WorldWideScience

Sample records for assessing health effects

  1. 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.

  2. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conduct of health assessments and health effects... HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.8 Conduct of health assessments and health effects...

  3. 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.

  4. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reporting of results of health assessments and... HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND... assessments and health effects studies. (a) ATSDR shall provide a report of the results of a health assessment...

  5. Risk assessment of ecotoxicant effect on children's health

    Directory of Open Access Journals (Sweden)

    M.N. Ivanchenko

    2010-03-01

    Full Text Available Assessment of health risk level is the major methodological approach for hygienic monitoring planning, for cause-effect basis of interrelation between environmental pollution and health. Pollution with heavy metals (cadmium, nickel of Zavodskoy district in Saratov results in increasing risk and this requires development of health protection ways and approaches

  6. Editorial: Lead Risk Assessment and Health Effects.

    Science.gov (United States)

    Mielke, Howard W

    2016-06-14

    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.

  7. [Assessment of health effects of CS gas].

    Science.gov (United States)

    Schindel, H J

    1993-07-01

    O-chlorobenzylidene malononitrile (CS) gas or aerosol is by no means a harmless tear-gas, as often is described; in particular, CS is a very effective irritating war gas. The effects of CS on humans are relatively unknown because publications in this respect are mostly on military medical research, partly classified as secret, and brought to the knowledge of a small number of experts only. CS is highly soluble in water, and hence the effects in police water jets are very low. The efficacy of CS-containing water-jetting consists only in the pressure of the jet stream. Medically, in police use, CS is therefore considered to be harmless. Military medical research results, however, show that persons older than 30 years, those under physical strain, and those with hitherto undetected aneurysm are especially at risk.

  8. 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)

  9. 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

  10. 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.

  11. Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health

    OpenAIRE

    Courtemanche, Charles; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela

    2017-01-01

    The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treat...

  12. Indoor allergens: assessing and controlling adverse health effects

    National Research Council Canada - National Science Library

    Pope, Andrew MacPherson; Patterson, Roy; Burge, Harriet

    1993-01-01

    ... on the Health Effects of Indoor Allergens Division of Health Promotion and Disease Prevention INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Washington, D.C. 1993 i Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from other this and...

  13. Air pollution epidemiology. Assessment of health effects and risks

    Energy Technology Data Exchange (ETDEWEB)

    Katsouyanni, K. [Athens Univ. (Greece). Dept. of Hygiene and Epidemiology

    1995-12-31

    Air pollution epidemiology is the study of the occurrence and distribution of health outcomes in association with community air pollution exposure. It is therefore specific in the exposure variable. Air pollution health effects became evident during high air pollution episodes which occurred in the first decades of our century. Since then, legal and other control measures have led to lower air pollution levels. However, recent results from several studies indicate that lower levels of air pollution than the previously considered safe have serious adverse health effects. Although, there is increasingly agreement that air pollution, at levels measured today, affects health, there is still a lot to be understood concerning specific causal pollutants, biologic mechanisms involved and sensitive groups of individuals. The extent of potential confounding, time-considerations in air pollution effects, individual variation in air pollution exposure and exposure misclassification are some factors which complicate the study of these issues. (author)

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

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    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...... 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...

  15. A LITERATURE REVIEW: MENTAL HEALTH EFFECTS AND ASSESSMENT TOOLS OF ALCOHOLISM AMONG THE ELDERLY

    OpenAIRE

    Muraguri, Marytriza; Mahat, Nirupa

    2014-01-01

    The purpose of this study was to explore the effects of alcoholism on the mental health among the elderly. Different assessment tools were used in this study in order to assess alcoholism in the older adults. The goal of the study was to create awareness among nurses and health professionals about possible mental health effects of alcoholism among the elderly. In addition, the study provided knowledge regarding the assessment tools used in assessing alcoholism among the older adults. Studies ...

