Science.gov (United States)

    Attema, Arthur E; Brouwer, Werner B F; I'Haridon, Olivier

    2013-12-01

    It is well-known that expected utility (EU) has empirical deficiencies. Cumulative prospect theory (CPT) has developed as an alternative with more descriptive validity. However, CPT's full function had not yet been quantified in the health domain. This paper is therefore the first to simultaneously measure utility of life duration, probability weighting, and loss aversion in this domain. We observe loss aversion and risk aversion for gains and losses, which for gains can be explained by probabilistic pessimism. Utility for gains is almost linear. For losses, we find less weighting of probability 1/2 and concave utility. This contrasts with the common finding of convex utility for monetary losses. However, CPT was proposed to explain choices among lotteries involving monetary outcomes. Life years are arguably very different from monetary outcomes and need not generate convex utility for losses. Moreover, utility of life duration reflects discounting, causing concave utility.

  9. Mental health assessment of rape offenders

    OpenAIRE

    Sarkar, Jaydip

    2013-01-01

    There is an urgent need for development of methods of assessment and management of sex offenders (rapists, child sex offenders, other sexual offenders, and murderers) to mount a society-wide battle against the scourge of sexual offences in India. This paper provides an overview of theories, models, and assessment methods of rapists. It draws upon literature from psychiatry, psychology, criminology, probation, and ethics to provide a framework for understanding reasons behind rape, how mental ...

  10. Cumulative stress and autonomic dysregulation in a community sample.

    Science.gov (United States)

    Lampert, Rachel; Tuit, Keri; Hong, Kwang-Ik; Donovan, Theresa; Lee, Forrester; Sinha, Rajita

    2016-05-01

    Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p stress and chronic stress each was significantly associated with SDNN and ULF even after the highly significant contributions of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

  11. Regional comprehensive assessment on environment-health of China

    Institute of Scientific and Technical Information of China (English)

    WANGWuyi; LIRibang; LIAOYongfeng; LIHairong; YANGLinsheng; TANJianan

    2004-01-01

    The aim of the study was to assess the environment-health development in different regions of China. 175 indicators, such as average life expectancy at birth, emission intensity of waste gas, GDP etc. were chosen to describe various aspects of the environment, health and development of China. Of all the indicators, life expectancy can sufficiently reflect health situation of population. Consequently,life expectancy was identified as key indicator, and 42 out of 175 indicators were selected for establishing the environment-health indicator framework with three grades of integrative indices to assess the development of environment-health of China. Based on the hierarchical relation between various grades of indices, the comprehensive environment-health index was calculated and contributed to classify the environment-health situation of 30 provinces, municipalities and autonomous regions in China which were divided into five grades by four predefined limits. Comprehensive assessment indicates that the environment-health situation of the eastern and coastal areas is superior to that of inland which is the western regions with underdeveloped economy and rigorous natural condition.Especially, the Qinghai-Tibet and Yunnan-Guizhou plateaus in southwestern China are most vulnerable in the environment and population health. These fit in with the pattern of national socio-economic development, which fully shows that socio-economic context plays a dominant role in the improvement of envirnment-health in China

  12. Defining and assessing health-related quality of life.

    Science.gov (United States)

    Holcík, J; Koupilová, I

    1999-11-01

    In recent years, there has been an increasing interest in quality of life assessment in clinical research and practice, as well as in public health and policy analysis. Indicators of health-related quality of life are important not only for health professionals and their patients, but also for health administrators and health economists in health care planning and policy making. Most studies on the outcome of treatments and interventions now include some kind of a quality of life measure. This usually takes a form of an assessment of symptoms and physical functioning, measurement of psychological well-being, life satisfaction, or coping and adjustment. Numerous scales of psychological health, physical health status and physical functioning have been developed for use in the assessment of health outcomes and a wide range of instruments for measurement of health-related quality of life is available. These fall into two broad categories of generic and disease-specific instruments. The selection of an instrument depends upon its measurement properties but also upon the specific context in which the instrument is going to be used. Adequate attention needs to be paid to the translation and validation of instruments for use across countries and cultural contexts.

  13. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    NARCIS (Netherlands)

    Rosenköttera, N.; Vondeling, H.; Blancquaert, I.; Mekel, O.C.L.; Kristensen, F.B.; Brand, A.

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the im

  14. Uncertainties associated with assessing the public health risk from Legionella

    OpenAIRE

    Harriet eWhiley; Alexandra eKeegan; Howard eFallowfield; Kirstin eRoss

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties a...

  15. "Lifetime Fitness for Health" Course Assessment: Implications for Curriculum Improvement

    Science.gov (United States)

    Cardinal, Bradley J.; Cardinal, Marita K.; Burger, Molly E.

    2005-01-01

    Every other year, comprehensive school health education programs and policies are assessed nationally using the School Health Education Profile (SHEP) survey (Grunbaum et al., 1998). The data are collected in modules that are completed by different stakeholders within the school system. As part of a cooperative agreement with the Centers for…

  16. Residential mental health assessment within Dutch criminal cases : A discussion

    NARCIS (Netherlands)

    van der Leij, JBJ; Jackson, JL; Malsch, M; Nijboer, JF

    2001-01-01

    In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a

  17. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    Science.gov (United States)

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed. PMID:26438747

  18. Selection of reproductive health end points for environmental risk assessment.

    OpenAIRE

    Savitz, D A; Harlow, S D

    1991-01-01

    In addition to the challenges inherent in environmental health risk assessment, the study of reproductive health requires thorough consideration of the very definition of reproductive risk. Researchers have yet to determine which end points need to be considered to comprehensively evaluate a community's reproductive health. Several scientific issues should be considered in the selection of end points: the severity of the outcomes, with a trade-off between clinical severity and statistical or ...

  19. An Assessment of Environmental Health Needs for Manned Spacecraft

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. Environmental monitoring coupled with other measures including active and passive controls and the implementation of environmental standards (SMACs, SWEGs, microbial and acoustics limits) are used to ensure environmental health in manned spacecraft. NASA scientists and engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. Environmental monitoring data confirms the health of ECLS systems, in addition to contributing to the management of the health of human systems. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in knowledge and technology, required to address those risks, were identified for various types of Exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of this assessment and findings are presented in this paper.

  20. Prioritising investments in health technology assessment: can we assess the potential value for money?

    OpenAIRE

    Linda Davies; Mike Drummond; Panos Papanikoloau

    1999-01-01

    The objective was to develop an economic prioritisation model to assist those involved in (i) the selection and prioritisation of health technology assessment topics and (ii) commissioning of HTA projects. The model used decision analytic techniques to estimate the expected costs and benefits of the health care interventions which were the focus of the HTA question(s) considered by the NHS Health Technology Assessment Programme in England. Initial estimation of the value for money of HTA was ...

  1. An overview of the mental health system in Gaza: an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS)

    OpenAIRE

    Saymah, Dyaa; Tait, Lynda; Michail, Maria

    2015-01-01

    Background Mental health system reform is urgently needed in Gaza to respond to increasing mental health consequences of conflict. Evidence from mental health systems research is needed to inform decision-making. We aimed to provide new knowledge on current mental health policy and legislation, and services and resource use, in Gaza to identify quality gaps and areas for urgent intervention. Methods As part of a mixed methods study, we used the World Health Organization’s Assessment Instrumen...

  2. Do patient preferences for health information vary by health literacy or numeracy? A qualitative assessment.

    Science.gov (United States)

    Gaglio, Bridget; Glasgow, Russell E; Bull, Sheana S

    2012-01-01

    Seeking health information can be a complicated process for a patient. Patients must know the topic of interest, where to look or ask, how to assess and comprehend, and how to evaluate the credibility and trustworthiness of the sources. In this study, the authors describe preferences of patients with multiple risk factors for cardiovascular disease with varying health literacy and numeracy abilities for receiving health information. Participants were recruited from 2 health care systems. Health literacy and numeracy were assessed and participants completed an orally administered survey consisting of open-ended questions about obtaining health information and preferences for health information. In-depth interviews were conducted with a subset of participants. A diverse sample of 150 individuals (11.3% Latino, 37.3% African American, 44.7% with income less than $15,000/year) participated. Most participants had adequate functional health literacy, while 65% had low numeracy skills. Regardless of health literacy or numeracy ability, participants overwhelmingly preferred to receive health information during a face-to-face conversation with their health care provider. While individuals with adequate functional health literacy identified a variety of health information sources, actions are needed to ensure multiple modalities are available and are in plain, clear language that reinforces patients' understanding and application of information to health behavior.

  3. A short assessment of health literacy (SAHL) in the Netherlands

    OpenAIRE

    Pander Maat, Henk; Essink-Bot, Marie-Louise; Leenaars, Karlijn EF; Fransen, Mirjam P

    2014-01-01

    Background An earlier attempt to adapt the REALM (Rapid Estimate of Adult Literacy in Medicine) word recognition test to Dutch was not entirely successful due to ceiling effects. In contrast to REALM, the Short Assessment of Health Literacy (SAHL) assesses both word recognition and comprehension in the health domain. The aim of this study was to design, test and validate a SAHL for Dutch patients (SAHL-D). Methods We pretested 95 health-related terms (n = 127) and selected 33 best performing ...

  4. A short assessment of health literacy (SAHL) in the Netherlands

    NARCIS (Netherlands)

    Pander Maat, Henk; Essink-Bot, Marie-Louise; Leenaars, Karlijn EF; Fransen, Mirjam P.

    2014-01-01

    Abstract Background: An earlier attempt to adapt the REALM (Rapid Estimate of Adult Literacy in Medicine) word recognition test to Dutch was not entirely successful due to ceiling effects. In contrast to REALM, the Short Assessment of Health Literacy (SAHL) assesses both word recognition and compreh

  5. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  6. Forensic mental health assessment in France: recommendations for quality improvement.

    Science.gov (United States)

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

  7. Utilisation of medical technology assessment in health policy

    NARCIS (Netherlands)

    van den Heuvel, WJA; Wieringh, R; van den Heuvel, LPM

    1997-01-01

    Objective: To assess the contribution of medical technology assessment (MTA) to health policy decision making, the question has to be answered whether MTA is actually being used in decision-making processes and what factors are related to its utilisation. Design: We investigated recent Dutch policy

  8. General health assessment in refugees claiming to have been tortured

    DEFF Research Database (Denmark)

    Draminsky Petersen, Hans; Christensen, Maria Elisabeth; Kastrup, Marianne;

    1994-01-01

    General health assessment of refugees claiming to have been previously exposed to torture takes place in a psychological atmosphere affected by the difficult situation of the refugee. Thirty-one refugees, mainly from the Middle East and Africa, were assessed as regards their physical and mental...

  9. Assessment of the Health Impacts of Climate Change in Kiribati

    Directory of Open Access Journals (Sweden)

    Lachlan McIver

    2014-05-01

    Full Text Available Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health.

  10. Assessment of the health impacts of climate change in Kiribati.

    Science.gov (United States)

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-05-01

    Kiribati-a low-lying, resource-poor Pacific atoll nation-is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

  11. A new adaptive testing algorithm for shortening health literacy assessments

    Directory of Open Access Journals (Sweden)

    Currie Leanne M

    2011-08-01

    Full Text Available Abstract Background Low health literacy has a detrimental effect on health outcomes, as well as ability to use online health resources. Good health literacy assessment tools must be brief to be adopted in practice; test development from the perspective of item-response theory requires pretesting on large participant populations. Our objective was to develop a novel classification method for developing brief assessment instruments that does not require pretesting on large numbers of research participants, and that would be suitable for computerized adaptive testing. Methods We present a new algorithm that uses principles of measurement decision theory (MDT and Shannon's information theory. As a demonstration, we applied it to a secondary analysis of data sets from two assessment tests: a study that measured patients' familiarity with health terms (52 participants, 60 items and a study that assessed health numeracy (165 participants, 8 items. Results In the familiarity data set, the method correctly classified 88.5% of the subjects, and the average length of test was reduced by about 50%. In the numeracy data set, for a two-class classification scheme, 96.9% of the subjects were correctly classified with a more modest reduction in test length of 35.7%; a three-class scheme correctly classified 93.8% with a 17.7% reduction in test length. Conclusions MDT-based approaches are a promising alternative to approaches based on item-response theory, and are well-suited for computerized adaptive testing in the health domain.

  12. Assessment of health impacts in electricity generation and use

    Energy Technology Data Exchange (ETDEWEB)

    Morris, S.C.

    1995-11-01

    This paper describes the health effects of concern associated with electricity generation, information from which health effects can be estimated, and how the boundaries of analysis are determined. It also describes advances, new approaches, and trends in the risk assessment process. It discusses the application of these advances to comparative risk studies. Trends in the risk assessment process include more explicit characterization of quantitative uncertainty, the broader application and acceptance of Monte Carlo analysis and other numerical methods to the propagation of uncertainties through the analysis, greater realism in risk assessment, and the application of greatly increased computational capabilities.

  13. River Health Assessment Based on Fuzzy Matter-element Model

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    [Objective] The study aimed to assess the health state of rivers by using fuzzy matter-element model.[Method] Based on fuzzy matter-element analysis theory,the assessment model of river health was established,then a modified method to calculate the superior subordinate degree was put forward according to Hamming distance.Afterwards,a multi-level evaluation model,which contained the assessment indicators about hydrological features,ecological characteristics,environmental traits and service function,was set ...

  14. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

    Hamel, D.R. [Department of Agriculture-Forest Service, Washington, DC (United States)

    1990-12-31

    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  15. Assessment in health psychology: Introduction to the special issue.

    Science.gov (United States)

    Butt, Zeeshan

    2016-09-01

    For the past 27 years, has been committed to publishing empirical research relevant to clinical assessment of basic and applied cognition, personality, interpersonal behavior, psychopathology, forensics, and biological psychology. There is growing interest in the use of patient-centered outcomes in medical/surgical care and for measuring health care performance. Patient-centered outcome measures complement traditional clinical outcomes of morbidity and mortality, capturing the patient's perspective regarding their health and its treatment. In this issue, we highlight 11 articles that address different aspects of such work. The articles in this special issue represent both the depth and breadth of the opportunities that exist for psychological assessment in the health setting. While there are countless patient-centered measures currently in use to measure health and health outcomes, the evidence base for their use can be quite variable (Butt, 2016). The hope is that future issues of will highlight more work in this area. (PsycINFO Database Record

  16. Assessment in health psychology: Introduction to the special issue.

    Science.gov (United States)

    Butt, Zeeshan

    2016-09-01

    For the past 27 years, has been committed to publishing empirical research relevant to clinical assessment of basic and applied cognition, personality, interpersonal behavior, psychopathology, forensics, and biological psychology. There is growing interest in the use of patient-centered outcomes in medical/surgical care and for measuring health care performance. Patient-centered outcome measures complement traditional clinical outcomes of morbidity and mortality, capturing the patient's perspective regarding their health and its treatment. In this issue, we highlight 11 articles that address different aspects of such work. The articles in this special issue represent both the depth and breadth of the opportunities that exist for psychological assessment in the health setting. While there are countless patient-centered measures currently in use to measure health and health outcomes, the evidence base for their use can be quite variable (Butt, 2016). The hope is that future issues of will highlight more work in this area. (PsycINFO Database Record PMID:27536998

  17. [Assessing and evaluating physical activity during counseling in health care].

    Science.gov (United States)

    Hagströmer, Maria; Wisén, Anita; Hassmén, Peter

    2015-01-01

    To make individualized counseling possible, valid and reliable measures of physical activity are necessary. In health care, quality must be continuously secured and developed. Follow-up of life-style habits such as physical activity does not differ from monitoring of other treatment in the health care setting.  After counseling and appropriate period of time, evaluation should be done to assess if there has been any change in the physical activity level. For assessment and evaluation of physical activity in routine clinical practice the National Board for Health and Social Welfare indicator questions regarding physical activity are recommended. For a more detailed assessment and evaluation of physical activity and sedentary behavior comprehensive validated instruments/diaries should be used. For precise and objective assessment and evaluation of both physical activity and sedentary behavior, movement sensors are recommended.

  18. Assessing health impacts of the Chad-Cameroon petroleum development and pipeline project: challenges and a way forward

    International Nuclear Information System (INIS)

    Health impact assessment (HIA) of projects, programmes and policies is increasingly recognized as a powerful methodology for mitigating negative health impacts and enhancing equitable and sustainable development, yet applications in the developing world are sparse. Here, we focus on a large infrastructure development in sub-Saharan Africa, namely the Chad-Cameroon petroleum development and pipeline project. We adapted a five-step process for HIA, consisting of (1) screening of project documents, (2) profiling of affected communities, (3) identifying priority health areas, predicting potential impacts, and proposing mitigation measures, (4) implementing interventions, and (5) monitoring and evaluation of health impacts. We found that project scoping was broad, including extensive environmental and social assessments. Innovative features of the project include the high degree of public-private partnerships, and the management of oil revenues for purposes of poverty reduction. The project also addressed occupational and public health issues, and developed and implemented measures to prevent or mitigate potential health impacts. However, there was a disproportionate emphasis on workers' health, particularly on the prevention/mitigation of construction-related injuries, sexually transmitted infections (STIs; mainly HIV/AIDS), and malaria. Health impacts among surrounding communities, and cumulative health impacts in the larger region were not considered in a comprehensive way. Concluding, there is a need for a more systemic approach to HIA and its incorporation within 'Equator Principles', which are increasingly adopted by the international financial community. This process would include clarification of corporate social responsibility beyond the project fence line in the mitigation of health problems at regional levels. Finally, we propose the establishment and running of a longitudinal demographic surveillance system, which--coupled with regular household surveys

  19. Cumulant expansions for atmospheric flows

    CERN Document Server

    Ait-Chaalal, Farid; Meyer, Bettina; Marston, J B

    2015-01-01

    The equations governing atmospheric flows are nonlinear, and consequently the hierarchy of cumulant equations is not closed. But because atmospheric flows are inhomogeneous and anisotropic, the nonlinearity may manifests itself only weakly through interactions of mean fields with disturbances such as thermals or eddies. In such situations, truncations of the hierarchy of cumulant equations hold promise as a closure strategy. We review how truncations at second order can be used to model and elucidate the dynamics of turbulent atmospheric flows. Two examples are considered. First, we study the growth of a dry convective boundary layer, which is heated from below, leading to turbulent upward energy transport and growth of the boundary layer. We demonstrate that a quasilinear truncation of the equations of motion, in which interactions of disturbances among each other are neglected but interactions with mean fields are taken into account, can successfully capture the growth of the convective boundary layer. Seco...

  20. Airborne infection control in India: Baseline assessment of health facilities

    Science.gov (United States)

    Parmar, Malik M.; Sachdeva, K.S.; Rade, Kiran; Ghedia, Mayank; Bansal, Avi; Nagaraja, Sharath Burugina; Willis, Matthew D.; Misquitta, Dyson P.; Nair, Sreenivas A.; Moonan, Patrick K.; Dewan, Puneet K.

    2016-01-01

    Background Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year. Method A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines. Result Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice. Conclusion A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice. PMID:26970461

  1. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

    Structural Health Monitoring (SHM) systems are designed for assisting owners and operators with information and forecasts concerning the fitness for purpose of structures and building systems. The benefit associated with the implementation of SHM may in some cases be intuitively anticipated......-posterior decision analysis. The quantification of the value of SHM builds upon the quantification of the value of information (VoI) or rather the benefit of monitoring. The suggested approach involves a probabilistic representation of the loads and environmental conditions acting on structures as well...... as their responses and performances over their life-cycle. In addition, the quality of monitoring and the performance of possible remedial actions triggered by monitoring results are modeled probabilistically.The consequences accounted for, in principle include all consequences associated with the performance...

  2. Editorial: Lead Risk Assessment and Health Effects

    Science.gov (United States)

    Mielke, Howard W.

    2016-01-01

    In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention. PMID:27314364

  3. Editorial: Lead Risk Assessment and Health Effects

    Directory of Open Access Journals (Sweden)

    Howard W. Mielke

    2016-06-01

    Full Text Available In 1980, Clair C. Patterson stated: “Sometime in the near future it probably will be shown that the older urban areas of the United States have been rendered more or less uninhabitable by the millions of tons of poisonous industrial lead residues that have accumulated in cities during the past century”. We live in the near future about which this quote expressed concern. This special volume of 19 papers explores the status of scientific evidence regarding Dr. Patterson’s statement on the habitability of the environments of communities. Authors from 10 countries describe a variety of lead issues in the context of large and small communities, smelter sites, lead industries, lead-based painted houses, and vehicle fuel treated with lead additives dispersed by traffic. These articles represent the microcosm of the larger health issues associated with lead. The challenges of lead risk require a concerted global action for primary prevention.