  16. Ranking the effects of urban development projects on social determinants of health: health impact assessment.

    Science.gov (United States)

    Shojaei, Parisa; Karimlou, Masoud; Nouri, Jafar; Mohammadi, Farahnaz; Malek Afzali, Hosein; Forouzan, Ameneh Setareh

    2014-05-30

    Health impact assessment (HIA) offer a very logical and interesting approach for those aiming to integrate health issues into planning processes. With a lot of works and plans waiting to be done (e.g., developing and updating plans, counseling planning commissions, cooperation with other organizations), planners find it difficult to prioritize health among a variety of possible issues and solutions they confront. In the present article, first, the list of social determinants of health associated with Chitgar man-made lake was extracted out using a qualitative method and with content analysis approach, and then they were prioritized using analytic hierarchy process. 28 social determinants of health including "intermediary" and "structural" determinants were extracted out. Regarding positive effects of lake on these determinants, "recreational services" and "traffic" received the highest and the lowest weights with 0.895 and 0.638 respectively among structural determinants and with consideration to "construction" option. Furthermore, among intermediary determinants for "construction" option, sub-criteria of both "physical activity" and "air quality" received the final highest weight (0.889) and "pathogenesis" indicated the lowest weight with 0.617. Moreover, lake demonstrated the highest negative effects on "housing" among "structural" determinants which it takes the highest weight (0.476) in "non-construction" option. Additionally, lake had the highest negative effects on "noise pollution" among "intermediary determinants" and it takes the highest weight (0.467) in "non-construction" option. It has been shown that urban development projects such as green spaces, man-made lakes … have a huge range of effects on community's health, and having not considered these effects by urban planners and mangers is going to confront urban health with many challenges.

  17. Effectiveness of computerized risk assessment system on enhancing workers' occupational health and attitudes towards occupational health.

    Science.gov (United States)

    Ho, Wan-Yi; Sung, Connie Y Y; Yu, Qiu-Hua; Chan, Chetwyn C H

    2014-01-01

    Efforts have been paid to lower the health risks associated with use of computers at the workplace. Computerized risk assessment systems are available in the market for adoption by companies. The Display Screen Equipment Risk Assessment and Management System was designed for conducting risk assessment and providing intelligent-driven solutions for DSE-related occupational health problems. This report summarizes two consecutive research work conducted on evaluating its effect in reducing body discomfort and mental fatigue, and enhancing sedentary workers' occupational health. Convenience sampling was adopted to recruit participants (111 participants for Study 1 and 75 participants for Study 2 who were randomly assigned to an immediate or a delayed intervention group. The intervention was using DSE RAM System to perform a risk assessment followed by an immediate modification of participant's workstation based on the recommendations generated by the System. Face to face interview was conducted and participants completed three sets of questionnaires right before the assessment and two weeks after the intervention. The results of Study 1 revealed that the DSE RAM System was effective for alleviating the discomfort and fatigue levels by rectifying the workstation-worker match. These mismatches were identified to be the heights of monitor, keyboard and chair with the workers. The results of Study 2 indicate that the System was specific for promoting participants to take more frequent rest breaks (OR: 3.65) and pay more attention to occupational safety and health information (OR: 3.90). In particular, the take frequent rest breaks behavior was found to predict decrease in discomfort in the eyes and mental fatigue (lack of energy). Nevertheless, there was no strong evidence on the use of the System can lead to immediate attitudinal changes towards occupational health and safety. The findings support the notion that workers' participation and integration of ergonomics into

  18. Health effects assessment of exposure to particles from wood smoke

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Elsa; Dybdahl, M. (Technical Univ. of Denmark, National Food Institute, Dept. of Toxicology and Risk Assessment, Soeborg (Denmark)); Larsen, Poul Bo (Danish Environmental Protection Agency, Copenhagen (Denmark))

    2008-07-01

    The number of residential wood burning devices has increased in Denmark during the latest years and it has been estimated that there in 2005 were about 551,000 wood stoves and about 48,000 wood boilers in Denmark. This has resulted in an increased exposure of the general Danish population to pollutants associated with residential wood smoke. New Danish monitoring results on particulate matter (PM) in ambient air have shown elevated PM levels in areas with many wood stoves, particularly during wintertime when wood burning is common. Due to the size distribution of wood smoke particles essentially all will be contained in the PM{sub 2.5} fraction. It has been estimated that about 17,665 tonnes PM{sub 2.5} per year (2005) in Denmark come from residential wood combustion. Therefore, there is an increasing concern that adverse human health effects might be associated with the increased exposure to residential wood smoke. This project has been set up in order to review the scientific literature concerning adverse health effects of pollutants associated with residential wood smoke with the main focus on particulate matter and to quantify and evaluate, if possible, the impact on human health of the increased exposure to particles in residential wood smoke. (au)

  19. A 3-year assessment of the effects of a self-administered health risk assessment on health care utilization, costs, and health risks.