  4. The "SMART Travel Health" Mobile Application Assessment.

    Science.gov (United States)

    Gallos, Parisis; Mantas, John

    2015-01-01

    An empirical study was conducted to evaluate the users' perception on a pilot mobile application ("SMART Travel Health"), their attitude towards use, and their intention to use it. A theoretical model was constructed based on TAM and other related works. The population was 88 travellers who used the pilot application. Data analysis was performed using partial least squares path modeling. Results highlight the very strong significant effect of perceived ease of use to perceived usefulness, the strong significant effect of perceived usefulness to attitude towards use, as well as, the significant effect of perceived ease of use to attitude towards using the application. Also, the strong significant effect of attitude towards use to behavioral intention to use is presenting the positive perception of the population about this mobile application. PMID:26153000

  5. Probabilistic assessment factors for human health risk assessment - A practical guide

    NARCIS (Netherlands)

    Vermeire T; Pieters M; Rennen M; Bos P; TNO-Voeding ATRA; CSR

    2001-01-01

    This report is a practical guide for the application of probabilistic distributions of default assessment factors in human health risk assessments. RIVM and TNO developed the use of probabilistic assessment factors as a first step towards further national and international harmonisation. Consensus w

  6. Identification of Cumulative Assessment Groups of Pesticides

    DEFF Research Database (Denmark)

    Nielsen, Elsa; Nørhede, Pia; Boberg, Julie;

    The present document has been produced and adopted by the bodies identified above as author(s). In accordance with Article 36 of Regulation (EC) No 178/2002, this task has been carried out exclusively by the author(s) in the context of a grant agreement between the European Food Safety Authority ...

  7. 累积跟踪概率的舰载主动声纳作用距离衡量方法%Based on Cumulative Tracking Probability for Assessing Detection Range of Active Sonar

    Institute of Scientific and Technical Information of China (English)

    初磊; 楼晓平; 肖汉华; 田云飞

    2013-01-01

    通过对水面舰艇声纳主动工作方式探测概率及作用距离的分析,探讨了目前常用的单次探测概率衡量方式所产生的问题,提出了累积跟踪概率的衡量方法,并结合某作战训练系统,应用蒙特卡洛法进行了仿真计算,计算结果表明,该方法可有效满足舰载声纳主动工作方式探测概率及作用距离的衡量需求,可为水面舰艇反潜作战的配置方法和指挥决策提供较高的参考价值.%Based on analysis of the dectection probability and dectection range for active sonars in surface ships,the assessing measure of cumulative tracking probability was brought out through probing into the problems on single -ping detection probability. This method could surfice for detection probability and detection range for active sonar in surface ship by the computing result,via combining this measure with a certain combating training system using Monte-Carlo calculation. This method could improve searching architectures of ASW surface ships and establish battle decision for ASW to a certian extent.

  8. Assessment of Cumulative Trauma Disorder (CTD) Risk for 3 Different Tasks Constructing and Repairing Multi-Layer Insulation (MLI) Blankets, Preparing the Dough for a Pizza, and Operating the Becton-Dickinson FACSAria Flow Cytometer

    Science.gov (United States)

    Gentzler, Marc; Kline, Martin; Palmer, Andrew; Terrone, Mark

    2007-01-01

    The Cumulative Trauma Disorder (CTD) risks for three different tasks using McCauley-Bell and Badiru's (1993) formula based on task, personal, and organizational factors were examined. For the Multi-Layer Insulation (MLI) blanket task, the results showed that the task, personal, and organizational risks were at about the same level. The personal risk factors for this task were evaluated using a hypothetical female employee age 52. For the pizza dough task, it was shown that the organizational risk was particularly high, with task related factors also at quite dangerous levels. On the other hand, there was a very low level of personal risk factors, based on a female age 17. The flow cytometer task was assessed with three different participants, a11 of whom had quite disparate levels of personal risk, which slightly affected the overall CTD risk. This reveals how individual difference variables certainly need to be considered. The task and organizational risks for this task were rated at about the same moderate level. The overall CTD risk averaged across the three participants was .335, indicating some risk. Compruing across the tasks revealed that the pizza dough task created the greatest overall CTD risk by far (.568), with the MLI (.325) and flow cytometer task (.335) having some risk associated with them. Future research should look into different tasks for more of a comparison

  9. Some Insights on Grassland Health Assessment Based on Remote Sensing

    Directory of Open Access Journals (Sweden)

    Dandan Xu

    2015-01-01

    Full Text Available Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment.

  10. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    Background: The fragmented delivery of healthcare and social services as advanced by WHO 2002. Objectives: This project of international collaboration assesses integrated home care (IHC) for frail elder somatic patients as compared to usual hospital care. Methods: The HTA follows the special......-up: Stroke: A meta-analysis including 14 randomized trials (N=2139) demonstrate a significant reduction (pcare with OR=0.75 (CI95%: 0.61-0.92). HF: 3 RCT (N=568) demonstrate each a significant reduction of all-cause readmissions. A meta...... with a minimum of national legislation/finance (Meso-strategy of dissemination). Implications: IHC is an approach to clinical continuity for a majority of frail elder somatic patients....

  11. Survey of Ambient Air Pollution Health Risk Assessment Tools.

    Science.gov (United States)

    Anenberg, Susan C; Belova, Anna; Brandt, Jørgen; Fann, Neal; Greco, Sue; Guttikunda, Sarath; Heroux, Marie-Eve; Hurley, Fintan; Krzyzanowski, Michal; Medina, Sylvia; Miller, Brian; Pandey, Kiran; Roos, Joachim; Van Dingenen, Rita

    2016-09-01

    Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer-based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration-response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools' inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).

  12. Cumulative Paired φ-Entropy

    Directory of Open Access Journals (Sweden)

    Ingo Klein

    2016-07-01

    Full Text Available A new kind of entropy will be introduced which generalizes both the differential entropy and the cumulative (residual entropy. The generalization is twofold. First, we simultaneously define the entropy for cumulative distribution functions (cdfs and survivor functions (sfs, instead of defining it separately for densities, cdfs, or sfs. Secondly, we consider a general “entropy generating function” φ, the same way Burbea et al. (IEEE Trans. Inf. Theory 1982, 28, 489–495 and Liese et al. (Convex Statistical Distances; Teubner-Verlag, 1987 did in the context of φ-divergences. Combining the ideas of φ-entropy and cumulative entropy leads to the new “cumulative paired φ-entropy” ( C P E φ . This new entropy has already been discussed in at least four scientific disciplines, be it with certain modifications or simplifications. In the fuzzy set theory, for example, cumulative paired φ-entropies were defined for membership functions, whereas in uncertainty and reliability theories some variations of C P E φ were recently considered as measures of information. With a single exception, the discussions in the scientific disciplines appear to be held independently of each other. We consider C P E φ for continuous cdfs and show that C P E φ is rather a measure of dispersion than a measure of information. In the first place, this will be demonstrated by deriving an upper bound which is determined by the standard deviation and by solving the maximum entropy problem under the restriction of a fixed variance. Next, this paper specifically shows that C P E φ satisfies the axioms of a dispersion measure. The corresponding dispersion functional can easily be estimated by an L-estimator, containing all its known asymptotic properties. C P E φ is the basis for several related concepts like mutual φ-information, φ-correlation, and φ-regression, which generalize Gini correlation and Gini regression. In addition, linear rank tests for scale that

  13. Rapid Health and Needs assessments after disasters: a systematic review

    Directory of Open Access Journals (Sweden)

    Yzermans CJ

    2010-06-01

    Full Text Available Abstract Background Publichealth care providers, stakeholders and policy makers request a rapid insight into health status and needs of the affected population after disasters. To our knowledge, there is no standardized rapid assessment tool for European countries. The aim of this article is to describe existing tools used internationally and analyze them for the development of a workable rapid assessment. Methods A review was conducted, including original studies concerning a rapid health and/or needs assessment. The studies used were published between 1980 and 2009. The electronic databasesof Medline, Embase, SciSearch and Psychinfo were used. Results Thirty-three studies were included for this review. The majority of the studies was of US origin and in most cases related to natural disasters, especially concerning the weather. In eighteen studies an assessment was conducted using a structured questionnaire, eleven studies used registries and four used both methods. Questionnaires were primarily used to asses the health needs, while data records were used to assess the health status of disaster victims. Conclusions Methods most commonly used were face to face interviews and data extracted from existing registries. Ideally, a rapid assessment tool is needed which does not add to the burden of disaster victims. In this perspective, the use of existing medical registries in combination with a brief questionnaire in the aftermath of disasters is the most promising. Since there is an increasing need for such a tool this approach needs further examination.

  14. Health assessment of hazardous air pollutants, The Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Vermeire, T.; van der Heijden, K. (National Institute of Public Health and Environmental Protection, Bilthoven (Netherlands))

    1990-10-01

    In The Netherlands, risk assessment of air pollutants goes back to 1980. From 1985 onwards the risk assessment of chemicals has crystallized in a systematic multi-media approach taking into account air, water, soil, and food. Criteria Documents support the formulation of environmental quality standards. Until now, 23 documents were prepared. Some toxicological aspects of the risk assessment for man in these documents are discussed with emphasis on carcinogenicity. As examples the main aspects of the risk assessments of benzene and trichloroethylene are described. A list of proposed health based standards for air pollutants is added.

  15. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. PMID:27021760

  16. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA.

  17. Uncertainties associated with assessing the public health risk from Legionella

    Directory of Open Access Journals (Sweden)

    Harriet eWhiley

    2014-09-01

    Full Text Available Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practises for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practises.

  18. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  19. "Sexual Health Assessment" for Mental Health and Medical Practitioners: Teaching Notes

    Science.gov (United States)

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

    The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…

  20. Dynamic population health modeling for quantitative health impact assessment : Methodological foundation and selected applications

    NARCIS (Netherlands)

    S.K. Lhachimi (Stefan)

    2011-01-01

    textabstractHealth Impact Assessment (HIA) – the evaluation policies, projects, or proposals concerning their effects on human health – becomes increasingly common practice at the local, national, and EU-level. So far, no standard tool exists to aid the quantification step in HIA. This thesis propos

  1. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    Science.gov (United States)

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  2. E-health readiness assessment: promoting "hope" in the health-care institutions of Pakistan.

    Science.gov (United States)

    Khoja, Shariq; Scott, Richard; Gilani, Salman

    2008-01-01

    e-Health readiness refers to the preparedness of health-care institutions to implement programmes that involve use of Information and Communication Technology (ICT) in provision and management of health services. Level of readiness depends on a number of factors that lead to success or failure of e-health programmes, and thus increase or decrease hope of achieving the desired results. This report presents results from in-depth interviews conducted during a larger study and presents views of managers and health-care providers from various institutions in Pakistan about the usefulness of e-health readiness assessment tools. Participants emphasized the need for implementing e-health programmes in the country, while appreciating the need for readiness assessment tools, and the way these tools could avoid failures related to implementation of e-health programmes. Participants also linked e-health readiness with the process of change management, essential for sustainable implementation of e-health programmes in the health-care institutions of developing countries.

  3. The Latino Mental Health Project: A Local Mental Health Needs Assessment

    OpenAIRE

    Cardemil, Esteban V.; Adams, Sara T.; Calista, Joanne L.; Connell, Joy; Encarnación, José; Esparza, Nancy K.; Frohock, Jeanne; Hicks, Ellen; Kim, Saeromi; Kokernak, Gerald; McGrenra, Michael; Mestre, Ray; Pérez, Maria; Pinedo, Tatiana M.; Quagan, Rosemary

    2007-01-01

    In this article, we present the results of a local needs assessment of the mental health experiences, service needs, and barriers to treatment-seeking of the Latino population in Worcester, Massachusetts. Overall, participants reported relatively high rates of experiences with symptoms of mental health problems, they indicated using a range of both formal and alternative mental health services, and they noted a variety of instrumental, attitudinal, and culturally-specific barriers to seeking ...

  4. The evolution of health literacy assessment tools: a systematic review

    OpenAIRE

    Altin, Sibel Vildan; Finke, Isabelle; Kautz-Freimuth, Sibylle; Stock, Stephanie

    2014-01-01

    Background Health literacy (HL) is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. By now, there is limited evidence on how the development of tools measuring HL proceeded in recent years and if scholars considered existing methodological guidance when developing an instrument. Methods We performed a systematic review of generic measurement tools developed to assess HL by searching PubMed, ERIC, CINAHL and Web of Kn...

  5. Health State Preference Assessment in Diabetic Peripheral Neuropathy

    OpenAIRE

    Sullivan, Sean D.; Doris P. Lew; E. Beth Devine; Zafar Hakim; Gayle E. Reiber; Veenstra, David L.

    2002-01-01

    Objective: To assess patient preferences for health states associated with diabetic peripheral neuropathy (DPN). Design and intervention: Seven health states describing varying stages of disease severity in DPN were developed: mild neuropathy, painful neuropathy, severe neuropathy, minor ulcer, severe ulcer, minor amputation and major amputation. Using a computer interview, both rating scale (RS) and standard gamble (SG) preference scores were elicited from 52 patients with diabetes mellitus....

  6. Environment, Safety and Health Progress Assessment of the Hanford Site

    International Nuclear Information System (INIS)

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES ampersand H) Progress Assessment of the Hanford Site, in Richland, Washington. The assessment, which was conducted from May 11 through May 22, 1992, included a selective-review of the ES ampersand H management systems and programs of the responsible DOE Headquarters Program Offices the DOE Richland Field Office, and the site contractors. The ES ampersand H Progress Assessments are part of the Secretary of Energy's continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the Hanford Site ES ampersand H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES ampersand H problems and requirements. They are not intended to be comprehensive compliance assessments of ES ampersand H activities. The point of reference for assessing programs at the Hanford Site was, for the most part, the Tiger Team Assessment of the Hanford Site, which was conducted from May 21 through July 18, 1990. A summary of issues and progress in the areas of environment, safety and health, and management is included

  7. Environment, Safety and Health Progress Assessment of the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

    This report documents the result of the US Department of Energy (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Hanford Site, in Richland, Washington. The assessment, which was conducted from May 11 through May 22, 1992, included a selective-review of the ES&H management systems and programs of the responsible DOE Headquarters Program Offices the DOE Richland Field Office, and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the Hanford Site ES&H Progress Assessment is to provide the Secretary with an independent assessment of the adequacy and effectiveness of the DOE and contractor management structures, resources, and systems to address ES&H problems and requirements. They are not intended to be comprehensive compliance assessments of ES&H activities. The point of reference for assessing programs at the Hanford Site was, for the most part, the Tiger Team Assessment of the Hanford Site, which was conducted from May 21 through July 18, 1990. A summary of issues and progress in the areas of environment, safety and health, and management is included.

  8. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

  9. Adaptive strategies for cumulative cultural learning.

    Science.gov (United States)

    Ehn, Micael; Laland, Kevin

    2012-05-21

    The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning.

  10. Cumulative Environmental Management Association : Wood Buffalo Region

    International Nuclear Information System (INIS)

    The recently announced oil sands development of the Wood Buffalo Region in Alberta was the focus of this power point presentation. Both mining and in situ development is expected to total $26 billion and 2.6 million barrels per day of bitumen production. This paper described the economic, social and environmental challenges facing the resource development of this region. In addition to the proposed oil sands projects, this region will accommodate the needs of conventional oil and gas production, forestry, building of pipelines and power lines, municipal development, recreation, tourism, mining exploration and open cast mining. The Cumulative Environmental Management Association (CEMA) was inaugurated as a non-profit association in April 2000, and includes 41 members from all sectors. Its major role is to ensure a sustainable ecosystem and to avoid any cumulative impacts on wildlife. Other work underway includes the study of soil and plant species diversity, and the effects of air emissions on human health, wildlife and vegetation. The bioaccumulation of heavy metals and their impacts on surface water and fish is also under consideration to ensure the quality and quantity of surface water and ground water. 3 figs

  11. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  12. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival. PMID:20659860

  13. A Resource Cost Aware Cumulative

    Science.gov (United States)

    Simonis, Helmut; Hadzic, Tarik

    We motivate and introduce an extension of the well-known cumulative constraint which deals with time and volume dependent cost of resources. Our research is primarily interested in scheduling problems under time and volume variable electricity costs, but the constraint equally applies to manpower scheduling when hourly rates differ over time and/or extra personnel incur higher hourly rates. We present a number of possible lower bounds on the cost, including a min-cost flow, different LP and MIP models, as well as greedy algorithms, and provide a theoretical and experimental comparison of the different methods.

  14. Assessment of health risks caused by air pollutants

    International Nuclear Information System (INIS)

    This report is a support document to an other report from the Swedish Environmental Protection Agency 'Risk assessment - a research programme aimed at health risks from air pollution in the general environment', report 3890, 1991 and is a survey of the scientific 'state of the art' in the different parts of risk assessment. Furthermore certain proposals are made concerning the scientific content of the future research in this area. (au)

  15. A framework for assessing e-health preparedness.

    Science.gov (United States)

    Wickramasinghe, Nilmini S; Fadlalla, Adam M A; Geisler, Elie; Schaffer, Jonathan L

    2005-01-01

    Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative. PMID:18048213

  16. An approach for assessing human health vulnerability and public health interventions to adapt to climate change.

    Science.gov (United States)

    Ebi, Kristie L; Kovats, R Sari; Menne, Bettina

    2006-12-01

    Assessments of the potential human health impacts of climate change are needed to inform the development of adaptation strategies, policies, and measures to lessen projected adverse impacts. We developed methods for country-level assessments to help policy makers make evidence-based decisions to increase resilience to current and future climates, and to provide information for national communications to the United Nations Framework Convention on Climate Change. The steps in an assessment should include the following: a) determine the scope of the assessment; b) describe the current distribution and burden of climate-sensitive health determinants and outcomes; c) identify and describe current strategies, policies, and measures designed to reduce the burden of climate-sensitive health determinants and outcomes; d) review the health implications of the potential impacts of climate variability and change in other sectors; e) estimate the future potential health impacts using scenarios of future changes in climate, socioeconomic, and other factors; f) synthesize the results; and g) identify additional adaptation policies and measures to reduce potential negative health impacts. Key issues for ensuring that an assessment is informative, timely, and useful include stakeholder involvement, an adequate management structure, and a communication strategy.

  17. The need for health impact assessment in China: Potential benefits for public health and steps forward

    International Nuclear Information System (INIS)

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  18. Experience and lessons from health impact assessment for human rights impact assessment.

    Science.gov (United States)

    Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

    2015-01-01

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated. PMID:26377091

  19. A paradox of cumulative culture.

    Science.gov (United States)

    Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

    2015-08-21

    Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem. PMID:25979371

  20. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    Science.gov (United States)

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  1. Integrating ethics in health technology assessment: many ways to Rome

    NARCIS (Netherlands)

    Hofmann, B.; Oortwijn, W.; Lysdahl, K. Bakke; Refolo, P.; Sacchini, D.; Wilt, G.J. van der; Gerhardus, A.

    2015-01-01

    OBJECTIVES: The aim of this study was to identify and discuss appropriate approaches to integrate ethical inquiry in health technology assessment (HTA). METHODS: The key question is how ethics can be integrated in HTA. This is addressed in two steps: by investigating what it means to integrate ethic

  2. PILOT VOLUNTEER TRAINING FOR WETLAND MONITORING AND HEALTH ASSESSMENT

    Science.gov (United States)

    Massachusetts Bays Estuary Program expressed a need to better assess and monitor the health of their saltmarshes. By training citizen volunteers in the methodologies of saltmarsh bioassessment, Mass Bays saw the additional opportunity to engage the public in their estuary protec...

  3. A 21st Century Roadmap for Human Health Risk Assessment

    Science.gov (United States)

    For decades human health risk assessment has depended primarily on animal testing to predict adverse effects in humans, but that paradigm has come under question because of calls for more accurate information, less use of animals, and more efficient use of resources. Moreover, t...

  4. Mapping of health technology assessment in selected countries

    NARCIS (Netherlands)

    Oortwijn, W.; Broos, P.; Vondeling, H.; Banta, D.; Todorova, L.

    2013-01-01

    Objectives: The aim of this study was to develop and apply an instrument to map the level of health technology assessment (HTA) development at country level in selected countries. We examined middle-income countries (Argentina, Brazil, India, Indonesia, Malaysia, Mexico, and Russia) and countries we

  5. Reimbursement of pharmaceuticals: Reference pricing versus health technology assessment

    NARCIS (Netherlands)

    M. Drummond (Michael); B. Jönsson (Bengt); F.F.H. Rutten (Frans); T. Stargardt (Tom)

    2011-01-01

    textabstractReference pricing and health technology assessment are policies commonly applied in order to obtain more value for money from pharmaceuticals. This study focussed on decisions about the initial price and reimbursement status of innovative drugs and discussed the consequences for market a

  6. Environmental Epigenetics: Potential Application in Human Health Risk Assessment

    Science.gov (United States)

    Although previous studies have shown a significant involvement of epigenetic dysregulation in human diseases, the applicability of epigenetic data in the current human health risk assessment paradigm is unclear. The goals of this study are to compare the relative sensitivities of...

  7. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    van Es, Harold

    2016-04-01

    Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

  8. Development and Implementation of Health Technology Assessment: A Policy Study

    Directory of Open Access Journals (Sweden)

    P Abooee

    2013-01-01

    Full Text Available Background: To provide an overview of the development of health technology assessment (HTA in Iran since 2007, and to facilitate further development of HTA and its integration into policy making.Methods: Data of this study were collected through key documents (e.g. literature, laws, and other official documentation and analyzed by experts of opinion in form of qualitative methods.Results: Health technology assessment entered to the political agenda in Iran only in 2007 with a strong impetus of an evidence-based medicine movement with the bellow objectives: Institutionalization of evidence-based decision making in Ministry of Health, Creating an localization for structural HTA in Health system of Iran, Setting up training courses in order to educate capable manpower to full up the capacity of the universities, Establishment of a new field in HTA subject in medical universities for MSc and PhD degree, International communication about HTA through national website and possible participation in international Congress.Conclusion: HTA has been established in the healthcare system of Iran but what is needed is a clear political will to push forward the objectives of HTA in Iran. Similar to other countries, advance the regulation on the adoption of new health technologies to improve not only technical or allocate efficiency, but also health equity.

  9. Assessment of health promotion content in undergraduate physiotherapy curricula

    Directory of Open Access Journals (Sweden)

    Kebogile Mokwena

    2015-04-01

    Full Text Available Background: The integration of health promotion in the treatment of patients should be included in all academic curricula in primary training of health professionals. However, the extent to which health promotion is included in the various curricula at undergraduate level is not known.Objective: To assess the extent to which health promotion content is integrated in undergraduate physiotherapy training programmes in South Africa. Method: This was a qualitative and descriptive study, using in-depth interviews with representatives of physiotherapy academic departments.Results: All universities have some content of health promotion, with the weighting varying between 12% and 40%. Health promotion is taught at various levels of study, and health promotion training blocks are in both urban and rural settings and include communities, schools and old-age homes. The theories of advocacy, enabling and mediation are covered, but there is limited practical training on these elements. There are limited human resources trained in health promotion, as well as a lack of clear processes of developing and reviewing teaching and training materials.Conclusion: There is lack of consensus on the weighting of health promotion, the level at which it is taught and how it is evaluated across universities. Challenges to integrate health promotion in physiotherapy curricula include lack of frequent curricula reviews, inadequate training of lecturers and lack of conducive practical sites.The physiotherapy profession needs to reach a consensus on minimum standards for integration of health promotion in undergraduate training, and the physiotherapy professional board has the potential to provide the required leadership.

  10. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    Science.gov (United States)

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. PMID:26774008

  11. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. PMID:27015612

  12. Migrants, health, and happiness: Evidence that health assessments travel with migrants and predict well-being.

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness.

  13. Health impact assessment. Schiphol airport. Overview of results until 1999

    Energy Technology Data Exchange (ETDEWEB)

    Franssen, E.A.M.; Lebret, E.; Staatsen, B.A.M.

    1999-07-01

    An English overview is given of the current results of the Dutch Health Impact Assessment Schiphol (HIAS) research programme. This programme consists of a series of studies with different designs. Results are described for each separate health end-point instead of by the separate studies: annoyance, cardiovascular diseases, sleep disturbance, respiratory diseases, perceived health, neurobehavioral effects, birth weight and perception of risks and residential satisfaction. Several of the more complex studies are still ongoing, or in the final stages of reporting. These concern a study of respiratory complaints in children in relation to air pollution and another of aircraft noise and sleep disturbance in adults. Based on the results of the HIAS a monitoring system will be developed to study the health status of the population periodically in relation to expansion of the airport.

  14. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. PMID:27117960

  15. Assessing the privacy policies in mobile personal health records.

    Science.gov (United States)

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs. PMID:25571104

  16. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making.

  17. Health Impact Assessment of an oil drilling project in California

    Directory of Open Access Journals (Sweden)

    Lindsay C. McCallum

    2016-04-01

    Full Text Available Objectives: The Health Impact Assessment (HIA was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability. Material and Methods: This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral. Results: There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space, and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values. Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Conclusions: Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool.

  18. Interview: Health technology assessment in Asia: an emerging trend.

    Science.gov (United States)

    Yang, Bong-min

    2012-05-01

    Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research. PMID:24237405

  19. Who comes to a workplace health risk assessment?

    Science.gov (United States)

    Dobbins, T A; Simpson, J M; Oldenburg, B; Owen, N; Harris, D

    1998-01-01

    Workplace health promotion initiatives have proliferated, but there are difficulties in recruiting employees of lower socioeconomic status and at higher risk of disease. A survey of health behaviors and attitudes was administered in 20 worksites and the opportunity to attend a health risk assessment promoted. Those more likely to attend were women, those of higher occupational prestige, and those from a non-English-speaking background. After adjustment for these variables, the only health behavior associated with attendance was smoking status. Perceived risk of lung cancer was significant, even after adjustment for smoking status. Stage of readiness to change health behaviors was associated with attendance, with those in the preparation stage being more likely to attend than those in the precontemplation stage. However, this association was statistically significant only for fruit and vegetable consumption. There was no relation between attendance and support for health promotion, perceived general health, or other perceived risk of disease. These findings suggest that additional risk communication strategies and environmental support are required to involve those with less prestigious occupations.

  20. An assessment of fiscal space for health in Bhutan.

    Science.gov (United States)

    Sharma, Jayendra

    2016-07-01

    Several factors are expected to put a strain on health financing in Bhutan. In a predominantly public-financed healthcare, ensuring that the health system gains sufficient fiscal space to ensure the sustainability of its financing is a critical policy concern. This fiscal space assessment bases its analysis on national surveys and statistics, international databases and review of official documents and reports. Assuming that the government health spending will continue to respond in the same way to growth as in the period 2002-2012, Bhutan can expect to see a robust increase in government investments in health. If elasticity of health expenditure with respect to GDP does not change significantly, projections indicate that per-capita government spending for health could more than double in the period 2012 to 2019. This increase from Ngultrum 2632 in 2012 to Ngultrum 6724 in 2019 could correspond to government health spending from 2.65% of GDP to 3.98% of GDP in the respective years. The country, however, needs to closely monitor and ensure that government investment in healthcare keeps pace with the growth of the national economy. Along with this, supplementary resources for healthcare could be explored through earmarked taxes and by generating efficiency gains. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25982663

  1. The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self-Assessed Health.

    Science.gov (United States)

    Darden, Michael; Gilleskie, Donna

    2016-08-01

    An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25981179

  2. The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self-Assessed Health.

    Science.gov (United States)

    Darden, Michael; Gilleskie, Donna

    2016-08-01

    An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Baltic Sea biodiversity status vs. cumulative human pressures

    DEFF Research Database (Denmark)

    Andersen, Jesper H.; Halpern, Benjamin S.; Korpinen, Samuli;

    2015-01-01

    Abstract Many studies have tried to explain spatial and temporal variations in biodiversity status of marine areas from a single-issue perspective, such as fishing pressure or coastal pollution, yet most continental seas experience a wide range of human pressures. Cumulative impact assessments have...

  4. Health-care technology assessment: a clinical perspective.

    Science.gov (United States)

    Chantler, Cyril

    2004-01-01

    Health technology assessment needs to relate to contemporary questions which concern public health-care systems: how to keep people healthy, how to focus on the needs of those with chronic disabilities and integrate care between the hospital and the community, how to encourage and audit effective teamwork, and how to establish a consensus about what is effective and affordable. Clinicians have an ethical responsibility to practice efficiently and economically, for profligacy in the care of one patient may mean that another is treated inadequately. For similar reasons, clinicians need to play a full role in the management of services. Advice from health technology assessment is vital and needs to be accurate, relevant, timely, clear, and accessible. As well as being concerned about what works, we need also to eliminate from practice what does not. Regular audit and appraisal of practice against the evidence base should be useful in this respect. Alternative approaches to management, such as the provision of care as opposed to aggressive treatments, need to be evaluated, and health technology assessment needs to consider how services are delivered, not just specific treatments. PMID:15176183

  5. Exposure assessment in studies on health effects of traffic exhaust

    Energy Technology Data Exchange (ETDEWEB)

    Setaelae, S. [Association for the Pulmonary Disabled, Helsinki (Finland); Jaakkola, J.J.K. [Helsinki Univ. (Finland). Dept. of Public Health

    1995-12-31

    A main source of outdoor air pollution is road traffic, which produces a complex mixture of nitrogen oxides, carbon monoxide, volatile hydrocarbons, airborne particles and some other compounds. Traffic exhaust affects also the concentrations of ozone and other photo chemical oxidants. In earlier studies those components have had remarkable health effects. Several studies on occupational exposure to automobile exhaust have been published and several studies have been observed an association between both outdoor and indoor pollutant levels and health outcomes. However, there are only a few epidemiological studies in which traffic exhaust, a complex mixture, has been studied in its entirety. During recent years, interesting epidemiological studies of the health effects of this complex mixture have been published. Human exposure assessment for traffic exhaust can be categorized according to the environment of exposure (indoors, outdoors, in-traffic) or to the method of exposure assessment (direct or indirect methods). In this presentation the methods are further categorized into (1) traffic activity, (2) air concentration measurements, and (3) dispersion models, in order to better understand the advantages and disadvantages of different approaches. The objective of this presentation is to make a critical review of exposure assessments in the epidemiological studies on health effects of traffic exhaust. (author)

  6. Forest ecosystem health assessment and analysis in China

    Institute of Scientific and Technical Information of China (English)

    XIAOFengjin; OUYANGHua; ZHANGQiang; FUBojie; ZHANGZhicheng

    2004-01-01

    Based on more than 300 forest sample plots surveying data and forestry statistical data, remote sensing information from the NOAA AVHRR database and the daily meteorological data of 300 stations, we selected vigor, organization and resilience as the indicators to assess large-scale forest ecosystem health in China and analyzed the spatial pattern of forest ecosystem health and influencing factors. The results of assessment indicated that the spatial pattern of forest ecosystem health showed a decreasing trend along latitude gradients and longitude gradients. The healthy forests are mainly distributed in natural forests, tropical rainforests and seasonal rainforests; secondarily orderly in northeast national forest zone, subtropical forest zonation and southwest forest zonation; while the unhealthy forests were mainly located in warm temperate zone and Xinjiang-Mongolia forest zone. The coefficient of correction between Forest Ecosystem Health Index (FEHI) and annual average precipitation was 0.58 (p<0.01), while the coefficient of correlation between FEHI and annual mean temperatures was 0.49 (p<0.01), which identified that the precipitation and temperatures affect the pattern of FEHI, and the precipitation's effect was stronger than the temperature's. We also measured the correlation coefficient between FEHI and NPP, biodiversity and resistance, which were 0.64, 0.76 and 0.81 (p<0.01) respectively. The order of effect on forest ecosystem health was vigor, organization and resistance.

  7. Human health risk assessment of heavy metals in urban stormwater.

    Science.gov (United States)

    Ma, Yukun; Egodawatta, Prasanna; McGree, James; Liu, An; Goonetilleke, Ashantha

    2016-07-01

    Toxic chemical pollutants such as heavy metals (HMs) are commonly present in urban stormwater. These pollutants can pose a significant risk to human health and hence a significant barrier for urban stormwater reuse. The primary aim of this study was to develop an approach for quantitatively assessing the risk to human health due to the presence of HMs in stormwater. This approach will lead to informed decision making in relation to risk management of urban stormwater reuse, enabling efficient implementation of appropriate treatment strategies. In this study, risks to human health from heavy metals were assessed as hazard index (HI) and quantified as a function of traffic and land use related parameters. Traffic and land use are the primary factors influencing heavy metal loads in the urban environment. The risks posed by heavy metals associated with total solids and fine solids (heavy metal does not pose a significant risk, the presence of multiple heavy metals could be detrimental to human health. These findings suggest that stormwater guidelines should consider the combined risk from multiple heavy metals rather than the threshold concentration of an individual species. Furthermore, it was found that risk to human health from heavy metals in stormwater is significantly influenced by traffic volume and the risk associated with stormwater from industrial areas is generally higher than that from commercial and residential areas.

  8. Stakeholder participation in health impact assessment: A multicultural approach

    Energy Technology Data Exchange (ETDEWEB)

    Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

    2013-11-15

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA.

  9. Stakeholder participation in health impact assessment: A multicultural approach

    International Nuclear Information System (INIS)

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

  10. Relationships Between Tobacco Abuse and Self-Assessment of Health.

    Science.gov (United States)

    Gawlikowska-Sroka, A; Dzięciołowska-Baran, E; Szczurowski, J

    2016-01-01

    Smoking cigarettes negatively influences the functioning of the body. Among other effects, it has an important impact on the respiratory system, circulation, and behavior. It leads to morphological and physiological changes in organs and tissues, so it can change mood. The aim of this study was to assess the relationships between tobacco abuse and self-assessment of health. The survey was conducted among Polish (243) and foreign (80) medical students at the Pomeranian Medical University in Szczecin, Poland. The study was based on a survey questionnaire of the authors' own design, comprising open and multi-choice questions. Our questionnaire was based on the international standard questionnaire from the Health Behavior in School-Aged Children study (Currie et al. 2009). 80 % of students surveyed were free of any chronic diseases. The results showed that only 23 % of the women and 20 % of the men assessed their health as very good, over 60 % as good, and the remaining at lower levels. We did not observe significant differences between smokers and non-smokers. Physical activity in both groups was generally assessed as good or sufficient. We did not observe significant differences between groups in the incidence of headache, abdominal pain, or vertigo. Significant differences were found in the intake of painkillers. PMID:26801152

  11. A Model for Risk Assessment in Health Care.

    Science.gov (United States)

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

    The purpose of our research is to reduce risks and hence prevent errors in the health care process. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from the world-known theoretical and practical models combined with experience in the Slovenian health care. The proposed organizational information model and software solution has a significant impact on the professional attention, communication and information, critical thinking, experience and knowledge. PMID:27332383

  12. Ethical assessment of national health insurance system of Korea.

    Science.gov (United States)

    Lee, Yuri; Kim, Soyoon; Kim, Ganglip

    2012-09-01

    The current adverse effects of the health insurance system in Korea are considered to be problems that arise from an insufficient reflection of the notion of respecting human rights. The ethical principles most commonly suggested and used in public health are the 4 principles suggested by Beauchamp and Childress in 1994. From the perspective of the community, these 4 principles of medical ethics can be expanded to resolve problems surrounding existing social systems from a socialistic standpoint. This article describes a flexible, easy-to-use model for incorporating the 4 medical ethics principles into the National Health Insurance System (NHIS). First, the principle of respect for autonomy involves respecting the decision-making capacities of autonomous medical consumers and providers and enabling individuals to make reasoned and informed choices. Second is the principle of good practice. The government and medical institutions should act in a way that benefits the health care consumers. The principle of prohibiting bad practice involves avoiding causing health problems. The National Health Insurance Corporation and health care providers should not harm the health care consumers. Finally, the principle of justice is concerned with distributing benefits, risks, and costs fairly-that is, the notion that patients in similar positions should be treated in a similar manner. If these problems are solved, health system quality could be better and more accessible and sustainable. The ethical assessment of the NHIS could be a trial to match the 4 medical ethics principles and the NHIS. It can be applied internationally to relevant policy makers in different settings.

  13. Health impact and damage cost assessment of pesticides in Europe.

    Science.gov (United States)

    Fantke, Peter; Friedrich, Rainer; Jolliet, Olivier

    2012-11-15

    Health impacts from pesticide use are of continuous concern in the European population, requiring a constant evaluation of European pesticide policy. However, health impacts have never been quantified accounting for specific crops contributing differently to overall human exposure as well as accounting for individual substances showing distinct environmental behavior and toxicity. We quantify health impacts and related damage costs from exposure to 133 pesticides applied in 24 European countries in 2003 adding up to almost 50% of the total pesticide mass applied in that year. Only 13 substances applied to 3 crop classes (grapes/vines, fruit trees, vegetables) contribute to 90% of the overall health impacts of about 2000 disability-adjusted life years in Europe per year corresponding to annual damage costs of 78 million Euro. Considering uncertainties along the full impact pathway mainly attributable to non-cancer dose-response relationships and residues in treated crops, we obtain an average burden of lifetime lost per person of 2.6 hours (95% confidence interval between 22 seconds and 45.3 days) or costs per person over lifetime of 12 Euro (95% confidence interval between 0.03 Euro and 5142 Euro), respectively. 33 of the 133 assessed substances accounting for 20% of health impacts in 2003 are now banned from the European market according to current legislation. The main limitation in assessing human health impacts from pesticides is related to the lack of systematic application data for all used substances. Since health impacts can be substantially influenced by the choice of pesticides, the need for more information about substance application becomes evident.

  14. The NICE ADHD health technology assessment: A review and critique

    Directory of Open Access Journals (Sweden)

    Schlander Michael

    2008-01-01

    Full Text Available Abstract Background Health technology assessments (HTAs by the National Institute for Health and Clinical Excellence (NICE enjoy high levels of international attention. The present analysis addresses NICE's appraisal of methylphenidate, atomoxetine and dexamphetamine for attention-deficit/hyperactivity disorder (ADHD in children and adolescents, published in March 2006. Methods A qualitative study of NICE Technology Appraisal No. 98 was done focusing on the >600-page technology assessment report, which aimed at evaluating ADHD treatment strategies by a clinical effectiveness review and an economic analysis using meta-analytical techniques and a cost-effectiveness model. Results The technology assessment was unable to differentiate between the various drugs in terms of efficacy, and its economic model was ultimately driven by cost differences. While the assessment concluded that the economic model "clearly identified an optimal treatment strategy" with first-line dexamphetamine, the NICE appraisal committee subsequently found it impossible to distinguish between the different strategies on grounds of cost-effectiveness. Analyzing the assessment reveals gaps and inconsistencies concerning data selection (ultimately relying on a small number of short-term studies only, data synthesis (pooling of heterogeneous study designs and clinical endpoints, and economic model structure (identifying double-counting of nonresponders as a likely source of bias, alongside further methodological anomalies. Conclusion Many conclusions of the NICE technology assessment rest on shaky grounds. There remains a need for a new, state-of-the-art systematic review of ADHD treatment strategies including economic evaluation, which ideally should address outcomes beyond children's health-related quality of life, such as long-term sequelae of the disorder and caregiver burden.

  15. Family Health Strategy: assessment and reasons for searching of health service by users

    Directory of Open Access Journals (Sweden)

    Loeste de Arruda-Barbosa

    2011-12-01

    Full Text Available Objective: To assess the evaluation of the users regarding the family health services and identify the main reasons that led them to seek such services. Methods: A descriptive study with qualitative approach, carried out in 5 Family Health Units with 25 users of theFamily Health Strategy (FHS of the city of Crato-CE, Brazil. The study took place from March to April 2009. Semi-structured interview was applied and recorded. We used thetechnique of thematic content analysis. Results: We found that the users of the FHS have great dissatisfaction, especially on the organization and access to health services, evaluating the family health as inefficient, although bringing care closer to the population, primarily through home visits. It was clear also that there is a search to the service mainly supported by curative vision and the acquisition of medicines. Conclusions: The subjects evaluate the organization and access to healthcare services as unsatisfactory, but value the actions, when there is a bond with the health team. However, there is still demand for health services, based on the search for medicines and medical consultation. Thus, it is necessary to improve services of the Family Health Strategy in Crato, with a view to ensure quality, accessibilityand greater resolution of health services.

  16. Assessment of environmental health in the 2012 East Azerbaijan earthquake

    Directory of Open Access Journals (Sweden)

    Farin Fatemi

    2013-09-01

    Material and Methods: Through multi-stages stratified sampling, we selected 8 and 4 villages from the earthquake zones of Heris and Varzaghan respectively. The collecting data tools in this research were the WHO checklist in 7 categories, 14 subcategories, and 37 environmental health activities and also the minimum standards of Sphere Project checklist. The status of environmental health in each village was assessed using the mentioned checklists. This study was carried out with attendance of research team in earthquake zones 21 days after the occurrence of earthquake. Results: Among the 37 environmental health activities, 7 activities were the joint ones, which Environmental Health Department had to carry it out with the coordination of other related organizations. In other words, the environmental health has the supervising role in these activities. Totally, such activities had more nonconformities compared with the activities in which environmental health was administered as the main responder. The details of results have been expressed in the full text. Conclusion: Providing intra-sector coordination, prioritizing the needs of the affected population and considering the principles of community based management in the natural disaster are proposed as the recommendations of this study.