    Science.gov (United States)

    Sieck, Cynthia J; Dembe, Allard E

    2014-12-01

    This study examines the effect of taking a health risk assessment (HRA) on health care costs, utilization, and member health risks over a 3-year period. This retrospective cohort study examined changes utilization, costs, and health risks among a random sample of 500 employees completing an HRA compared with a matched group of 500 employees who did not complete an HRA. The HRA group accessed services more frequently and at a lower overall cost, was more likely to utilize primary care and preventive services after the HRA, and improved on seven out of eight health risk measures. This study demonstrates that significant and sustained improvement in health risks and lower health care costs may be achievable with efforts such as an HRA that seeks to engage employees in health improvement efforts.

  20. Health effects assessment of exposure to particles from wood smoke

    DEFF Research Database (Denmark)

    Nielsen, Elsa

    2007-01-01

    distribution of wood smoke particles, essentially all will be contained in the PM2.5 fraction. In Denmark, recent results indicate that about 10,000 tonnes PM2.5 per year, about half of the total particle emission in Denmark, come from residential wood combustion. Based on a few measurement campaigns conducted...... in Denmark in selected residential areas with different kinds of heating, the annual average PM2.5 exposure from wood smoke can be estimated at 0.4–2 mg/m3 as a preliminary estimate for the whole Danish population. Epidemiological studies evaluating adverse health effects from ambient air pollution...

  1. Measuring policy and related effects of a health impact assessment related to connectivity.

    Science.gov (United States)

    Bias, Thomas K; Abildso, Christiaan G

    2017-02-01

    Health Impact Assessments are an important tool to help policymakers perceive the potential positive and negative contributions of decisions to public health. While they have been increasingly used in the United States, studies have not examined intermediate effects. Using key stakeholder interviews, this manuscript examines policy outcomes and other related effects of the HIA 21months after completing a Health Impact Assessment Report around connectivity policy. Further, it reflects on the measurement of these effects as part of the monitoring and evaluation stage of the Health Impact Assessment process. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Using risk-assessment sheet to improve effectiveness of health examination service.

    Science.gov (United States)

    Tohtubtiang, Kraisorn; Tantibhaedhyangkul, Usa

    2005-11-01

    Several techniques to improve compliance of physicians toward health examination guidelines of many countries were studied. However the method to improve compliance of Thai physicians toward Thailand's guidelines has never been studied. To determine the effectiveness of using risk-assessment sheets to improve the compliance of physicians toward Thailand's health examination service guideline. Risk-assessment sheets were constructed based on recommendations in Guide to Periodic Health Examination and Maintenance for Thai People. One hundred and two adult clients who came for health examination service from January to March 2003 were asked to fill in risk-assessment sheets and compared them with 103 recorded health examination report from the hospitals computer before the risk-assessment sheets were developed. Clients using the risk-assessment sheets group received recommended health examination significantly more than those in the non-using group (p health examination statistically and practically increased the compliance of physicians toward health examination guidelines and reduced unnecessary expenditure.

  3. Onboard System Health Assessment

    Science.gov (United States)

    Barry, Tom; Cunningham, Harry

    1990-01-01

    Viewgraphs and discussion of onboard system health assessment are presented. Success of the space station program will be measured by how well it addresses the basic requirements for (1) maintaining the orbiting Space Station Freedom fully operational for its projected life of thirty years, and (2) the cost-effective execution of the overall space station program. Onboard system health assessment must provide complete and thorough testing capabilities along with effective associated redundancy/fault management.

  4. Cost-effectiveness analysis: adding value to assessment of animal health welfare and production.

    Science.gov (United States)

    Babo Martins, S; Rushton, J

    2014-12-01

    Cost-effectiveness analysis (CEA) has been extensively used in economic assessments in fields related to animal health, namely in human health where it provides a decision-making framework for choices about the allocation of healthcare resources. Conversely, in animal health, cost-benefit analysis has been the preferred tool for economic analysis. In this paper, the use of CEA in related areas and the role of this technique in assessments of animal health, welfare and production are reviewed. Cost-effectiveness analysis can add further value to these assessments, particularly in programmes targeting animal welfare or animal diseases with an impact on human health, where outcomes are best valued in natural effects rather than in monetary units. Importantly, CEA can be performed during programme implementation stages to assess alternative courses of action in real time.