  17. Assessment and forecast of Beijing and Shanghai's urban ecosystem health.

    Science.gov (United States)

    Li, Yongfa; Li, Dong

    2014-07-15

    In this paper, we first analyze the 5 most cited papers with the title containing "Urban ecosystem health" in Chinese academic journals, and 5 newer papers retrieved from the CSSCI (Chinese Social Sciences Citation Index). The results show that the number of indicators to be used together in more than three papers is 28, and then we select 27 of them to assess Beijing and Shanghai's urban ecosystem health from 2000 to 2011. Secondly, when we standardize the original data, the worst value adjustment coefficient is introduced innovatively. Thirdly, using the entropy method, the weights of concrete indicators of Beijing and Shanghai in the different adjustment coefficients are calculated respectively. Fourthly, based on the fuzzy matter-element method, using the Hamming approach degree, the two cities' ecosystem health index and the contribution value to overall health index from each component are calculated. Lastly, using gray prediction model, the evolutionary time response sequence function of Beijing and Shanghai's urban ecosystem health index is identified, and thus both cities' urban ecosystem health is predicted. PMID:24784740

  18. Assessment, authorization and access to medicaid managed mental health care.

    Science.gov (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  19. Observations on work force and training needs for assessing environmental health risks.

    OpenAIRE

    DeRoos, R L; Anderson, P N; Berberich, N J; Maugans, B; Omenn, G S; Rentos, P. G.

    1988-01-01

    The continuing discoveries of hazardous waste sites have stimulated environmental health risk assessment efforts in State and local environmental health agencies. Elements of risk assessment are defined, showing how risk assessment interfaces with risk management. Environmental health risk assessment involves work components (tasks, activities, and technologies), the worker (position, classification, and occupation), and work organization (purpose, outputs, and objectives). Information from s...

  20. Cumulative Carbon and Anthropocene Climate

    Science.gov (United States)

    Matthews, D.; Pierrehumbert, R.; Solomon, S.

    2010-12-01

    In this presentation we will highlight a few of the key findings of the recently completed National Research Council Study Climate Stabilization Targets: Emissions, Concentrations and Impacts over Decades to Millennia (NRC, 2010), and discuss their implications for planetary stewardship. A synthesis of published results shows that the single number which most characterizes the magnitude of the human imprint on the climate of the coming millennia is the net amount of carbon released as CO2 by fossil fuel burning and land use changes during the time over which humanity continues such activities. Details of emissions scenarios are not important; rather it is the net carbon released by the time the emissions have been brought to essentially zero that controls long-term climate changes. In this report, we estimate that global temperatures increase by about 1 degree for approximately every 570 Pg of carbon emitted. Each degree of global temperature change is associated with quantifiable impacts on human and natural systems, including loss of arctic sea ice, decreased productivity of several major food crops, decreased precipitation in dry regions, and increases in area burnt by wildfire. Furthermore, the long timescale of temperature changes due to cumulative carbon emissions entails a lock-in to many centuries of continued sea-level rise, as well as the possibility of substantial contributions to sea-level rise from both Greenland and the West-Antarctic ice sheet. Reductions in methane or other short-lived greenhouse gas emissions can be of benefit in mitigating the near term climate changes, but CO2 is unique among major greenhouse gases in its ability to disrupt climate on multi-millennial time scales. This implies a need for correspondingly special treatment of this gas in emissions control protocols, for example by setting targets for allowable cumulative carbon emissions over time. The authoring committee was composed of Susan Solomon, Chair, David Battisti, Scott

  1. Proposing a framework for Health Impact Assessment in Iran

    OpenAIRE

    Fakhri, Ali; Harris, Patrick; Maleki, MohammadReza

    2015-01-01

    Background Health impact assessments (HIA) of policies and projects are conducted differently in different contexts although there has been less HIA research to date in non-western countries. Global HIA research has however suggested that the technical conduct of HIAs is tied to broader conditions and influences to do with decision making and policy development. This study was conducted to develop a conceptual framework for progressing HIA in Iran including all factors influencing HIA plannin...

  2. Assessment of an Anomaly Detector for Jet Engine Health Monitoring

    OpenAIRE

    Sebastien Borguet; Olivier Léonard

    2011-01-01

    The goal of module performance analysis is to reliably assess the health of the main components of an aircraft engine. A predictive maintenance strategy can leverage this information to increase operability and safety as well as to reduce costs. Degradation undergone by an engine can be divided into gradual deterioration and accidental events. Kalman filters have proven very efficient at tracking progressive deterioration but are poor performers in the face of abrupt events. Adaptive estimati...

  3. Health technology assessment: the contribution of qualitative research.

    Science.gov (United States)

    Leys, Mark

    2003-01-01

    The pragmatism in health care has made health technology assessment (HTA) restrict its scope to a particular set of problems, c.q. methods. The "multidisciplinary and comprehensive nature" of HTA, as the concept is presented in certain definitions, is lacking. Health care is also dominated by a positivistic-rationalistic approach of evaluation. In contrast, social studies of evaluations learn that a major difference has to be made between scientific research on (potential) impact of a technology and valuing these effects. In this contribution, we will discuss how the positivistic scientific bias of current HTA practice can be made up with other research traditions. More specifically, we focus on the question of how social scientists and particularly how qualitative research can contribute to HTA, complementary to positivistic studies of evidence and efficacy. PMID:12862189

  4. Adopting a Clinical Assessment Framework in Older Adult Mental Health.

    Science.gov (United States)

    Hung, Lillian; Lee, Patience Anne; Au-Yeung, Andy T; Kucherova, Irina; Harrigan, MaryLou

    2016-07-01

    Obtaining new knowledge accepted and used by practitioners remains a slow process. A dearth of knowledge translation research exists that explores how to effectively move knowledge to practice in the field of older adult mental health. The current article reports findings of a knowledge translation study that examined what factors enabled the adoption of a new clinical assessment framework, P.I.E.C.E.S.™, into practice in an older adult tertiary mental health unit. Theoretical insights of appreciative inquiry were used to guide the study. Qualitative methods were used, including focus groups with 20 staff and individual interviews with three leaders. The appreciative inquiry approach helped researchers successfully facilitate knowledge translation. Enabling factors included: (a) fostering positive energy to make continuous improvement, (b) working with team members across disciplines at all levels, and (c) using knowledge translation tools to enable and sustain the new practice. [Journal of Psychosocial Nursing and Mental Health Services, 54 (7), 26-31.]. PMID:27362382

  5. [Health risk assessment of coke oven PAHs emissions].

    Science.gov (United States)

    Bo, Xin; Wang, Gang; Wen, Rou; Zhao, Chun-Li; Wu, Tie; Li, Shi-Bei

    2014-07-01

    Polycyclic aromatic hydrocarbons (PAHs) produced by coke oven are with strong toxicity and carcinogenicity. Taken typical coke oven of iron and steel enterprises as the case study, the dispersion and migration of 13 kinds of PAHs emitted from coke oven were analyzed using AERMOD dispersion model, the carcinogenic and non-carcinogenic risks at the receptors within the modeling domain were evaluated using BREEZE Risk Analyst and the Human Health Risk Assessment Protocol for Hazardous Waste Combustion (HHRAP) was followed, the health risks caused by PAHs emission from coke oven were quantitatively evaluated. The results indicated that attention should be paid to the non-carcinogenic risk of naphthalene emission (the maximum value was 0.97). The carcinogenic risks of each single pollutant were all below 1.0E-06, while the maximum value of total carcinogenic risk was 2.65E-06, which may have some influence on the health of local residents. PMID:25244863

  6. Clean Slate transportation and human health risk assessment

    International Nuclear Information System (INIS)

    Public concern regarding activities involving radioactive material generally focuses on the human health risk associated with exposure to ionizing radiation. This report describes the results of a risk analysis conducted to evaluate risk for excavation, handling, and transport of soil contaminated with transuranics at the Clean Slate sites. Transportation risks were estimated for public transport routes from the Tonopah Test Range (TTR) to the Envirocore disposal facility or to the Area 3 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS) for both radiological risk and risk due to traffic accidents. Human health risks were evaluated for occupational and radiation-related health effects to workers. This report was generated to respond to this public concern, to provide an evaluation of the risk, and to assess feasibility of transport of the contaminated soil for disposal

  7. Approaches to integrated monitoring for environmental health impact assessment

    Directory of Open Access Journals (Sweden)

    Liu Hai-Ying

    2012-11-01

    Full Text Available Abstract Although Integrated Environmental Health Monitoring (IEHM is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.

  8. Social and ethical analysis in health technology assessment.

    Science.gov (United States)

    Tantivess, Sripen

    2014-05-01

    This paper presents a review of the domestic and international literature on the assessment of the social and ethical implications of health technologies. It gives an overview of the key concepts, principles, and approaches that should be taken into account when conducting a social and ethical analysis within health technology assessment (HTA). Although there is growing consensus among healthcare experts that the social and ethical ramifications of a given technology should be examined before its adoption, the demand for this kind of analysis among policy-makers around the world, including in Thailand, has so far been lacking. Currently decision-makers mainly base technology adoption decisions using evidence on clinical effectiveness, value for money, and budget impact, while social and ethical aspects have been neglected. Despite the recognized importance of considering equity, justice, and social issues when making decisions regarding health resource allocation, the absence of internationally-accepted principles and methodologies, among other factors, hinders research in these areas. Given that developing internationally agreed standards takes time, it has been recommended that priority be given to defining processes that are justifiable, transparent, and contestable. A discussion of the current situation in Thailand concerning social and ethical analysis of health technologies is also presented. PMID:24964703

  9. Mutagenesis and teratogenesis as end points in health impact assessment

    International Nuclear Information System (INIS)

    The genetic and teratogenic effects of agents released to the environment as a consequence of energy production are exceedingly difficult to evaluate. Nevertheless, these effects on human health may be very costly in the context of cost-benefit analysis. In fact, the procedures required to limit mutagenic or teratogenic agents to the levels considered acceptable by regulatory bodies may constitute a major fraction of the cost of energy, especially where prudence dictates that a lack of empirical data requires extremely conservative regulations. Experience with ionizing radiation and with regulation of nuclear power installations illustrates the difficulty of genetic and teratogenic health impact assessment and the great uncertainties involved, as well as the influence of these impacts on the regulatory process and the consequent increased cost of power from this source. Data on genetic and teratogenic impacts on human health from chemical agents released to the environment by other energy technologies are much less complete, and, because of the large number of potentially active agents involved, it is evident that generic solutions to health impact assessment will be required to evaluate these energy alternatives

  10. Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

    Science.gov (United States)

    Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

    2016-09-01

    In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning.

  11. Assessing the Education and Training Needs of Nebraska's Public Health Workforce

    OpenAIRE

    Brandon L Grimm; Patrik eJohansson; Preethy eNayar; Betty eApenteng; Samuel eOpoku; Anh eNguyen

    2015-01-01

    IntroductionIn 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821) conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments and urban Indian clinic) public health workforce across three professional levels. The objectives of the needs assessment were to, determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health trainin...

  12. Assessing the role of GPs in Nordic health care systems.

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-01

    Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the "gate keeping" role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.

  13. ARIES: System for Health effects Assessment in industrial risk

    Energy Technology Data Exchange (ETDEWEB)

    Rabago, I.; Vidania, R. de; Inmaculada, S.

    1992-07-01

    In this work we present a general description of ARIES*, a tool designed in order to support the assessment of expected health effects derived from an accidental release of toxic compounds. ARIES includes two sequential and complementary steps. The first one (a quantitative phase) is being developed. for inhalation exposures, using numerical models, empirical correlations, physiological parameters and toxicological index, to estimate short term consequences over the exposed population. Next it will be published a new report were It will be described with detail the procedure designed to the quantitative assessment of the exposure. The system starts the assessment process with values of external concentrations which are processed, together with different exposure values (existing for humans and scaled up irom animals), as inputs for different kinds of models. From these, and other physiological values ARIES calculates the inhaled equivalent doses and the expected associated effects as a function of the exposure limes. Once overcome this first step, ARIES is complemented with an additional system that executes the selection of relevant information from toxicological data bases (qualitative phase). The system works , applying a string of filters and searches that displays selected Information, giving an additional support to the assessment. Both steps, just referred, are integrated into a logical informatics support. The informatics code is developed in dbase language even for the design of the procedure as for the mathematical models linked to the system ( extrapolation, dose inhaled models, etc.) to execute the numerical analysis of the assessment. The system has been designed in order to include progressively new chemicals and the improvements obtained in the development of mathematical models related with dose-effect relationships. At this moment, is programmed a first prototype of ARIES that can be executed in PC's and it can run for several products

  14. Utilization and Limitations of the American College Health Association's National College Health Assessment Instrument: A Systematic Review

    Science.gov (United States)

    Rahn, Rhonda N.; Pruitt, Buster; Goodson, Patricia

    2016-01-01

    Objective: To analyze the literature in which researchers have utilized the National College Health Assessment (NCHA) I or the NCHA II. Participants and Methods: The authors selected peer-reviewed articles published between 2004 and July 2013 utilizing a single search term: National College Health Assessment. Articles were assessed for instrument…

  15. Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

    Science.gov (United States)

    Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

    2003-01-01

    Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy. PMID:12802900

  16. A joint urban planning and public health framework: contributions to health impact assessment.

    Science.gov (United States)

    Northridge, Mary E; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public's health.

  17. Oral-to-inhalation route extrapolation in occupational health risk assessment: A critical assessment

    NARCIS (Netherlands)

    Rennen, M.A.J.; Bouwman, T.; Wilschut, A.; Bessems, J.G.M.; Heer, C.de

    2004-01-01

    Due to a lack of route-specific toxicity data, the health risks resulting from occupational exposure are frequently assessed by route-to-route (RtR) extrapolation based on oral toxicity data. Insight into the conditions for and the uncertainties connected with the application of RtR extrapolation ha

  18. 78 FR 15023 - Office of Health Assessment and Translation Webinar on the Assessment of Data Quality in Animal...

    Science.gov (United States)

    2013-03-08

    ... HUMAN SERVICES National Institutes of Health Office of Health Assessment and Translation Webinar on the... quality in animal studies. The Office of Health Assessment and Translation (OHAT), Division of the... known about current human exposure levels. OHAT also organizes workshops or state-...

  19. Endocrine disruptor phthalates in bottled water: daily exposure and health risk assessment in pregnant and lactating women.

    Science.gov (United States)

    Jeddi, Maryam Zare; Rastkari, Noushin; Ahmadkhaniha, Reza; Yunesian, Masud

    2016-09-01

    Over the last decade, the consumption of water bottled in polyethylene terephthalate (PET) has considerably increased, raising concerns over water quality and packaged materials. This study aims to investigate the levels of the anti-androgenic phthalates including bis-(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP), and benzyl butyl phthalate (BBP), in bottled water and its corresponding health risks in pregnant and lactating women. The phthalate levels were measured in six different brands of bottled water exposed to temperatures ranging between -18 and 40 °C and sunlight for 45 days. The phthalate was quantified using the gas chromatography-mass spectrometry (GC-MS). In addition, the non-carcinogenic effects were assessed using hazard quotient (HQ) approach, and cumulative health risk assessment was performed on the basis of hazard index (HI) calculation. In order to assess the carcinogenic risk due to the possible carcinogen DEHP (group 2B), the excess lifetime cancer risk (ELCR) was used. DEHP and DBP contaminants were detected at different storage conditions in all of the bottled water samples during the storage time. BBP was only detected at high temperature (≥25 °C) and outdoor conditions. The maximum concentrations of all phthalates were observed when water samples were kept at 40 °C. In contrast, storage at freezing conditions had no significant effect on the concentration level of all phthalates. The estimated intake by women was between 0.0021 μg/kg/day for BBP and 0.07 μg/kg/day for DEHP. The highest HQ for phthalate intake via bottled water consumption was much lower than 1 (HQ < 0.004), which implies that adverse effects are very unlikely to occur. The execution of a cumulative risk assessment for combined phthalate exposure demonstrated that the HIs for anti-androgenic effect were lower than 1 in all of the conditions. Furthermore, ELCR for DEHP based on the highest detected level was found to be less than 10(-6), which is

  20. Cumulate Fragments in Silicic Ignimbrites

    Science.gov (United States)

    Bachmann, O.; Ellis, B. S.; Wolff, J.

    2014-12-01

    Increasingly, studies are concluding that silicic ignimbrites are the result of the amalgamation of multiple discrete magma batches. Yet the existence of discrete batches presents a conundrum for magma generation and storage; if silicic magma batches are not generated nearly in situ in the upper crust, they must traverse, and reside within, a thermally hostile environment with large temperature gradients, resulting in low survivability in their shallow magmatic hearths. The Snake River Plain (Idaho, USA) is a type example of this 'multi-batch' assembly with ignimbrites containing multiple populations of pyroxene crystals, glass shards, and crystal aggregates. The ubiquitous crystal aggregates hint at a mechanism to facilitate the existence of multiple, relatively small batches of rhyolite in the upper crust. These aggregates contain the same plagioclase, pyroxene, and oxide mineral compositions as single phenocrysts of the same minerals in their host rocks, but they have significantly less silicic bulk compositions and lack quartz and sanidine, which occur as single phenocrysts in the deposits. This implies significant crystallization followed by melt extraction from mushy reservoir margins. The extracted melt then continues to evolve (crystallizing sanidine and quartz) while the melt-depleted margins provide an increasingly rigid and refractory network segregating the crystal-poor batches of magma. The hot, refractory, margins insulate the crystal-poor lenses, allowing (1) extended residence in the upper crust, and (2) preservation of chemical heterogeneities among batches. In contrast, systems that produce cumulates richer in low-temperature phases (quartz, K-feldspars, and/or biotite) favour remelting upon recharge, leading to less segregation of eruptible melt pockets and the formation of gradationally zoned ignimbrites. The occurrence of similar crystal aggregates from a variety of magmatic lineages suggests the generality of this process.

  1. Children neglected: Where cumulative risk theory fails.

    Science.gov (United States)

    O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

    2015-07-01

    Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. PMID:25869185

  2. A Photographic View of Cumulative Distribution Functions

    Science.gov (United States)

    Jernigan, Robert W.

    2008-01-01

    This article shows a concrete and easy recognizable view of a cumulative distribution function(cdf). Photograph views of the search tabs on dictionaries are used to increase students' understanding and facility with the concept of a cumulative distribution function. Projects for student investigations are also given. This motivation and view helps…

  3. An equity tool for health impact assessments: Reflections from Mongolia

    International Nuclear Information System (INIS)

    A health impact assessment (HIA) is a tool for assessing the potential effects of a project or policy on a population's health. In this paper, we discuss a tool for successfully integrating equity concerns into HIAs. This discussion is the product of collaboration by Mongolian and Canadian experts, and it incorporates comments and suggestions of participants of a workshop on equity focused HIAs that took place in Mongolia in October, 2010. Our motivation for discussing this tool is based on the observation that existing HIAs tend either to fail to define equity or use problematic accounts of this concept. In this paper we give an overview of socio-demographic and health indicators in Mongolia and briefly discuss its mining industry. We then review three accounts of equity and argue for the importance of developing a consensus understanding of this concept when integrating considerations of equity into an HIA. Finally, we present findings from the workshop in Mongolia and outline a tool, derived from lessons from this workshop, for critically considering and integrating the concept of equity into an HIA.

  4. Bridge health assessment system with fatigue analysis algorithm

    Science.gov (United States)

    Wang, Xuan; Wang, M. L.; Zhao, Yang

    2005-05-01

    A modern bridge is such a complicated system that is difficult to analyze by conventional mathematic tools. A rational bridge monitoring requires a good knowledge of the actual condition of various structural components. Fatigue analysis of concrete bridges is one of the most important problems. Concrete bridges are often undergoing a fatigue deterioration, starting with cracking and ending with large holes through the web. There is a need for the development of efficient health assessment system for fatigue evaluation and prediction of the remaining life. This information has clear economical consequences, as deficient bridges must be repaired or closed. The goal of this research is to provide a practical expert system in bridge health evaluation and improve the understanding of bridge behavior during their service. Efforts to develop a functional bridge monitoring system have mainly been concentrated upon successful implementation of experienced-based machine learning. The reliability of the techniques adopted for damage assessment is also important for bridge monitoring systems. By applying the system to an in-service PC bridge, it has been verified that this fuzzy logic expert system is effective and reliable for the bridge health evaluation.

  5. 78 FR 12764 - Draft Office of Health Assessment and Translation Approach for Systematic Review and Evidence...

    Science.gov (United States)

    2013-02-25

    ... for Systematic Review and Evidence Integration for Literature-Based Health Assessments--February 2013... out literature-based health assessments that incorporates systematic review methodology. Systematic... a framework for incorporating systematic review and evidence integration into NTP...