  5. Cumulative effects of antiandrogenic chemical mixtures and their relevance to human health risk assessment

    Science.gov (United States)

    Toxicological studies of defined chemical mixtures assist human health risk assessment by establishing the manner by which chemicals interact with one another to induce an effect. This paper reviews how antiandrogenic chemical mixtures can alter reproductive tract development in ...

  6. Selection and evaluation of exposure-effect-relationships for health impact assessment in the field of noise and health

    NARCIS (Netherlands)

    Kempen EEMM van; Staatsen BAM; Kamp I van; MGO

    2005-01-01

    This report is a background document that can be used to assess the health impact attributable to noise in the Netherlands. To this end the available exposure-effect-relationships in the field of noise and health are reviewed and evaluated, using data published in the epidemiological literature as

  7. Comprehensive assessment of fruits and vegetables human health effects in a LCA context

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Jolliet, O.; Fantke, Peter

    2016-01-01

    the environmental and nutritional effects of foods expressed in Disability Adjusted Life Years (DALYs). For the environmental health assessment we consider impact categories such as global warming and particulate matter (PM) as well as chemical exposure due to pesticide residues. Global warming and PM are assessed...... following a traditional LCA approach. For the pesticide residue exposure, we use publically available health impact scores derived from toxicological studies of numerous pesticide active ingredients. For the nutritional assessment we focus on the various health outcomes considered in the global burden...

  8. Assessing the effects of noise abatement measures on health risks: A case study in Istanbul

    Energy Technology Data Exchange (ETDEWEB)

    Ongel, Aybike, E-mail: aybike.ongel@eng.bahcesehir.edu.tr [Bahcesehir University, Department of Civil Engineering, Istanbul 34353 (Turkey); Sezgin, Fatih, E-mail: fatih.sezgin@ibb.gov.tr [Istanbul Metropolitan Municipality, Environmental Protection Agency, Istanbul 34169 (Turkey)

    2016-01-15

    In recent decades, noise pollution caused by industrialization and increased motorization has become a major concern around the world because of its adverse effects on human well-being. Therefore, transportation agencies have been implementing noise abatement measures in order to reduce road traffic noise. However, limited attention is given to noise in environmental assessment of road transportation systems. This paper presents a framework for a health impact assessment model for road transportation noise emissions. The model allows noise impacts to be addressed with the health effects of air pollutant and greenhouse gas emissions from road transportation. The health damages assessed in the model include annoyance, sleep disturbance, and cardiovascular disease in terms of acute myocardial infarction. The model was applied in a case study in Istanbul in order to evaluate the change in health risks from the implementation of noise abatement strategies. The noise abatement strategies evaluated include altering pavement surfaces in order to absorb noise and introducing speed limits. It was shown that significant improvements in health risks can be achieved using open graded pavement surfaces and introducing speed limits on highways. - Highlights: • Transportation noise has a significant effect on health. • Noise should be included in the environmental assessment of transportation systems. • Traffic noise abatement measures include noise reducing pavements and speed limits. • Noise abatement measures help reduce the health risks of transportation noise. • Speed limit reduction on uncongested roads is an effective way to reduce health risks.

  9. How effects on health equity are assessed in systematic reviews of interventions.

    Science.gov (United States)

    Welch, Vivian; Tugwell, Peter; Petticrew, Mark; de Montigny, Joanne; Ueffing, Erin; Kristjansson, Betsy; McGowan, Jessie; Benkhalti Jandu, Maria; Wells, George A; Brand, Kevin; Smylie, Janet

    2010-12-08

    Enhancing health equity has now achieved international political importance with endorsement from the World Health Assembly in 2009.  The failure of systematic reviews to consider effects on health equity is cited by decision-makers as a limitation to their ability to inform policy and program decisions.  To systematically review methods to assess effects on health equity in systematic reviews of effectiveness. We searched the following databases up to July 2 2010: MEDLINE, PsychINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Index to Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on October 7 2010. We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. Data were extracted using a pre-tested form by two independent reviewers. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews.  Thirty-four methodological studies were included.  The methods used by these included studies were: 1) Targeted approaches (n=22); 2) gap approaches (n=12) and gradient approach (n=1).  Gender or sex was assessed in eight out of 34 studies, socioeconomic status in ten studies, race/ethnicity in seven studies, age in seven studies, low and middle income countries in 14 studies, and two studies assessed multiple factors across health inequity may exist.Only three studies provided a definition of health equity. Four methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (all 34 studies used a type of descriptive method); 2) descriptive assessment of reporting