  6. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment

    Directory of Open Access Journals (Sweden)

    Lysdahl, Kristin Bakke

    2016-03-01

    Full Text Available Complexity entails methodological challenges in assessing health care interventions. In order to address these challenges, a series of characteristics of complexity have been identified in the Health Technology Assessment (HTA literature. These characteristics are primarily identified and developed to facilitate effectiveness, safety, and cost-effectiveness analysis. However, ethics is also a constitutive part of HTA, and it is not given that the conceptions of complexity that appears relevant for effectiveness, safety, and cost-effectiveness analysis are also relevant and directly applicable for ethical analysis in HTA. The objective of this article is therefore to identify and elaborate a set of key characteristics of complex health care interventions relevant for addressing ethical aspects in HTA. We start by investigating the relevance of the characteristics of complex interventions, as defined in the HTA literature. Most aspects of complexity found to be important when assessing effectiveness, safety, and efficiency turn out also to be relevant when assessing ethical issues of a given health technology. However, the importance and relevance of the complexity characteristics may differ when addressing ethical issues rather than effectiveness. Moreover, the moral challenges of a health care intervention may themselves contribute to the complexity. After identifying and analysing existing conceptions of complexity, we synthesise a set of five key characteristics of complexity for addressing ethical aspects in HTA: 1 multiple and changing perspectives, 2 indeterminate phenomena, 3 uncertain causality, 4 unpredictable outcome, and 5 ethical complexity. This may serve as an analytic tool in addressing ethical issues in HTA of complex interventions.

  7. Applying ethological and health indicators to practical animal welfare assessment.

    Science.gov (United States)

    Wemelsfelder, F; Mullan, S

    2014-04-01

    There is a growing effort worldwide to develop objective indicators for animal welfare assessment, which provide information on an animal's quality of life, are scientifically trustworthy, and can readily be used in practice by professionals. Animals are sentient beings capable of positive and negative emotion, and so these indicators should be sensitive not only to their physical health, but also to their experience of the conditions in which they live. This paper provides an outline of ethological research aimed at developing practical welfare assessment protocols. The first section focuses on the development and validation of welfare indicators generally, in terms of their relevance to animal well-being, their interobserver reliability, and the confidence with which the prevalence of described features can be estimated. Challenges in this work include accounting for the ways in which welfare measures may fluctuate over time, and identifying measures suited to monitoring positive welfare states. The second section focuses more specifically on qualitative welfare indicators, which assess the 'whole animal' and describe the expressive qualities of its demeanour (e.g. anxious, content). Such indicators must be validated in the same way as other health and behaviour indicators, with the added challenge of finding appropriate methods of measurement. The potential contribution of qualitative indicators, however, is to disclose an emotional richness in animals that helps to interpret information provided by other indicators, thus enhancing the validity of welfare assessment protocols. In conclusion, the paper emphasises the importance of integrating such different perspectives, showing that new knowledge of animals and new ways of relating to animals are both needed for the successful development of practical welfare assessment tools. PMID:25000783

  8. Health effects assessment of chemical exposures: ARIES methodology

    Energy Technology Data Exchange (ETDEWEB)

    Sierra, L; Montero, M.; Rabago, I.; Vidania, R.

    1995-07-01

    In this work, we present ARIES* update: a system designed in order to facilitate the human health effects assessment produced by accidental release of toxic chemicals. The first version of ARIES was developed in relation to 82/501/EEC Directive about mayor accidents in the chemical industry. So, the first aim was the support of the effects assessment derived for the chemicals included into this directive. From this establishment, it was considered acute exposures for high concentrations. In this report, we present the actual methodology for considering other type of exposures, such as environmental and occupational. Likewise other versions, the methodology comprises two approaches: quantitative and qualitative assessments. Quantitative assessment incorporates the mathematical algorithms useful to evaluate the effects produced by the most important routes of exposure: inhalation, ingestion, eye contact and skin absorption, in a short, medium and long term. It has been included models that realizes an accurate quantification of doses, effects,... and so on, such as simple approaches when the available information is not enough. Qualitative assessment, designed in order to complement or replace the previous one, is incorporated into an informatics system, developed in Clipper. It executes and displays outstanding and important toxicological information of about 100 chemicals. This information comes from ECDIN (Environmental Chemicals Data and Information Network) database through a collaboration with JRC-ISPRA working group. (Author) 24 refs.

  9. Health effects assessment of chemical exposures: ARIES methodology

    International Nuclear Information System (INIS)

    In this work, we present ARIES* update: a system designed in order to facilitate the human health effects assessment produced by accidental release of toxic chemicals. The first version of ARIES was developed in relation to 82/501/EEC Directive about mayor accidents in the chemical industry. So, the first aim was the support of the effects assessment derived for the chemicals included into this directive. From this establishment, it was considered acute exposures for high concentrations. In this report, we present the actual methodology for considering other type of exposures, such as environmental and occupational. Likewise other versions, the methodology comprises two approaches: quantitative and qualitative assessments. Quantitative assessment incorporates the mathematical algorithms useful to evaluate the effects produced by the most important routes of exposure: inhalation, ingestion, eye contact and skin absorption, in a short, medium and long term. It has been included models that realizes an accurate quantification of doses, effects,... and so on, such as simple approaches when the available information is not enough. Qualitative assessment, designed in order to complement or replace the previous one, is incorporated into an informatics system, developed in Clipper. It executes and displays outstanding and important toxicological information of about 100 chemicals. This information comes from ECDIN (Environmental Chemicals Data and Information Network) database through a collaboration with JRC-ISPRA working group. (Author) 24 refs

  10. The Latvian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

    Science.gov (United States)

    Rumba, I; Ruperto, N; Bikis, E; Remberga, S; Saulite, I; Plotkina, N; Viksna, A; Krauca, M; Breca, I; Vikmanis, U

    2001-01-01

    We report herein the results of the cross-cultural adaptation and validation into the Latvian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Latvian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. A total of 141 subjects were enrolled: 80 patients with JIA (16% systemic onset, 32.5% polyarticular onset, 19% extended oligoarticular subtype, and 32.5% persistent oligoarticular subtype) and 61 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Latvian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

  11. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  12. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

    Science.gov (United States)

    McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool. PMID:27597937

  13. Contamination of Sachet Water in Nigeria: Assessment and Health Impact

    Directory of Open Access Journals (Sweden)

    Omalu ICJ

    2011-01-01

    Full Text Available Adequate supply of fresh and clean drinking water is a basic need for all human beings. Water consumers are frequently unaware of the potential health risks associated with exposure to water borne contaminants which have often led to diseases like diarrhoea, cholera, dysentery, typhoid fever, legionnaire’s disease and parasitic diseases. The inadequacy of pipe borne water-supply in Nigeria is a growing problem; as a result people resort to buying water from vendors, and sachet or bottled water became a major source of drinking water. Although, portable and affordable, the problems of its purity and other health concerns have begun to manifest. Sachet water have been reported to contain bacteria such as Bacillus sp., Pseudomonas sp., Klebsiella sp., Streptococcus sp., and oocysts of Cryptosporidia sp. Apart from environmental contaminants, improper storage and handling by vendors also poses a serious threat to the health of the ignorant consumers. This paper tends to review the quality of these ‘pure water’; its physical examination, microbial assessments, its impacts on health, and the various strategies adopted by the concerned authorities to regulate this thriving industry.

  14. Exploring the role of GIS during community health assessment problem solving: experiences of public health professionals

    Directory of Open Access Journals (Sweden)

    Scotch Matthew

    2006-09-01

    Full Text Available Abstract Background A Community health assessment (CHA involves the use of Geographic Information Systems (GIS in conjunction with other software to analyze health and population data and perform numerical-spatial problem solving. There has been little research on identifying how public health professionals integrate this software during typical problem solving scenarios. A better understanding of this is needed to answer the "What" and the "How". The "What" identifies the specific software being used and the "How" explains the way they are integrated together during problem solving steps. This level of understanding will highlight the role of GIS utilization during problem solving and suggest to developers how GIS can be enhanced to better support data analysis during community health assessment. Results An online survey was developed to identify the information technology used during CHA analysis. The tasks were broken down into steps and for our analysis these steps were categorized by action: Data Management/Access, Data Navigation, Geographic Comparison, Detection of Spatial Boundaries, Spatial Modelling, and Ranking Analysis. 27 CHA professionals completed the survey, with the majority of participants (14 being from health departments. Statistical software (e.g. SPSS was the most popular software for all but one of the types of steps. For this step (detection of spatial boundaries, GIS was identified as the most popular technology. Conclusion Most CHA professionals indicated they use statistical software in conjunction with GIS. The statistical software appears to drive the analysis, while GIS is used primarily for simple spatial display (and not complex spatial analysis. This purpose of this survey was to thoroughly examine into the process of problem solving during community health assessment data analysis and to gauge how GIS is integrated with other software for this purpose. These findings suggest that GIS is used more for spatial

  15. Nutrition and Health Technology Assessment: When Two Worlds Meet

    Directory of Open Access Journals (Sweden)

    Marten J. Poley

    2015-10-01

    Full Text Available There is a growing recognition that nutrition may have a positive impact on public health and that it may reduce medical expenditures. Yet, such claims need to be substantiated by evidence. This evidence could be delivered by health technology assessment (HTA, which can be thought of as the evaluation of technologies for clinical effectiveness, cost-effectiveness, and ethical, legal, and social impacts. The application of HTA to the field of ‘nutrition interventions’ is recent. So far, HTA and nutrition have represented two worlds far apart in many respects. This contribution, roughly, addresses the following issues: is there a need for HTAs in the field of nutrition, what would such HTAs look like, and how can the results coming from these HTAs optimally aid policy making?

  16. Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice

    Directory of Open Access Journals (Sweden)

    Jonathan Heller

    2014-10-01

    Full Text Available Equity is a core value of Health Impact Assessment (HIA. Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1 the HIA process and products focused on equity; (2 the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3 the HIA resulted in a shift in power benefiting communities facing inequities; and (4 the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.

  17. Assessment of mercury health risks to adults from coal combustion

    Energy Technology Data Exchange (ETDEWEB)

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  18. Air pollutants and health outcomes: Assessment of confounding by influenza

    Science.gov (United States)

    Thach, Thuan-Quoc; Wong, Chit-Ming; Chan, King-Pan; Chau, Yuen-Kwan; Neil Thomas, G.; Ou, Chun-Quan; Yang, Lin; Peiris, Joseph S. M.; Lam, Tai-Hing; Hedley, Anthony J.

    2010-04-01

    We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996-2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus effects of influenza on associations between nitrogen dioxide (NO 2), sulfur dioxide (SO 2), particulate matter with aerodynamic diameter ≤10 μm (PM 10) and ozone (O 3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%). Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO 2 and stroke hospitalization with O 3. Following adjustment, changes in ER% for all pollutants were 0.1% for mortality from stroke with NO 2 and SO 2, cardiac or heart disease with NO 2, PM 10 and O 3, lower respiratory infections with NO 2 and O 3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO 2, SO 2 and O 3 and acute lower respiratory infections hospitalization with PM 10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by

  19. Cumulative psychosocial stress, coping resources, and preterm birth.

    Science.gov (United States)

    McDonald, Sheila W; Kingston, Dawn; Bayrampour, Hamideh; Dolan, Siobhan M; Tough, Suzanne C

    2014-12-01

    Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95 % CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95 % CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at psychosocial stress on the risk for early delivery.

  20. Vegan lifestyle behaviors: an exploration of congruence with health-related beliefs and assessed health indices.

    Science.gov (United States)

    Dyett, Patricia A; Sabaté, Joan; Haddad, Ella; Rajaram, Sujatha; Shavlik, David

    2013-08-01

    This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in health behaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean=22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use.

  1. Risk assessment of genetically modified crops for nutrition and health.

    Science.gov (United States)

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods.

  2. Health Technology Assessment of Magnetic Resonance Imaging in Shanxi Province

    Institute of Scientific and Technical Information of China (English)

    Yueze Liu; Jianwen Cao; Zuxun Lu

    2004-01-01

    Assess the current status of MRI in Shanxi province by health technology assessment method to provide suggestion and guidelines for future government decisions on the procurement and installation of new high-tech medical equipments. All of the 21 hospitals installed MRIs were surveyed.The results showed that 1 ) Diffusion of MRI is consistent with the economic development in different regional districts and hospital levels in Shanxi province. 2) There are better monetary returns of MRI in higher level hospitals than lower level hospitals. 3) Most MRIs in Shanxi province had been running at a loss, and the first class tertiary level hospitals had been making profit from providing MRI services to patients. 4) Better cost-benefit accorded with higher hospital level, more patients serviced etc. 5 ) The biggest investment risk is the initial purchase and installation of MRI. 6) Positive rates and veracity of MRI diagnosis were higher. 7) MRI is a safe equipment.

  3. mHealth in Chronic Pain Assessment: Present and Future.

    Science.gov (United States)

    Pliakos, Ioannis; Kefaliakos, Antonios; Diomidous, Marianna

    2016-01-01

    Chronic Pain (CP) is a condition which is difficult to assess. Existing methods are based on self-management treatments and leaving the big part of the assessment on the patient. According on this method, mHealth applications offer tools to CP patients to self-manage their condition and improve it. All the applications are limited by the type of data they collect and the data based on self-reporting. In the future the applications for CP management will not be based only on this type of data. Multiple types of data will be gathered and analyzed, as well as the specialists will be able to have a better prospective for the patients' pain levels. PMID:27350520

  4. mHealth in Chronic Pain Assessment: Present and Future.

    Science.gov (United States)

    Pliakos, Ioannis; Kefaliakos, Antonios; Diomidous, Marianna

    2016-01-01

    Chronic Pain (CP) is a condition which is difficult to assess. Existing methods are based on self-management treatments and leaving the big part of the assessment on the patient. According on this method, mHealth applications offer tools to CP patients to self-manage their condition and improve it. All the applications are limited by the type of data they collect and the data based on self-reporting. In the future the applications for CP management will not be based only on this type of data. Multiple types of data will be gathered and analyzed, as well as the specialists will be able to have a better prospective for the patients' pain levels.

  5. Risk assessment of genetically modified crops for nutrition and health.

    Science.gov (United States)

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods. PMID:19146501

  6. Assessing Community Health Risks: Proactive Vs Reactive Sampling

    Directory of Open Access Journals (Sweden)

    Sarah Taylor

    2009-01-01

    Full Text Available Problem statement: A considerable number of native birds died in the West Australian coastal town of Esperance and surroundings during late 2006 and early 2007, which raised community concerns about environmental contamination. Forensic investigations of dead birds suggested that lead may have been the causative agent. At the time, lead and nickel, as well as iron ore and other materials, were being exported through the Port of Esperance (port. Government agencies undertook a targeted environmental sampling programme to identify the exposure sources and the extent of contamination. Results of ambient air monitoring, blood lead level investigations and analysis of metals in rainwater tanks suggested widespread contamination of the Esperance town site with lead and nickel. The Department of Environment and Conservation (DEC retained Golder Associates Pty Ltd., (Golder to undertake a human health and ecological risk assessment (risk assessment using the information collected through the investigation of lead and nickel contamination in Esperance. The quantity and quality of exposure data are an important contributor to the uncertainty associated with the outcomes of a risk assessment. Conclusion: As the data were collected essentially as part of the emergency response to the events in Esperance, there was some uncertainty about the suitability and completeness of the data for risk assessment. The urgent nature of the emergency response meant that sampling was opportunistic and not necessarily sufficient or suitable for risk assessment from a methodical and scientific perspective. This study demonstrated the need for collecting ‘meaningful and reliable’ data for assessing risks from environmental contamination.

  7. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  8. Symmetric cumulants and event-plane correlations

    CERN Document Server

    Giacalone, Giuliano; Noronha-Hostler, Jacquelyn; Ollitrault, Jean-Yves

    2016-01-01

    The ALICE Collaboration has recently measured the correlations between amplitudes of anisotropic flow in different Fourier harmonics, referred to as symmetric cumulants. We derive approximate relations between symmetric cumulants involving $v_4$ and $v_5$ and the event-plane correlations measured by ATLAS. The validity of these relations is tested using event-by-event hydrodynamic calculations. The corresponding results are in better agreement with ALICE data than existing hydrodynamic predictions. We make quantitative predictions for three symmetric cumulants which are not yet measured.

  9. Nonlinear cumulative damage model for multiaxial fatigue

    Institute of Scientific and Technical Information of China (English)

    SHANG De-guang; SUN Guo-qin; DENG Jing; YAN Chu-liang

    2006-01-01

    On the basis of the continuum fatigue damage theory,a nonlinear uniaxial fatigue cumulative damage model is first proposed.In order to describe multiaxial fatigue damage characteristics,a nonlinear multiaxial fatigue cumulative damage model is developed based on the critical plane approach,The proposed model can consider the multiaxial fatigue limit,mean hydrostatic pressure and the unseparated characteristic for the damage variables and loading parameters.The recurrence formula of fatigue damage model was derived under multilevel loading,which is used to predict multiaxial fatigue life.The results showed that the proposed nonlinear multiaxial fatigue cumulative damage model is better than Miner's rule.

  10. Residential mental health assessment within Dutch criminal cases: a discussion.

    Science.gov (United States)

    van der Leij, J B; Jackson, J L; Malsch, M; Nijboer, J F

    2001-01-01

    In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a part-time basis by district courts. This article discusses the procedures applied in such cases as well as the relevant legal provisions. It focuses particularly on the clinical observation, evaluation, and reporting that is carried out over a number of weeks in the residential setting of the Pieter Baan Centrum. Specific attention is paid to procedures applied in this clinic. It is suggested that Dutch procedures for the use of mental health expertise can best be characterized by three aspects: multidisciplinary observation and reporting, the use of a sliding scale for indicating degree of responsibility, and, finally, the involvement and payment of experts by the state as such, rather than by the prosecution and/or the defense.

  11. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  12. Environmental and health impact assessment for ports in Thailand.

    Science.gov (United States)

    Chanchang, Chamchan; Sithisarankul, Pornchai; Supanitayanon, Thanawat

    2016-01-01

    Port development in Thailand is an essential part of the national maritime interest in connection with ship and shore activities. The growth of maritime industry and transportation has led to the expansion of ports' areas and capacity. Each port type causes different environmental impacts. Therefore, the Port Authority of Thailand has set up guidelines on ports' environmental management. This is divided into 3 major phases; namely, planning, construction and operation commencement periods. The Report of Environmental and Health Impact Assessment (EIA, HIA and EHIA) is regarded as the environmental management process in the planning period. It is a key tool to anticipate and prevent any adverse effects that might occur on the environment as well as community health resulting from the project implementation. This measure, in turn, creates advance preparation on both the preventive and problem-solving means before the project gets off the ground. At present, the majority of new projects on port development have still been in the process of information gathering for EHIA submission. Some cannot start to operate due to their EHIA failure. For example, the Tha-sala port which did not pass EHIA, mainly because emphasis had been focused on adhering to legal regulations without taking into consideration the in-depth analysis of data being conducted by community entities in the area. Thus caused the project to be finally abolished. Impact assessment on environment and health should be aimed at detailed understanding of the community in each particular area so that effective data of objective achievement in preventing environmental problems could actually be carried out and welcomed by the concerned society. PMID:27364177

  13. Development of the eHealth Literacy Assessment Toolkit, eHLA

    DEFF Research Database (Denmark)

    Lauritzen, Dorthe Furstrand; Kayser, Lars

    2015-01-01

    In a world with rising focus on the use of eHealth, the match between the competences of the individual and the demands of eHealth systems becomes increasingly important, thus making assessment of eHealth literacy as a measure of user competences a vital element. We propose the eHealth Literacy...... Assessment toolkit, eHLA, evaluating the user by seven scales: computer familiarity, confidence, incentive and performance as well as functional health literacy, health literacy self-assessment and health literacy performance, as a first step toward development of technology that accommodates the literacy...

  14. Teaching Community Health Assessment Skills in a Problem-based Format.

    Science.gov (United States)

    Sass, Pamela; Edelsack, Pyser

    2001-01-01

    Describes a four-week rotation at the State University of New York Health Science Center in Brooklyn in which medical residents are taught community health assessment using a problem-based format. They use demographic and health data to create rates they believe will help to illuminate the health status and health issues of their assigned…

  15. Assessing the Physical Activity of Health Volunteers Based on the Pender’s Health Promotion Model

    Directory of Open Access Journals (Sweden)

    Rahimian M.* MSc,

    2015-12-01

    Full Text Available Aims Physical inactivity has been identified as the 4th leading risk factor for global mortality causing an estimated of 3.2million deaths per year. This study aimed to assess the physical activity of health volunteers with Pender’s Health Promotion Model. Instrument & Methods This cross-sectional analytical study was performed on 80 health volunteers in Torbat-e-Jam City, Iran, in 2015. A researcher-made questionnaire with the following sections was used to gather data; perceived benefits, perceived barriers, selfefficacy, interpersonal influences, positive emotion, commitment, modeling and competing preferences. SPSS 16 sofware was used to analyze data by independent T, Pearson’s correlation coefficient and linear regression tests. Findings There was no significant difference between the scores according to educational levels, age groups, BMI score, marital status, habitat and experience as a health volunteer duration. Physical activity had positive correlation with perceived benefits, self-efficacy, commitment, positive emotion and situational influences and a negative correlation with perceived barriers. Situational influences, as the strongest predictor of the physical activity, predicted 35.1% of it and then positive emotions predicted 34.7% and self-efficacy predicted 23.4% of physical activity. Conclusion The level of physical activity in health volunteers of Torbat-e-Jam City, Iran, is not appropriate and is less than moderate.

  16. Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

    Science.gov (United States)

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. PMID:26399633

  17. Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

    Science.gov (United States)

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner.

  18. Assessing the Impact of a Human Rights-Based Approach across a Spectrum of Change for Women's, Children's, and Adolescents' Health.

    Science.gov (United States)

    Thomas, Rebekah; Kuruvilla, Shyama; Hinton, Rachel; Jensen, Steven L B; Magar, Veronica; Bustreo, Flavia

    2015-12-10

    Global momentum around women's, children's, and adolescents' health, coupled with the ambitious and equalizing agenda of the Sustainable Development Goals (SDGs), has exposed a tension between the need for comprehensive, multi-actor, rights-based approaches that seek to "close the gaps" and a growing economic and political imperative to demonstrate efficiency, effectiveness, and returns on specific investments. To address this challenge, this paper proposes a framework to measure "results" in a way that offers a more nuanced understanding of the impact of human rights-based approaches and their complexity, as well as their contextual, multi-sectoral, and evolving nature. We argue that the impact of human rights-based approaches is best measured across a spectrum of change-at the individual, programmatic, structural, and societal levels. Such an analysis would allow for more accurate assessments of the cumulative effect of these changes. The paper also underscores the long-overdue need to better define the parameters of a human rights-based approach to health. This is an important part of the research agenda on human rights and health in the context of the SDGs and the Global Strategy for Women's, Children's and Adolescents' Health, and amid calls for better measurement and greater accountability for resources, results, and rights at all levels. While this paper focuses on women's, children's, and adolescents' health, the proposed framework can apply as readily to other areas of health and provides a new frame of reference for assessing the impact of human rights-based approaches.

  19. A global human health risk assessment for Decamethylcyclopentasiloxane (D5).

    Science.gov (United States)

    Franzen, Allison; Van Landingham, Cynthia; Greene, Tracy; Plotzke, Kathy; Gentry, Robinan

    2016-02-01

    Decamethylcyclopentasiloxane (D5) is a low-molecular-weight cyclic siloxane used primarily as an intermediate in the production of several widely-used industrial and consumer products and intentionally added to consumer products, personal products and some dry cleaning solvents. The global use requires consideration of consumer use information and risk assessment requirements from various sources and authoritative bodies. A global "harmonized" risk assessment was conducted to meet requirements for substance-specific risk assessments conducted by regulatory agencies such as USEPA's Integrated Risk Information System (IRIS), Health Canada and various independent scientific committees of the European Commission, as well as provide guidance for chemical safety assessments under REACH in Europe, and other relevant authoritative bodies. This risk assessment incorporates global exposure information combined with a Monte Carlo analysis to determine the most significant routes of exposure, utilization of a multi-species, multi-route physiologically based pharmacokinetic (PBPK) model to estimate internal dose metrics, benchmark modeling to determine a point of departure (POD), and a margin of safety (MOS) evaluation to compare the estimates of intake with the POD. Because of the specific pharmacokinetic behaviors of D5 including high lipophilicity, high volatility with low blood-to-air partition coefficients and extensive metabolic clearance that regulate tissue dose after exposure, the use of a PBPK model was essential to provide a comparison of a dose metric that reflects these processes. The characterization of the potential for adverse effects after exposure to D5 using a MOS approach based on an internal dose metric removes the subjective application of uncertainty factors that may be applied across various regulatory agencies and allows examination of the differences between internal dose metrics associated with exposure and those associated with adverse effects. PMID

  20. Vegetation Health and Productivity Indicators for Sustained National Climate Assessments

    Science.gov (United States)

    Jones, M. O.; Running, S. W.

    2014-12-01

    The National Climate Assessment process is developing a system of physical, ecological, and societal indicators that communicate key aspects of the physical climate, climate impacts, vulnerabilities, and preparedness for the purpose of informing both decision makers and the public. Implementing a 14 year record of Gross and Net Primary Productivity (GPP/NPP) derived from the NASA EOS MODIS satellite sensor we demonstrate how these products can serve as Ecosystem Productivity and Vegetation Health National Climate Indicators for implementation in sustained National Climate Assessments. The NPP product combines MODIS vegetation data with daily global meteorology to calculate annual growth of all plant material at 1 sq. km resolution. NPP anomalies identify regions with above or below average plant growth that may result from climate fluctuations and can inform carbon source/sink dynamics, agricultural and forestry yield measures, and response to wildfire or drought conditions. The GPP product provides a high temporal resolution (8-day) metric of vegetation growth which can be used to monitor short-term vegetation response to extreme events and implemented to derive vegetation phenology metrics; growing season start, end, and length, which can elucidate land cover and regionally specific vegetation responses to a changing climate. The high spatial resolution GPP and NPP indicators can also inform and clarify responses seen from other proposed Pilot Indicators such as forest growth/productivity, land cover, crop production, and phenology. The GPP and NPP data are in continuous production and will be sustained into the future with the next generation satellite missions. The long-term Ecosystem Productivity and Vegetation Health Indicators are ideal for use in sustained National Climate Assessments, providing regionally specific responses to a changing climate and complete coverage at the national scale.

  1. Pesticide assessment: Protecting public health on the home turf.

    Science.gov (United States)

    Sears, Meg; Walker, C Robin; van der Jagt, Richard Hc; Claman, Paul

    2006-04-01

    Pesticide regulation is examined in the context of Health Canada's Pest Management Regulatory Agency's assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec's Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.

  2. [Assessing the impact of the environment on human health].

    Science.gov (United States)

    Locatelli, Marine

    2016-05-01

    In public health, nurses are concerned with the global health of populations. A recently qualified nurse, interested in this area of health, enhanced her skills with a master's degree specialising in the links between the environment and health.

  3. Nanomaterials safety assessment: contribution from the Portuguese National Institute of Health (INSA) research

    OpenAIRE

    Albuquerque, José Maria

    2015-01-01

    The National Health Institute Doutor Ricardo Jorge (INSA) is a public organization of the Portuguese Ministry of Health, which develops a triple role as State Laboratory in the health sector, National Reference Laboratory and National Health Observatory. All operative units composing the departments develop multidisciplinary programs in problem areas of Public Health, namely performing R&D, health monitoring, training, laboratory external quality assessment and general health services. INS...

  4. [COMPREHENSIVE ASSESSMENT OF HEALTH IN BABIES OF EARLY PRESCHOOL AGE].

    Science.gov (United States)

    Denisov, A P; Semenova, N V; Kun, O A; Denisova, O A

    2015-01-01

    Health of the children's population is one of the most important components of safety of the country. The incidence level in children of early age reflects an interaction of economic, ecological, social and hygienic and medico-organizational factors in society. The issue of the paper is the comprehensive assessment of health of children of the first three years of life upon indices of the morbidity rate, physical development, interrelation of given indices with the structure of the family and their social status. Indices of the physical development of boys in the all age groups exceeded the corresponding indices in girls (p children along with the age (p children was established in the first year of life, the minimal one--in the third year. In the all age groups diseases of respiratory organs prevailed, at this their proportion in the total amount of diseases in the third year of life considerably exceeded the same in first and second years of life. The highest incidences of children took place in the families formed by juvenile and lonely women. Diseases of digestive organs in the second and third years of life in children from juvenile and lonely mothers were considerably enlarged on frequency (by 1,4-1,7 times), infectious and parasitic diseases (by 1,1-1,7 times) in comparison with children from full families. In the all studied types offamilies and age groups the state of health of children was worse, than in full families. There was substantiated the development of the multilevel system for the prophylaxis of losses of health in children at early preschool age. PMID:26856178

  5. A framework for assessing the performance of health systems.

    OpenAIRE

    Murray, C. J.; Frenk, J.

    2000-01-01

    Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, t...

  6. Environmental health risk assessment and management for global climate change

    Science.gov (United States)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

  7. Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

    Science.gov (United States)

    Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

    2014-01-01

    Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

  8. Risk management assessment of Health Maintenance Organisations participating in the National Health Insurance Scheme

    Directory of Open Access Journals (Sweden)

    Princess Christina Campbell

    2014-01-01

    Full Text Available Background: The National Health Insurance Scheme (NHIS, operated majorly in Nigeria by health maintenance organisations (HMOs, took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%. The other risk-management strategies not utilised in the NHIS 10 (47.4% were risk equalisation and reinsurance. As high as 11 (52.4% of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1% were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4% participated in the Millennium development goal (MDG maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance.

  9. Pion interferometry with higher-order cumulants

    OpenAIRE

    Eggers, H. C.; Buschbeck, B.; Lipa, P.

    1996-01-01

    We have measured second- and third-order cumulants in UA1 data ($\\bar pp$ collisions at 630 GeV/c). Rather than quoting numerical values for source parameters, we have used these in three checks to test the ``quantum statistics'' theory for consistency over these cumulants. In the process, we have found a method for folding theoretical correlation functions with experimental one-particle distributions. Our preliminary results appear to indicate that, for the specific tests performed, the data...

  10. Human cumulative culture: a comparative perspective.

    Science.gov (United States)

    Dean, Lewis G; Vale, Gill L; Laland, Kevin N; Flynn, Emma; Kendal, Rachel L

    2014-05-01

    Many animals exhibit social learning and behavioural traditions, but human culture exhibits unparalleled complexity and diversity, and is unambiguously cumulative in character. These similarities and differences have spawned a debate over whether animal traditions and human culture are reliant on homologous or analogous psychological processes. Human cumulative culture combines high-fidelity transmission of cultural knowledge with beneficial modifications to generate a 'ratcheting' in technological complexity, leading to the development of traits far more complex than one individual could invent alone. Claims have been made for cumulative culture in several species of animals, including chimpanzees, orangutans and New Caledonian crows, but these remain contentious. Whilst initial work on the topic of cumulative culture was largely theoretical, employing mathematical methods developed by population biologists, in recent years researchers from a wide range of disciplines, including psychology, biology, economics, biological anthropology, linguistics and archaeology, have turned their attention to the experimental investigation of cumulative culture. We review this literature, highlighting advances made in understanding the underlying processes of cumulative culture and emphasising areas of agreement and disagreement amongst investigators in separate fields. PMID:24033987

  11. Combining environment and health information systems for the assessment of atmospheric pollution on human health.

    Science.gov (United States)

    Skouloudis, Andreas N; Kassomenos, Pavlos

    2014-08-01

    The use of emerging technologies for environmental monitoring with satellite and in-situ sensors have become essential instruments for assessing the impact of environmental pollution on human health, especially in areas that require high spatial and temporal resolution. This was until recently a rather difficult problem. Regrettably, with classical approaches the spatial resolution is frequently inadequate in reporting environmental causes and health effects in the same time scale. This work examines with new tools different levels of air-quality with sensor monitoring with the aim to associate those with severe health effects. The process established here facilitates the precise representation of human exposure with the population attributed in a fine spatial grid and taking into account environmental stressors of human exposure. These stressors can be monitored with innovative sensor units with a temporal resolution that accurately describes chronic and acute environmental burdens. The current understanding of the situation in densely populated areas can be properly analyzed, before commitments are made for reductions in total emissions as well as for assessing the effects of reduced trans-boundary fluxes. In addition, the data processed here with in-situ sensors can assist in establishing more effective regulatory policies for the protection of vulnerable population groups and the satellite monitoring instruments permit abatement strategies that are close to real-time over large geographical areas.

  12. Assessment of an Anomaly Detector for Jet Engine Health Monitoring

    Directory of Open Access Journals (Sweden)

    Sebastien Borguet

    2011-01-01

    Full Text Available The goal of module performance analysis is to reliably assess the health of the main components of an aircraft engine. A predictive maintenance strategy can leverage this information to increase operability and safety as well as to reduce costs. Degradation undergone by an engine can be divided into gradual deterioration and accidental events. Kalman filters have proven very efficient at tracking progressive deterioration but are poor performers in the face of abrupt events. Adaptive estimation is considered as an appropriate solution to this deficiency. This paper reports the evaluation of the detection capability of an adaptive diagnosis tool on the basis of simulated scenarios that may be encountered during the operation of a commercial turbofan engine. The diagnosis tool combines a Kalman filter and a secondary system that monitors the residuals. This auxiliary component implements a generalised likelihood ratio test in order to detect abrupt events.

  13. Oral contraceptive use and impact of cumulative intake of estrogen and progestin on risk of ovarian cancer

    DEFF Research Database (Denmark)

    Faber, M T; Jensen, A; Frederiksen, K;

    2013-01-01

    Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk.......Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk....

  14. Investigating Underlying Principles to Guide Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Ali Fakhri

    2014-06-01

    Full Text Available Background Many countries conduct Health Impact Assessment (HIA of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods This study was conducted in three stages: 1 Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2 The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3 Finally, these principles were agreed by experts using nominal group technique. Results The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion Determining the principles of HIA from

  15. Investigating underlying principles to guide health impact assessment

    Science.gov (United States)

    Fakhri, Ali; Maleki, Mohammadreza; Gohari, Mahmoodreza; Harris, Patrick

    2014-01-01

    Background: Many countries conduct Health Impact Assessment (HIA) of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods: This study was conducted in three stages: 1) Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2) The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3) Finally, these principles were agreed by experts using nominal group technique. Results: The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion: Determining the principles of HIA from peer

  16. Technical Consultation of the Hubble Space Telescope (HST) System Health Assessment: Analysis of HST Health

    Science.gov (United States)

    Gentz, Steven J.; Heard, Brent N.; Hodson, Robert F.; Pettit, Duane H.; Pandolf, John E.; Azzolini, John D.; Dennehy, Cornelius J.; Farley, Rodger E.; Kirchman, Frank J.; Spidaliere, Peter D.

    2005-01-01

    The NESC conducted an abridged independent examination of available information and personnel interviews to evaluate the current and anticipated state of the spacecraft subsystems and the parameters that describe the HST's health. These examinations included the projected timeliness of a robotic SM and whether the GSFC baseline concept is likely to provide the capability to extend the useful scientific life of the HST by an additional 5 years. The NESC team collected a broad spectrum of pertinent HST Program analyses, reports, briefings, and the results of the IPAO and the Aerospace Corporation AOA assessments as they relate to the degradation of the HST s health. This review included the state of the HST subsystems having the potential to impact the viability of the HST, but will not be serviced under the baseline robotic SM.

  17. Reflections on the social epidemiologic dimension of health technology assessment.

    Science.gov (United States)

    Kazanjian, Arminée

    2004-01-01

    Certain key parameters such as safety, efficacy, effectiveness, and cost effectiveness have long been established as key in HTA analysis. Equally important, however, are sociolegal and epidemiologic perspectives. A comprehensive analytic framework will consider the implications of using a technology in the context of societal norms, cultural values, and social institutions and relations. The methodology in which this expanded framework has been developed is termed 'Strategic HTA' to denote its power for the decision-making process. In addition to systematic reviews of published evidence, it incorporates analyses of the influence of dominant social relations on technological development and diffusion. This essay discusses the social epidemiologic aspects of health technology assessment, which includes factors such as sex and gender. It seeks to show how it is possible to bring data from wide-ranging disciplinary perspectives within the parameters of a single scientific inquiry; to draw from them scientifically defensible conclusions; and thereby to realize a deeper understanding of technology impact within a health care system. Armed with such an understanding, policy officials will be better prepared to resolve the competitive clamor of stakeholder voices, and to make the most "equitable" use of the available resources. PMID:15209176

  18. Public health risk assessment of groundwater contamination in Batman, Turkey.

    Science.gov (United States)

    Nalbantcilar, M Tahir; Pinarkara, Sukru Yavuz

    2016-08-01

    In this study, a comprehensive analysis of groundwater was performed to assess contamination and phenol content in Batman, Turkey, particularly in residential areas near agriculture, livestock and oil industry facilities. From these areas, where potentially contaminated groundwater used for drinking and irrigation threatens public health, 30 groundwater samples were collected and analyzed for heavy metal concentrations (Al, As, B, Ba, Ca, Cd, Cl, Co, Cr, Cu, Fe, Hg, Li, Mg, Mn, Mo, Na, Ni, NO3, P, Pb, phenol, S, Sb, Se, SO4, Sr, U, and Zn). Compared with the standards of the Environmental Protection Agency, Al, Fe, and Mn concentrations in groundwater exceeded secondary drinking water regulations, NO3 concentrations were high for maximum contaminant levels, and As, Pb, and U concentrations exceeded maximum contaminant level goals in all samples. Ni, Sb, and Se concentrations also exceeded limits set by the Turkish Standards Institution. Nearly all samples revealed concentrations of Se, Sb, Hg, and phenol due to nearby petroleum refineries, oil storage plants, and agricultural and livestock areas. The results obtained from this study indicate that the groundwater in Batman contains elements in concentrations that approach or exceed limits and thus threatens public health with increased blood cholesterol, decreased blood sugar, and circulatory problems. PMID:27441860

  19. An Assessment of Integrated Health Management (IHM) Frameworks

    Energy Technology Data Exchange (ETDEWEB)

    N. Lybeck; M. Tawfik; L. Bond; J. Coble

    2012-05-01

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  20. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    In order to meet the ever increasing demand for energy, the United States (U.S.) nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework-a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  1. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging nuclear power plants presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to the better understanding and management of the challenges posed by aging nuclear power plants. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of a NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of a NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system

  2. Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback

    OpenAIRE

    Kraaijenhagen Roderik A; Vosbergen Sandra; Peek Niels; Niessen Maurice AJ; Colkesen Ersen B; van Kalken Coenraad K; Tijssen Jan GP; Peters Ron JG

    2011-01-01

    Abstract Background Primary prevention programs at the worksite can improve employee health and reduce the burden of cardiovascular disease. Programs that include a web-based health risk assessment (HRA) with tailored feedback hold the advantage of simultaneously increasing awareness of risk and enhancing initiation of health-behaviour change. In this study we evaluated initial health-behaviour change among employees who voluntarily participated in such a HRA program. Methods We conducted a q...

  3. Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

    Energy Technology Data Exchange (ETDEWEB)

    Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)

    1990-12-31

    The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

  4. Health Literacy Assessment of the STOFHLA: Paper versus Electronic Administration Continuation Study

    Science.gov (United States)

    Chesser, Amy K.; Keene Woods, Nikki; Wipperman, Jennifer; Wilson, Rachel; Dong, Frank

    2014-01-01

    Low health literacy is associated with poor health outcomes. Research is needed to understand the mechanisms and pathways of its effects. Computer-based assessment tools may improve efficiency and cost-effectiveness of health literacy research. The objective of this preliminary study was to assess if administration of the Short Test of Functional…

  5. Phthalate concentrations in personal care products and the cumulative exposure to female adults and infants in Shanghai.

    Science.gov (United States)

    Bao, Jiaqin; Wang, Min; Ning, Xiaojun; Zhou, Yaobin; He, Yuping; Yang, Jielin; Gao, Xi; Li, Shuguang; Ding, Zhuoping; Chen, Bo

    2015-01-01

    Phthalate esters (PE) are synthetic chemicals widely used in industry, and have been detected in personal care products (PCP). Recent findings of human reports demonstrated endocrine-disrupting action associated with phthalate exposures. The aims of this study were to (1) measure levels of 11 PE in 198 PCP collected from retail markets in Shanghai and (2) assess daily dermal exposure in adult females and infants. The health risk of cumulative exposure to eight PE on reproductive system function derived from dermal PCP use was further assessed by utilizing the hazard index (HI) approach. Diethyl phthalate (DEP) was the most frequently detected compound (29.8%), followed by diisobutyl phthalate (DiBP) (6.6%). The geometric mean (GM) concentrations of daily exposure to DEP, bis(2-methoxyethyl) phthalate (DMEP), DiBP, dibutyl phthalate (DBP), diphenyl phthalate (DPP), and bis(2-ethylhexyl) phthalate (DEHP) in female adults were 0.018, 0.012, 0.002, 0.001, 0.003, and 0.002 μg/kg body weight (bw)/d, respectively. The GM daily exposure levels to PE in infants and adult females were similar except for DEHP, which was higher in infants. DEP exposure was highest in both subpopulations at either GM or maximal level. All HI of 8 PE were far less than 1, ranging from 0.0002 to 0.005, indicating no cumulative reproductive risks to these populations. DBP, DMEP, and DEHP were three major contributors to the cumulative HI. In summary, the level of phthalate in PCP from Shanghai retail markets posed no apparent cumulative risk to adult females and infants in China. PMID:25734628

  6. Health Risk Assessment of Groundwater Arsenic Pollution in Southern Taiwan

    Science.gov (United States)

    Liang, Ching-Ping

    2015-04-01

    This study investigates the risk of arsenic (As) exposure to the residents in Pingtung Plain of Taiwan, where more than 50% of people extracts groundwater to meet the drinking purpose and monitoring groundwater shows that a considerable portion of groundwater has an As concentration of more than safe drinking water guideline of 10μg/L-1. Exposure and risk assessment are carried out in accordance with the provisional daily intake (PTDI) recommended by the FAO/WHO as well as hazard quotient and cancer risk standards based on the US Environmental Protection Agency. The variability of body weights and drinking water consumption scenarios are considered in exposure and risk assessment. Results shows that daily intake exceeds 2.1μg day-1 kg-1 BW for 2% of population, HQ level above unity for 20% , and can risk greater than 10-6 for 80%. These results implies that drinking water directly from groundwater will place many people at the risk of exposure and any efforts to supply safe drinking water is imperial for governing in order to protect the human health of inhabitants in Pingtung Plain.