  10. Exposure Assessment Methods in Studies on Waste Management and Health Effects: An Overview

    Directory of Open Access Journals (Sweden)

    Andrea Spinazzè

    2017-02-01

    Full Text Available Concerns and uncertainties persist about potential environmental and health effects associated with exposure to emissions from widely adopted waste management facilities: despite a limited amount of evidence having been found for some exposure-effect associations, most of the available studies were characterized by limitations related to poor exposure assessment, which could introduce biases and weaknesses in the interpretation of results. This communication provides a brief overview of the exposure assessment methods used in studies on waste management and health effects: problems, key issues, priorities and challenges are briefly presented and discussed. The main conclusions refer to the need of newly developed and harmonized exposure assessment strategies and techniques, which represent an essential step in the study of waste-disposal facilities’ health impacts.

  11. IMPROVING THE EFFECTIVENESS AND EFFICIENCY OF EVIDENCE PRODUCTION FOR HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Facey, Karen; Henshall, Chris; Sampietro-Colom, Laura; Thomas, Sarah

    2015-01-01

    Health Technology Assessment (HTA) needs to address the challenges posed by high cost, effective technologies, expedited regulatory approaches, and the opportunities provided by collaborative real-world evaluation of technologies. The Health Technology Assessment International (HTAi) Policy Forum met to consider these issues and the implications for evidence production to inform HTA. This paper shares their discussion to stimulate further debate. A background paper, presentations, group discussions, and stakeholder role play at the 2015 HTAi Policy Forum meeting informed this paper. HTA has an important role to play in helping improve evidence production and ensuring that the health service is ready to adopt effective technologies. It needs to move from simply informing health system decisions to also working actively to align stakeholder expectations about realistic evidence requirements. Processes to support dialogue over the health technology life cycle need to be developed that are mindful of limited resources, operate across jurisdictions and learn from past processes. Collaborations between health technology developers and health systems in different countries should be encouraged to develop evidence that will inform decision making. New analytical techniques emerging for real-world data should be harnessed to support modeling for HTA. A paradigm shift (to "Health Innovation System 2.0") is suggested where HTA adopts a more central, proactive role to support alignment within and amongst stakeholders over the whole life cycle of the technology. This could help ensure that evidence production is better aligned with patient and health system needs and so is more effective and efficient.

  12. Comprehensive Assessment of Step Aerobics Exercises Effect on Women’s Physical Performance and Physical Health

    Directory of Open Access Journals (Sweden)

    І. П. Масляк

    2015-03-01

    Full Text Available Objective: To identify the dynamics of physical performance and physical health indicators in young and middle-aged women under the effect of step aerobics exercises. Material and methods. The grounds for the study were Kharkiv fitness club “Zorianyi”. The participants were 28 women aged 20-35. The study used the following methods: theoretical analysis of scientific and methodical literature, pedagogical experiment, methods of mathematical statistics, methods of determining physical performance (Harvard step test and physical health (anthropometry, pulsometry, tonometry, spirometry, dynamometry. Results: The study assessed the level of physical performance and physical health; analyzed age-related performance differences; determined the level of the effect of step aerobics on women’s physical performance and physical health. Conclusions: Step-aerobics exercises proved to have a positive effect on the level of physical performance and physical health of the young and middle-aged women.

  13. 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.

  14. Impact of response shift on the assessment of treatment effects using the Oral Health Impact Profile.

    Science.gov (United States)

    Reissmann, Daniel R; Remmler, Antje; John, Mike T; Schierz, Oliver; Hirsch, Christian

    2012-12-01

    The assessment of changes in oral health-related quality of life (OHRQoL) is challenging because individuals' concepts and internal standards of OHRQoL may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile (OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQoL before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQoL after treatment, patients were also asked to rate their pre-treatment OHRQoL without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size (Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively. © 2012 Eur J Oral Sci.

  15. 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.