  7. Assessment of Environmental Sustainability in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    María Carmen Carnero

    2015-06-01

    Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

  8. Cumulative effects of planned industrial development and climate change on marine ecosystems

    Directory of Open Access Journals (Sweden)

    Cathryn Clarke Murray

    2015-07-01

    Full Text Available With increasing human population, large scale climate changes, and the interaction of multiple stressors, understanding cumulative effects on marine ecosystems is increasingly important. Two major drivers of change in coastal and marine ecosystems are industrial developments with acute impacts on local ecosystems, and global climate change stressors with widespread impacts. We conducted a cumulative effects mapping analysis of the marine waters of British Columbia, Canada, under different scenarios: climate change and planned developments. At the coast-wide scale, climate change drove the largest change in cumulative effects with both widespread impacts and high vulnerability scores. Where the impacts of planned developments occur, planned industrial and pipeline activities had high cumulative effects, but the footprint of these effects was comparatively localized. Nearshore habitats were at greatest risk from planned industrial and pipeline activities; in particular, the impacts of planned pipelines on rocky intertidal habitats were predicted to cause the highest change in cumulative effects. This method of incorporating planned industrial development in cumulative effects mapping allows explicit comparison of different scenarios with the potential to be used in environmental impact assessments at various scales. Its use allows resource managers to consider cumulative effect hotspots when making decisions regarding industrial developments and avoid unacceptable cumulative effects. Management needs to consider both global and local stressors in managing marine ecosystems for the protection of biodiversity and the provisioning of ecosystem services.

  9. 78 FR 38315 - Registration Review; Draft Human Health and Ecological Risk Assessments; Notice of Availability

    Science.gov (United States)

    2013-06-26

    ... AGENCY Registration Review; Draft Human Health and Ecological Risk Assessments; Notice of Availability... availability of EPA's draft human health and ecological risk assessments for the registration review of... comprehensive draft risk assessments for each of the subject chemicals and is making them available for...

  10. Predicting Cumulative Incidence Probability by Direct Binomial Regression

    DEFF Research Database (Denmark)

    Scheike, Thomas H.; Zhang, Mei-Jie

    Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard......Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard...

  11. Development of the eHealth Literacy Assessment Toolkit, eHLA

    DEFF Research Database (Denmark)

    Lauritzen, Dorthe Furstrand; Kayser, Lars

    2015-01-01

    In a world with rising focus on the use of eHealth, the match between the competences of the individual and the demands of eHealth systems becomes increasingly important, thus making assessment of eHealth literacy as a measure of user competences a vital element. We propose the eHealth Literacy...

  12. School-Based Mental Health Professionals' Bullying Assessment Practices: A Call for Evidence-Based Bullying Assessment Guidelines

    Science.gov (United States)

    Blake, Jamilia; Banks, Courtney S.; Patience, Brenda A.; Lund, Emily M.

    2014-01-01

    A sample of 483 school-based mental health professionals completed a survey about the training they have received related to conducting bullying assessments in schools, competence in conducting an assessment of bullying, and the bullying assessment methods they used. Results indicate that school counselors were usually informed about incidents of…

  13. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Science.gov (United States)

    2011-06-30

    ... Practice Environment in Public Health Genomics AGENCY: Centers for Disease Control and Prevention (CDC..., and other information helpful to assess the current research, policy, and practice environment in... systematic process for evaluating genetic tests, translating genomics into public health research...

  14. Healthe Kids: An Assessment of Program Performance and Participation

    Science.gov (United States)

    Dean, Bonnie B.; Kindermann, Sylvia L.; Carson, Tabetha; Gavin, Jan; Frerking, Melissa; Bergren, Martha Dewey

    2014-01-01

    Many states in the United States have mandated school health screenings for early identification and referral to professional services for a set of health conditions. Healthe Kids, a community-based program, began offering school-based health screenings to Missouri elementary schools in March 2007. The purpose of the article is to provide a…

  15. Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries

    Directory of Open Access Journals (Sweden)

    Handy Deirdre

    2005-04-01

    Full Text Available Abstract Background We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland Methods We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation. Results The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services. Conclusion We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process.

  16. Cancer and non-cancer health effects from food contaminant exposures for children and adults in California: a risk assessment

    OpenAIRE

    Vogt Rainbow; Bennett Deborah; Cassady Diana; Frost Joshua; Ritz Beate; Hertz-Picciotto Irva

    2012-01-01

    Abstract Background In the absence of current cumulative dietary exposure assessments, this analysis was conducted to estimate exposure to multiple dietary contaminants for children, who are more vulnerable to toxic exposure than adults. Methods We estimated exposure to multiple food contaminants based on dietary data from preschool-age children (2–4 years, n=207), school-age children (5–7 years, ...

  17. Cumulative processes and quark distribution in nuclei

    International Nuclear Information System (INIS)

    Assuming existence of multiquark (mainly 12q) bags in nuclei the spectra of cumulative nucleons and mesons produced in high-energy particle-nucleus collisions are discussed. The exponential form of quark momentum distribution in 12q-bag (agreeing well with the experimental data on lepton-nucleus interactions at large q2) is shown to result in quasi-exponential distribution of cumulative particles over the light-cone variable αsub(B). The dependence of f(αsub(B); psub(perpendicular)) (where psub(perpendicular) is the transverse momentum of the bag) upon psub(perpendicular) is considered. The yields of cumulative resonances as well as effects related to the u- and d-quark distributions in N > Z nuclei being different are dicscussed

  18. Exact cumulant Kramers-Moyal-like expansion

    Science.gov (United States)

    Morgado, W. A. M.

    2015-11-01

    We derive an exact equation, a Cumulant Kramers-Moyal Equation (CKME), quite similar to the Kramers-Moyal Equation (KME), for the probability distribution of a Markovian dynamical system. It can be applied to any well behaved (converging cumulants) continuous time systems, such as Langevin equations or other models. An interesting but significant difference with respect to the KME is that their jump-moments are proportional to cumulants of the dynamical variables, but not proportional to central moments, as is the case for the KME. In fact, they still obey a weaker version of Pawula's theorem, namely Marcinkiewicz's theorem. We compare the results derived from the equations herein with the ones obtained by computing via Gaussian and biased, and unbiased, Poisson Langevin dynamics and a Poisson non-Langevin model. We obtain the exact CKME time-evolution equation for the systems, and in several cases, those are distinct from the Fokker-Planck equation or the KME.

  19. Cumulative Culture and Future Thinking: Is Mental Time Travel a Prerequisite to Cumulative Cultural Evolution?

    Science.gov (United States)

    Vale, G. L.; Flynn, E. G.; Kendal, R. L.

    2012-01-01

    Cumulative culture denotes the, arguably, human capacity to build on the cultural behaviors of one's predecessors, allowing increases in cultural complexity to occur such that many of our cultural artifacts, products and technologies have progressed beyond what a single individual could invent alone. This process of cumulative cultural evolution…

  20. Childhood Cumulative Risk and Later Allostatic Load

    DEFF Research Database (Denmark)

    Doan, Stacey N; Dich, Nadya; Evans, Gary W

    2014-01-01

    cardiovascular, hypothalamic pituitary adrenal axis, sympathetic adrenal medullary system, and metabolic activity. Smoking and alcohol/drug use were tested as mediators of the hypothesized childhood risk-adolescent allostatic load relationship. Results: Cumulative risk exposure at age 9 predicted increases...... in allostatic load 8 years later. Smoking, but not alcohol and drug use, was a significant mediator of the prospective, longitudinal relationship between childhood cumulative risk and adolescent allostatic load. Conclusions: The present paper contributes to the understanding of the role of early life stress...

  1. Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?

    Directory of Open Access Journals (Sweden)

    Sandman, Lars

    2014-11-01

    Full Text Available [english] An essential component of health technology assessment (HTA is the assessment of ethical aspects. In some healthcare contexts, tasks are strictly relegated to different expert groups: the HTA-agencies are limited to assessment of the technology and other actors within the health care sector are responsible for appraisal and recommendations. Ethical aspects of health technologies are considered with reference to values or norms in such a way that may be prescriptive, or offer guidance as to how to act or relate to the issue in question. Given this internal prescriptivity, the distinction between assessment and appraisal seems difficult to uphold, unless the scrutiny stops short of a full ethical analysis of the technology. In the present article we analyse the distinction between assessment and appraisal, using as an example ethical aspects of implementation of GPS-bracelets for people with dementia. It is concluded that for HTA-agencies with a strictly delineated assessment role, the question of how to deal with the internal prescriptivity of ethics may be confusing. A full ethical analysis might result in a definite conclusion as to whether the technology in question is ethically acceptable or not, thereby limiting choices for decision-makers, who are required to uphold certain ethical values and norms. At the same time, depending on the exact nature of such a conclusion, different action strategies can be supported. A positive appraisal within HTA could result in a decision on implementation, or of the technology, thereby making it available to patients, or decisions to and even the use of the technology (even if someone else will have to fund it. A neutral appraisal, giving no definite answer as to whether implementation is recommended or not, could result in a towards the technology. A negative appraisal could result in a decision to or even implementation. This paper presents an overview of the implications of different outcomes

  2. CRED REA Coral Health and Disease Assessment at Rose Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 12 sites at...

  3. CRED REA Coral Health and Disease Assessment at Aguijan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 1 sites at...

  4. CRED REA Coral Health and Disease Assessment at Molokai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  5. CRED REA Coral Health and Disease Assessment at Guguan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  6. CRED REA Coral Health and Disease Assessment at Guam, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  7. CRED REA Coral Health and Disease Assessment at Ofu-Olosega Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  8. CRED REA Coral Health and Disease Assessment at Tutuila Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 23 sites at...

  9. CRED REA Coral Health and Disease Assessment at Alamagan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  10. CRED REA Coral Health and Disease Assessment at Oahu, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  11. CRED REA Coral Health and Disease Assessment at Maug Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  12. CRED REA Coral Health and Disease Assessment at Jarvis Island, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  13. CRED REA Coral Health and Disease Assessment at Agrihan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  14. CRED REA Coral Health and Disease Assessment at Lisianski Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  15. CRED REA Coral Health and Disease Assessment at Ta'u Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  16. CRED REA Coral Health and Disease Assessment at Hawaii Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 17 sites at...

  17. CRED REA Coral Health and Disease Assessment at Niihau Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  18. CRED REA Coral Health and Disease Assessment at Pagan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  19. CRED REA Coral Health and Disease Assessment at Johnston Atoll, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  20. CRED REA Coral Health and Disease Assessment at Kauai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 4 sites at...

  1. CRED REA Coral Health and Disease Assessment at Midway Atoll, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  2. CRED REA Coral Health and Disease Assessment at Necker Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  3. CRED REA Coral Health and Disease Assessment at Maui Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 11 sites at...

  4. CRED REA Coral Health and Disease Assessment at Asuncion Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  5. CRED REA Coral Health and Disease Assessment at Kingman Reef, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 11 sites at...

  6. CRED REA Coral Health and Disease Assessment at Kure Atoll, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  7. CRED REA Coral Health and Disease Assessment at Tinian Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 5 sites at...

  8. CRED REA Coral Health and Disease Assessment at Rota Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  9. CRED REA Coral Health and Disease Assessment at Saipan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 8 sites at...

  10. CRED REA Coral Health and Disease Assessment at Uracas Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  11. CRED REA Coral Health and Disease Assessment at Swains Atoll, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 8 sites at...

  12. CRED REA Coral Health and Disease Assessment at Lehua Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  13. CRED REA Coral Health and Disease Assessment at Maro Reef, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  14. CRED REA Coral Health and Disease Assessment at Wake Atoll, Pacific Remote Island Areas in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 12 sites at...

  15. CRED REA Coral Health and Disease Assessment at Lanai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  16. CRED REA Coral Health and Disease Assessment at Sarigan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  17. CRED REA Coral Health and Disease Assessment at Kaula Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  18. CRED REA Coral Health and Disease Assessment at Laysan Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  19. CRED REA Coral Health and Disease Assessment at French Frigate Shoals, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  20. An urban American Indian health clinic's response to a community needs assessment.

    Science.gov (United States)

    Dennis, Mary Kate; Momper, Sandra L

    2016-01-01

    Utilizing community-based methods, we assessed the behavioral and physical health needs of a Detroit metropolitan Indian health clinic. The project goal was to identify health service needs for urban American Indians/Alaska Natives and develop the infrastructure for culturally competent and integrative behavioral and physical health care. We conducted 38 semi-structured interviews and 12 focus groups with service providers and community members. Interview and focus group data indicated a need for 1) more culturally competent services and providers, 2) more specialized health services, and 3) more transportation options. We then report on the Indian health clinic's and community's accomplishments in response to the needs assessment. PMID:27668592

  1. A framework for assessing the performance of health systems.

    Science.gov (United States)

    Murray, C J; Frenk, J

    2000-01-01

    Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance

  2. Health impact assessment in China: Emergence, progress and challenges

    International Nuclear Information System (INIS)

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  3. Assessment of OEP health's risk in nuclear medicine

    Science.gov (United States)

    Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M.

    2012-10-01

    The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 ± 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

  4. HEALTH TECHNOLOGY ASSESSMENT, DELIBERATIVE PROCESS, AND ETHICALLY CONTESTED ISSUES.

    Science.gov (United States)

    Daniels, Norman; van der Wilt, Gert Jan

    2016-01-01

    Healthcare technology assessment (HTA) aims to support decisions as to which technologies should be used in which situations to optimize value. Because such decisions will create winners and losers, they are bound to be controversial. HTA, then, faces a dilemma: should it stay away from such controversies, remaining a source of incomplete advice and risking an important kind of marginalization, or should it enter the controversy? The question is a challenging one, because we lack agreement on principles that are fine grained enough to tell us what choices we should make. In this study, we will argue that HTA should take a stand on ethical issues raised by the technology that is being investigated. To do so, we propose adding a form of procedural justice to HTA to arrive at decisions that the public can regard as legitimate and fair. A fair process involves deliberation about the reasons, evidence, and rationales that are considered relevant to meeting population-health needs fairly. One important way to make sure that there is real deliberation about relevant reasons is to include a range of stakeholders in the deliberative process. To illustrate how such deliberation might work, we use the case of cochlear implants for deaf children. PMID:27472157

  5. Health information: what can mobile phone assessments add?

    Science.gov (United States)

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients' health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures.In this pilot study, two randomly selected groups of patients provided information about their pain for one week postoperatively. One group responded via cell phones, and the other, a control group, responded using paper-based questionnaires.The mobile phone system was found to provide a fast and safe basis for reporting pain postoperatively in real time. The results indicate that on days 3 and 4 the mobile phone group reported significantly higher levels of pain than the control group, and the cholecystectomy patients reported significantly more pain at movement on days 3 and 4 than the hysterectomy patients.The mobile phone approach is an adaptation to modern technology and the mobility of individuals. This technology is user friendly and requires minimal support. However, as the sample size was small (n = 37), further studies are needed before additional conclusions can be drawn. PMID:23209453

  6. Health assessment of bonded composite repairs with frequency response techniques

    Science.gov (United States)

    White, Caleb; Whittingham, Brendan; Li, Henry C. H.; Herszberg, Israel; Mouritz, Adrian P.

    2007-01-01

    Structural health monitoring (SHM) technology may be applied to composite bonded repairs to enable the continuous through-life assessment of the repair's efficacy. This paper describes an SHM technique for the detection of debonding in composite bonded patches based on frequency response. The external doubler repair, commonly used to patch aircraft structures, is examined in this paper. An experimental investigation was conducted using carbon/epoxy doubler repairs bonded to carbon/epoxy substrates, with piezoelectric devices used to measure variations in the frequency response of the repaired structure due to debonding of the external doubler. Three piezoelectric devices were adhered to the structure; the actuator to the external doubler and two sensors to the parent panel. To simulate real repair design requirements (minimum surface perturbation) piezoelectric devices were installed on 'internal' surfaces. Clearance for the actuator was created by the removal of damaged material. The frequency response signature of the repaired structure with simulated debonds is analysed with respect to the response of fully bonded repairs. Results are discussed with implications for the development of a technique to monitor the integrity of external bonded repairs.

  7. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  8. Health information: what can mobile phone assessments add?

    Science.gov (United States)

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients' health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures.In this pilot study, two randomly selected groups of patients provided information about their pain for one week postoperatively. One group responded via cell phones, and the other, a control group, responded using paper-based questionnaires.The mobile phone system was found to provide a fast and safe basis for reporting pain postoperatively in real time. The results indicate that on days 3 and 4 the mobile phone group reported significantly higher levels of pain than the control group, and the cholecystectomy patients reported significantly more pain at movement on days 3 and 4 than the hysterectomy patients.The mobile phone approach is an adaptation to modern technology and the mobility of individuals. This technology is user friendly and requires minimal support. However, as the sample size was small (n = 37), further studies are needed before additional conclusions can be drawn.

  9. The Global Mental Health Assessment Tool - Primary Care Version (GMHAT/PC). Development, reliability and validity

    OpenAIRE

    Sharma, Vimal K; Lepping, Peter; Cummins, Anthony GP; Copeland, John RM; Parhee, Rashmi; Mottram, Patricia

    2004-01-01

    The Global Mental Health Assessment Tool – Primary Care Version (GMHAT/PC) is a computerised clinical assessment tool developed to assess and identify a wide range of mental health problems in primary care. It generates a computer diagnosis, a symptom rating, a self-harm risk assessment, and a referral letter. Patients from primary care and community psychiatric outpatient clinics and a small sample of inpatients were interviewed for a period of two months using the GMHAT/PC...

  10. Assessing the Education and Training Needs of Nebraska's Public Health Workforce

    Directory of Open Access Journals (Sweden)

    Brandon L Grimm

    2015-06-01

    Full Text Available IntroductionIn 2012, the Great Plains Public Health Training Center (Grant #UB6HP22821 conducted an online survey of state and local health departments and the American Indian (tribal clinics, tribal health departments and urban Indian clinic public health workforce across three professional levels. The objectives of the needs assessment were to, determine the competency levels of the state’s public health workforce, assess gaps in public health competencies, identify public health training interests, needs and preferences and, determine the barriers and motivators to participating in public health training.MethodsThe assessment was developed using the Council on Linkages Between Academia and Public Health Practice, Core Competencies for Public Health Professionals survey (Council of Linkages, 2010. The final assessment was created and piloted by numerous individuals representing practice and academia. ResultsRespondents identified cultural competency and communication skills as the two most important public health competency domains. Although the public health professionals perceived that they were least proficient in the area of policy development and program planning, participants identified the greatest needs for training in financial planning & management skills and analytical/assessment skills. In general, respondents preferred instructor-led interactive training sessions offered as onsite multi-day workshops or computer-based courses. Respondents identified obesity, health disparities, physical activity, chronic diseases and diabetes as the top five public health topical areas. ConclusionThese priorities align with State and National public health plans. The findings of the needs assessment were used to tailor educational opportunities to build the capacity of Nebraska’s public health system. Additionally, the results were used to develop workforce development plans for numerous local health departments throughout Nebraska.