  16. How does unemployment affect self-assessed health? A systematic review focusing on subgroup effects.

    Science.gov (United States)

    Norström, Fredrik; Virtanen, Pekka; Hammarström, Anne; Gustafsson, Per E; Janlert, Urban

    2014-12-22

    Almost all studies on the effect on health from unemployment have concluded that unemployment is bad for your health. However, only a few review articles have dealt with this relation in recent years, and none of them have focused on the analysis of subgroups such as age, gender, and marital status. The objective of our article is to review how unemployment relates to self-assessed health with a focus on its effect on subgroups. A search was performed in Web of Science to find articles that measured the effect on health from unemployment. The selection of articles was limited to those written in English, consisting of original data, and published in 2003 or later. Our definition of health was restricted to self-assessed health. Mortality- and morbidity-related measurements were therefore not included in our analysis. For the 41 articles included, information about health measurements, employment status definitions, other factors included in the statistical analysis, study design (including study population), and statistical method were collected with the aim of analysing the results on both the population and factor level. Most of the studies in our review showed a negative effect on health from unemployment on a population basis. Results at the factor levels were most common for gender (25 articles), age (11 articles), geographic location (8 articles), and education level (5 articles). The analysis showed that there was a health effect for gender, age, education level, household income, and geographic location. However, this effect differed between studies and no clear pattern on who benefits or suffers more among these groups could be determined. The result instead seemed to depend on the study context. The only clear patterns of association found were for socioeconomic status (manual workers suffer more), reason for unemployment (being unemployed due to health reasons is worse), and social network (a strong network is beneficial). Unemployment affects groups of

  17. Biological effects of anthropogenic chemical stress: Tools for the assessment of ecosystem health (BEAST)

    DEFF Research Database (Denmark)

    Lehtonen, Kari K.; Sundelin, Brita; Lang, Thomas

    In the Baltic Sea Action Plan the urgent need to develop biological effects monitoring of hazardous substances and the assessment of ecosystem health has been clearly indicated. These goals will be tackled in the newly launched BEAST project (Biological Effects of Anthropogenic Chemical Stress...... of Finland, Gulf of Riga, Gulf of Gdansk and the Belt Sea, most of which are characterised by scarce data on biological effects of hazardous substances. The data acquired will be combined with previous data (e.g. national monitoring activities, case studies, EU BEEP project) to reach the goals of WP2 and WP3....... The BEAST project involves 16 partner institutions from all nine Baltic Sea countries, being thereby the largest international effort in this field conducted in the area. In this presentation, the outline of a joint multidiciplinary research scheme for the assessment of ecosystem health of the Gulf...

  18. Health effects

    Energy Technology Data Exchange (ETDEWEB)

    Mahieu, L

    1998-07-01

    The main objectives of research in the field of health effects at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study; (4) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phases of its development; (5) to assess the genetic risks of material exposure to ionizing radiation; (6) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (7) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas for 1997 are reported.

  19. Alberta oil sands community exposure and health effects assessment : analysis of health records as a proxy for health outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Wang, F.; Mackenzie, A.; Schopflocher, D.; Shaw, S.; Robb, J.; Gabos, S. [Alberta Health and Wellness, Edmonton, AB (Canada)

    2002-07-01

    A large scale study was conducted to assess potential links between air quality and human health outcomes. Health records were used as a proxy measure for health outcomes. Residents of Fort McMurray and Lethbridge, Alberta, Canada were used in the comparison of risks of selected morbidity and mortality measures during a 3 year period between 1995 and 1998. Data on the socio-demography, morbidity, and mortality were linked by PI and geographic area from the Health Care Insurance Plan, physical and hospital billing systems, and vital statistics death registration. Age was the most important confounder. Asthma incidence for children 3 years or less was examined along with prevalence and mortality of selected diseases for each sex and age group. Results showed that the incidence of asthma varied by age and sex but not by study area. There was no major difference in death from lung cancer, cardiovascular disease, coronary heart disease, respiratory disorders and COPD between residents of the target and control communities. 6 figs.