  11. Cumulative human threats on fish biodiversity components in Tunisian waters

    Directory of Open Access Journals (Sweden)

    F. BEN RAIS LASRAM

    2014-06-01

    Full Text Available Human activities are increasingly impacting biodiversity. To improve conservation planning measures in an ecosystem-based management context, we need to explore how the effects of these activities interact with different biodiversity components. In this study, we used a semi-quantitative method to assess the cumulative impacts of human activities on three biodiversity components (species richness, phylogenetic diversity, and functional diversity in Tunisia’s exclusive economic zone. For each of the nine activities considered, we developed an understanding of their effects from local studies and the expert opinion of stakeholders with country-specific experience. We mapped the cumulative effects and the three biodiversity components and then assessed the degree to which these elements overlapped using an overlap index. This is the first time such an assessment has been made for Tunisia’s marine ecosystems and our assessment highlight the inappropriateness of current conservation measures. The results of this study have specific application for the prioritization of future management actions.

  12. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    M.A.J. Niessen (Maurice); E.L. Laan (Eva); S.J.W. Robroek (Suzan); M.L.E. Essink-Bot (Marie-Louise); N. Peek (Niels); R.A. Kraaijenhagen (Roderik); C.K. van Kalken (Coen); A. Burdorf (Alex)

    2013-01-01

    textabstractBackground: The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. Objective: To analyze whether individual characterist

  13. Health assessment document for hydrogen sulfide: review draft

    Energy Technology Data Exchange (ETDEWEB)

    Ammann, H.M.; Bradow, F.; Fennell, D.; Griffin, R.; Kearney, B.

    1986-08-01

    Hydrogen sulfide is a highly toxic gas which is immediately lethal in concentrations greater than 2000 ppm. The toxic end-point is due to anoxia to brain and heart tissues which results from its interaction with the celluar enzyme cytochrome oxidase. Inhibition of the enzyme halts oxidative metabolism which is the primary energy source for cells. A second toxic end-point is the irritative effect of hydrogen sulfide on mucous membranes, particularly edema at sublethal doses (250 to 500 ppm) in which sufficient exposure occurs before conciousness is lost. Recovered victims of exposure report neurologic symptoms such as headache, fatigue, irritability, vertigo, and loss of libido. Long-term effects are similar to those caused by anoxia due to other toxic agents like CO, and probably are not due to specific H/sub 2/S effects. H/sub 2/S is not a cumulative poison. No mutagenic, carcinogenic, reproductive, or teratogenic effects have been reported in the literature.

  14. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...

  15. Assessing the Use of Mobile Health Technology by Patients: An Observational Study in Primary Care Clinics

    OpenAIRE

    Ramirez, Veronica; Johnson, Emily; Gonzalez, Cesar; Ramirez, Vanessa; Rubino, Barbara; Rossetti, Gina

    2016-01-01

    Background There is significant potential for mobile health technology to improve health outcomes for patients with chronic diseases. However, there is a need for further development of mobile health technology that would help to improve the health of lower-income communities. Objective The study objective was to assess mobile phone and app usage among a culturally diverse patient population, and to determine whether patients would be interested in using mobile health technology to help manag...

  16. Environmental Health Risk Assessment and Countermeasures on a Fire Extinguisher

    Energy Technology Data Exchange (ETDEWEB)

    Park, J.K.; Jeong, D.W. [Korea Environment Institute, Seoul (Korea)

    2001-12-01

    Brominated flame retardants encompass a large number of different organic compounds sharing the common feature of containing bromine, which has an inhibitory effect on the development of fire. The substances are added to plastic materials, insulation foam, and other materials so as to enable the products to comply with fire safety requirements and wishes. The most problematic groups of compounds are polybrominated biphenyls(PBBs) and polybrominated diphenyl ethers(PBDEs). The objective of this project is to develop a management strategy for all problematic brominated flame retardants. A number of studies have shown that several of the brominated flame retardants occur in increasing concentrations in nature and in human beings. This is of concern because certain of the brominated flame retardants are suspected of having undesirable effects on the environment and health. The substances are generally very stable, especially so in the case of PBBs and PBDEs. These are strong reasons for hastening the phase-out of PBBs and PBDEs as group. Moreover, PBBs and PBDEs have attracted international attention. Within the OECD, business organisations have made voluntary agreements concerning PBBs and PBDEs. Rules of the EU forbid the use of PBBs in textiles coming into contact with the skin. The environmental and health risks of PBDEs are currently being evaluated as a part of an EU programme for existing substances. In Germany, PBBs and PBDEs are restricted through the Dioxin Ordinance and voluntary agreements with industry. Brominated flame retardants encompass a large number of different organic compounds sharing the common feature of containing bromine, which has an inhibitory effect on the development of fire. The substances are added to plastic materials, insulation foam, and other materials so as to enable the products to comply with fire safety requirements and wishes. The most problematic groups of compounds are polybrominated biphenyls(PBBs) and polybrominated diphenyl

  17. Needs Assessment in Health Research Projects: A New Approach to Project Management in Iran

    Directory of Open Access Journals (Sweden)

    Niloofar Peykari

    2013-02-01

    Full Text Available Background: The science and technology health plan has defined the outline of health research to the national vision of Iran by 2025. The aim of this study was to focus on the process of needs assessment of health research projects also health research priority setting in Iran.Methods: The project management life cycle has four phases: Initiation, Planning, Execution and Closure. Based on abovementioned points we conducted the study.Results: Focusing on the needs assessment led to systematic implementation of needs assessment of health project in all of the medical sciences universities. Parallel with this achieved strategies health research priority setting was followed through specific process from empowerment to implementation.Conclusion: We should adopt with more systematic progressive methods of health project managements for both our national convenience as well as our international health research programs.

  18. Pavlovian conditioning and cumulative reinforcement rate.

    Science.gov (United States)

    Harris, Justin A; Patterson, Angela E; Gharaei, Saba

    2015-04-01

    In 5 experiments using delay conditioning of magazine approach with rats, reinforcement rate was varied either by manipulating the mean interval between onset of the conditioned stimulus (CS) and unconditioned stimulus (US) or by manipulating the proportion of CS presentations that ended with the US (trial-based reinforcement rate). Both manipulations influenced the acquisition of responding. In each experiment, a specific comparison was made between 2 CSs that differed in their mean CS-US interval and in their trial-based reinforcement rate, such that the cumulative reinforcement rate-the cumulative duration of the CS between reinforcements-was the same for the 2 CSs. For example, a CS reinforced on 100% of trials with a mean CS-US interval of 60 s was compared with a CS reinforced on 33% of trials and a mean duration of 20 s. Across the 5 experiments, conditioning was virtually identical for the 2 CSs with matched cumulative reinforcement rate. This was true as long as the timing of the US was unpredictable and, thus, response rates were uniform across the length of the CS. We conclude that the effects of CS-US interval and of trial-based reinforcement rate are reducible entirely to their common effect on cumulative reinforcement rate. We discuss the implications of this for rate-based, trial-based, and real-time associative models of conditioning.

  19. Cumulative Disadvantage among the Highly Ambitious.

    Science.gov (United States)

    McClelland, Katherine

    1990-01-01

    Using a social reproduction theory framework, analyzes the process by which high school seniors aspiring to high-level positions are sorted out after graduation. Analyzes early educational attainments and changes in occupational expectations. Shows a process of cumulative disadvantage in which White males are more likely to achieve their goals.…

  20. Mapping research on health systems in Europe: a bibliometric assessment.

    NARCIS (Netherlands)

    Velasco Garrido, M.; Hansen, J.; Busse, R.

    2011-01-01

    Objective: Europe's health care decision-makers are facing an increasingly complex and rapidly changing landscape. It is crucial that health care problems are addressed with evidence-informed policy and that evidence finding is aimed at those topics most urgent on policy agendas. Research on health

  1. Development of Welding Fumes Health Index (WFHI for Welding Workplace's Safety and Health Assessment.

    Directory of Open Access Journals (Sweden)

    Azian Hariri

    2014-08-01

    Full Text Available This study aimed to develop an index that can rank welding workplace that associate well with possible health risk of welders.Welding Fumes Health Index (WFHI were developed based on data from case studies conducted in Plant 1 and Plant 2. Personal sampling of welding fumes to assess the concentration of metal constituents along with series of lung function tests was conducted. Fifteen metal constituents were investigated in each case study. Index values were derived from aggregation analysis of metal constituent concentration while significant lung functions were recognized through statistical analysis in each plant.The results showed none of the metal constituent concentration was exceeding the permissible exposure limit (PEL for all plants. However, statistical analysis showed significant mean differences of lung functions between welders and non-welders. The index was then applied to one of the welding industry (Plant 3 for verification purpose. The developed index showed its promising ability to rank welding workplace, according to the multiple constituent concentrations of welding fumes that associates well with lung functions of the investigated welders.There was possibility that some of the metal constituents were below the detection limit leading to '0' value of sub index, thus the multiplicative form of aggregation model was not suitable for analysis. On the other hand, maximum or minimum operator forms suffer from compensation issues and were not considered in this study.

  2. Assessing Health Literacy: A New Domain for Collaboration between Language Testers and Health Professionals

    Science.gov (United States)

    Elder, Catherine; Barber, Melissa; Staples, Margaret; Osborne, Richard H.; Clerehan, Rosemary; Buchbinder, Rachelle

    2012-01-01

    Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have…

  3. Competencies for public health finance: an initial assessment and recommendations.

    Science.gov (United States)

    Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

    2004-01-01

    The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers. PMID:15552772

  4. Special issue on eHealth and mHealth: Challenges and future directions for assessment, treatment, and dissemination.

    Science.gov (United States)

    Borrelli, Belinda; Ritterband, Lee M

    2015-12-01

    This special issue is intended to promote a discussion of eHealth and mHealth and its connection with health psychology. "eHealth" generally refers to the use of information technology, including the Internet, digital gaming, virtual reality, and robotics, in the promotion, prevention, treatment, and maintenance of health. "mHealth" refers to mobile and wireless applications, including text messaging, apps, wearable devices, remote sensing, and the use of social media such as Facebook and Twitter, in the delivery of health related services. This special issue includes 11 articles that begin to address the need for more rigorous methodology, valid assessment, innovative interventions, and increased access to evidence-based programs and interventions. PMID:26651461

  5. A Needs Assessment, Development, and Formative Evaluation of a Health Promotion Smartphone Application for College Students

    Science.gov (United States)

    Miller, Tiffany; Chandler, Laura; Mouttapa, Michele

    2015-01-01

    Background: Approximately half of college students who completed the National College Health Assessment 2013 indicated a greater need for health-related information. University-based smartphone applications may help students better access this information. Purpose: This study describes the needs assessment, development, and formative evaluation of…

  6. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment

    Science.gov (United States)

    This assessment strengthens and expands our understanding of climate-related health impacts by providing a more definitive description of climate-related health burdens in the United States. It builds on the 2014 USGCRP National Climate Assessment and reviews and synthesizes key ...

  7. 77 FR 5793 - Beaches Environmental Assessment and Coastal Health Act; Availability of BEACH Act Grants

    Science.gov (United States)

    2012-02-06

    ... AGENCY Beaches Environmental Assessment and Coastal Health Act; Availability of BEACH Act Grants AGENCY... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act.... EPA encourages coastal and Great Lakes states and tribes that have received BEACH Act grants in...

  8. 78 FR 70040 - Draft Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Science.gov (United States)

    2013-11-22

    ... nitrogen oxides (77 FR 7149). EPA's ``Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides--Health Criteria'' was made available for public comment on May 3, 2013 (78 FR 26026), and... AGENCY Draft Integrated Science Assessment for Nitrogen Oxides--Health Criteria AGENCY:...

  9. Assessment of health care by children and adolescents depends on when they respond to the questionnaire

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Ammentorp, Jette; Kofoed, Poul-Erik

    2010-01-01

    The aim of this study was to examine the assessments and priorities by children and adolescents of health care in a paediatric outpatient clinic, to examine the influence of the time factor on the assessments and priorities by children and adolescents of health care, and to determine...

  10. 40 CFR 158.2083 - Experimental use permit biochemical pesticides human health assessment data requirements table.

    Science.gov (United States)

    2010-07-01

    ... pesticides human health assessment data requirements table. 158.2083 Section 158.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS DATA REQUIREMENTS FOR PESTICIDES Biochemical Pesticides § 158.2083 Experimental use permit biochemical pesticides human health assessment...

  11. Patient and public involvement in scope development for a palliative care health technology assessment in europe

    NARCIS (Netherlands)

    Brereton, L.; Goyder, E.; Ingleton, C.; Gardiner, C.; Chilcott, J.; Wilt, G.J. van der; Oortwijn, W.; Mozygemba, K.; Lysdahl, K.B.; Sacchini, D.; Lepper, W.

    2014-01-01

    BACKGROUND: Patient and Public Involvement (PPI) helps to ensure that study findings are useful to end users but is under-developed in Health Technology Assessment (HTA). "INTEGRATE-HTA, (a co-funded European Union project -grant agreement 30614) is developing new methods to assess complex health te

  12. 76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

    Science.gov (United States)

    2011-06-24

    ... health needs assessment (CHNA) and implementation strategy/plan development and execution. HHS/CDC is... accreditation standards, current practices in CHNA, implementation strategy/plan development and execution, and... Health Needs Assessment and Implementation Strategy; Public Forum AGENCY: Centers for Disease Control...

  13. Approaches to advancing quantitative human health risk assessment of environmental chemicals in the post-genomic era

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, Weihsueh A., E-mail: chiu.weihsueh@epa.gov [National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington DC, 20460 (United States); Euling, Susan Y.; Scott, Cheryl Siegel; Subramaniam, Ravi P. [National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington DC, 20460 (United States)

    2013-09-15

    The contribution of genomics and associated technologies to human health risk assessment for environmental chemicals has focused largely on elucidating mechanisms of toxicity, as discussed in other articles in this issue. However, there is interest in moving beyond hazard characterization to making more direct impacts on quantitative risk assessment (QRA) — i.e., the determination of toxicity values for setting exposure standards and cleanup values. We propose that the evolution of QRA of environmental chemicals in the post-genomic era will involve three, somewhat overlapping phases in which different types of approaches begin to mature. The initial focus (in Phase I) has been and continues to be on “augmentation” of weight of evidence — using genomic and related technologies qualitatively to increase the confidence in and scientific basis of the results of QRA. Efforts aimed towards “integration” of these data with traditional animal-based approaches, in particular quantitative predictors, or surrogates, for the in vivo toxicity data to which they have been anchored are just beginning to be explored now (in Phase II). In parallel, there is a recognized need for “expansion” of the use of established biomarkers of susceptibility or risk of human diseases and disorders for QRA, particularly for addressing the issues of cumulative assessment and population risk. Ultimately (in Phase III), substantial further advances could be realized by the development of novel molecular and pathway-based biomarkers and statistical and in silico models that build on anticipated progress in understanding the pathways of human diseases and disorders. Such efforts would facilitate a gradual “reorientation” of QRA towards approaches that more directly link environmental exposures to human outcomes.

  14. A LITERATURE REVIEW OF ASSESSMENT AND MENTAL HEALTH, FROM THE BRAZILIAN VIRTUAL LIBRARY IN HEALTH ECONOMICS: RESULTS AND CHALLENGES.

    Directory of Open Access Journals (Sweden)

    Carla Estefania Albert

    2014-02-01

    Full Text Available This article presents a literature review of the literature on evaluation of mental health services from BVS ECO, without limited timeline. Design and Methods: A systematic review of texts in Spanish, Portuguese and English. It used certain preliminary criteria for inclusion and exclusion to identify relevant studies, using descriptors: evaluation, mental health evaluation/ assessment. Results: There were 48 articles of which 21 were excluded. The main theme of the publications was the verification of costs versus service complexity, and among the most recent publications, based on the type of treatment of psychological disorders. Conclusions: As a facilitator of research in Health Economics, BVS ECO should allow access to the full text and it is urgently to review the classification and inclusion of publications in the Base about evaluations inquiries. In terms of production, there is a tendency of articles over time, with detailing methodologies and objectives of border between health assessment and health economic evaluation.

  15. SUBJECTIVE HEALTH ASSESSMENT AND HEALTH BEHAVIOUR OF ADULT INHABITANTS OF TOWNS LOCATED IN THE VICINITY OF WIND FARMS IN POLAND

    Directory of Open Access Journals (Sweden)

    Bożena Mroczek

    2010-06-01

    Full Text Available Background. The development of wind power industry is beneficial both for human beings and their environment, even so it causes anxiety of people living near wind farms. It is highly related to insufficient information on the effect of wind farms on human health. The aim of this study was to assess subjective health, existing problems and health behaviours demonstrated by the residents of places located near wind farms. Materials of methods. The study was performed in January and February 2009. The research tool was a questionnaire consisting of the Norwegian version of The SF-36 General Health Questionnaire, the Visual Analog Scale (VAS for health assessment, and author’s questions. Information was obtained from 343 respondents, whose average age was 45 years. Out of them 57% had a job, while 12% were unemployed. All respondents were country dwellers. Results: General health was assessed as excellent or very good by 30%, as bad by 10.8%. One-fourth of respondents observed the worsening of their health. Some 59.2% claimed that wind farms were over 1500 m from their houses; people living in the shortest distance form a wind mill (700 m constituted 8%. One-third thought that windmills were safe for health; 69.1% did not regard windmills beneficial to themselves, and 2.6% could not see any advantages for the local community. Overweight and obesity were found in 42.34%, and 96.8% suffered from chronic diseases. Conclusions: 1. Subjective quality of life assessment depends directly on internal conditions of an individual. Construction of wind farms is not evaluated as an investment that changes the life of an individual. It is thought to have no effect on the assessment of health or its worsening. 2. Risk behaviours in the group examined do not differ from those observed in the general population. The factors which make the behaviours different are gender, age below 65 and occupational inactivity.

  16. Promoting Physical and Mental Health among College Students: A Needs Assessment

    Science.gov (United States)

    Bezyak, Jill; Clark, Alena

    2016-01-01

    Purpose: To conduct an initial needs assessment of physical and mental health behavior among college students to improve understanding of physical and mental health needs among future helping professionals. Method: A sample of 24 undergraduate students was used to provide a description of mental health, physical activity, and healthy eating…

  17. The Sensitivity of the Geriatric Oral Health Assessment Index to Dental Care.

    Science.gov (United States)

    Dolan, Teresa A.

    1997-01-01

    A 24-month study of 96 patients in a community-based oral health promotion project found the Geriatric Oral Health Assessment Index (GOHAI), a self-report measure of oral health, to be sensitive to provision of dental care. Some further development of measures is needed. Potential applications of this and similar self-report measures in dental…

  18. The University Environment: A Comprehensive Assessment of Health-Related Advertisements

    Science.gov (United States)

    Szymona, Katie; Quick, Virginia; Olfert, Melissa; Shelnutt, Karla; Kattlemann, Kendra K.; Brown-Esters, Onikia; Colby, Sarah E.; Beaudoin, Christina; Lubniewski, Jocelyn; Maia, Angelina Moore; Horacek, Tanya; Byrd-Bredbenner, Carol

    2012-01-01

    Purpose: Little is known about health-related advertising on university environments. Given the power of advertising and its potential effect on health behaviors, the purpose of this paper is to assess the health-related advertisement environment and policies on university campuses. Design/methodology/approach: In total, ten geographically and…

  19. Problem structuring in health technology assessment : an argumentative approach to increase its usefulness

    NARCIS (Netherlands)

    Moret-Hartman, Margriet

    2008-01-01

    This thesis addresses the problem of the limited impact of Health Technology Assessment (HTA) research on health policy and clinical practice. HTA is a type of policy research that aims to provide information concerning medical technologies in order to support health care decision making. Although,

  20. Health impact assessment of air pollution using a dynamic exposure profile: Implications for exposure and health impact estimates

    International Nuclear Information System (INIS)

    In both ambient air pollution epidemiology and health impact assessment an accurate assessment of the population exposure is crucial. Although considerable advances have been made in assessing human exposure outdoors, the assessments often do not consider the impact of individual travel behavior on such exposures. Population-based exposures to NO2 and O3 using only home addresses were compared with models that integrate all time-activity patterns—including time in commute—for Flanders and Brussels. The exposure estimates were used to estimate the air pollution impact on years of life lost due to respiratory mortality. Health impact of NO2 using an exposure that integrates time-activity information was on average 1.2% higher than when assuming that people are always at their home address. For ozone the overall estimated health impact was 0.8% lower. Local differences could be much larger, with estimates that differ up to 12% from the exposure using residential addresses only. Depending on age and gender, deviations from the population average were seen. Our results showed modest differences on a regional level. At the local level, however, time-activity patterns indicated larger differences in exposure and health impact estimates, mainly for people living in more rural areas. These results suggest that for local analyses the dynamic approach can contribute to an improved assessment of the health impact of various types of pollution and to the understanding of exposure differences between population groups. - Highlights: ► Exposure to ambient air pollution was assessed integrating population mobility. ► This dynamic exposure was integrated into a health impact assessment. ► Differences between the dynamic and residential exposure were quantified. ► Modest differences in health impact were found at a regional level. ► At municipal level larger differences were found, influenced by gender and age.