  20. Subgroup analyses in cost-effectiveness analyses to support health technology assessments.

    Science.gov (United States)

    Fletcher, Christine; Chuang-Stein, Christy; Paget, Marie-Ange; Reid, Carol; Hawkins, Neil

    2014-01-01

    'Success' in drug development is bringing to patients a new medicine that has an acceptable benefit-risk profile and that is also cost-effective. Cost-effectiveness means that the incremental clinical benefit is deemed worth paying for by a healthcare system, and it has an important role in enabling manufacturers to obtain new medicines to patients as soon as possible following regulatory approval. Subgroup analyses are increasingly being utilised by decision-makers in the determination of the cost-effectiveness of new medicines when making recommendations. This paper highlights the statistical considerations when using subgroup analyses to support cost-effectiveness for a health technology assessment. The key principles recommended for subgroup analyses supporting clinical effectiveness published by Paget et al. are evaluated with respect to subgroup analyses supporting cost-effectiveness. A health technology assessment case study is included to highlight the importance of subgroup analyses when incorporated into cost-effectiveness analyses. In summary, we recommend planning subgroup analyses for cost-effectiveness analyses early in the drug development process and adhering to good statistical principles when using subgroup analyses in this context. In particular, we consider it important to provide transparency in how subgroups are defined, be able to demonstrate the robustness of the subgroup results and be able to quantify the uncertainty in the subgroup analyses of cost-effectiveness. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Indoors and health: results of a systematic literature review assessing the potential health effects of living in basements.

    Science.gov (United States)

    Mezzoiuso, Angelo Giosué; Gola, Marco; Rebecchi, Andrea; Riccò, Matteo; Capolongo, Stefano; Buffoli, Maddalena; Tirani, Marcello; Odone, Anna; Signorelli, Carlo

    2017-10-23

    A new law approved in March 2017 in the Lombardy Region makes it possible to live in basements. Basements are defined as buildings partly below curb level but with at least one-half of its height above the curb. Basements' features and structural characteristics might pose risks to human health. In this paper we adopt a multidisciplinary approach to assess the potential health effects of living in basements. In particular, we define a conceptual framework to describe basements' structural characteristics which are risk factors, as well as the mechanisms through which they impact on human health. We also conduct a systematic review on the scientific databases PubMed,Embase, DOAJ, Proquest and EBSCO to retrieve, pool and critically analyze all available research that quantified the risk of living in basements for different health outcomes. Available evidence suggests living in basements increases the risk of respiratory diseases (asthma and allergic disorders); more heterogeneous data are available for cancers and cardiovascular diseases. As more quantitative data need to be prospectively retrieved to assess and monitor the risk of living in basements for human health, clear minimum requirements for light, air, sanitation and egress are to be defined by technical experts and enforced by policy makers.

  2. Whole dairy matrix or single nutrients in assessment of health effects: current evidence and knowledge gaps.

    Science.gov (United States)

    Thorning, Tanja Kongerslev; Bertram, Hanne Christine; Bonjour, Jean-Philippe; de Groot, Lisette; Dupont, Didier; Feeney, Emma; Ipsen, Richard; Lecerf, Jean Michel; Mackie, Alan; McKinley, Michelle C; Michalski, Marie-Caroline; Rémond, Didier; Risérus, Ulf; Soedamah-Muthu, Sabita S; Tholstrup, Tine; Weaver, Connie; Astrup, Arne; Givens, Ian

    2017-05-01

    Foods consist of a large number of different nutrients that are contained in a complex structure. The nature of the food structure and the nutrients therein (i.e., the food matrix) will determine the nutrient digestion and absorption, thereby altering the overall nutritional properties of the food. Thus, the food matrix may exhibit a different relation with health indicators compared to single nutrients studied in isolation. The evidence for a dairy matrix effect was presented and discussed by an expert panel at a closed workshop, and the following consensus was reached: 1) Current evidence does not support a positive association between intake of dairy products and risk of cardiovascular disease (i.e., stroke and coronary heart disease) and type 2 diabetes. In contrast, fermented dairy products, such as cheese and yogurt, generally show inverse associations. 2) Intervention studies have indicated that the metabolic effects of whole dairy may be different than those of single dairy constituents when considering the effects on body weight, cardiometabolic disease risk, and bone health. 3) Different dairy products seem to be distinctly linked to health effects and disease risk markers. 4) Different dairy structures and common processing methods may enhance interactions between nutrients in the dairy matrix, which may modify the metabolic effects of dairy consumption. 5) In conclusion, the nutritional values of dairy products should not be considered equivalent to their nutrient contents but, rather, be considered on the basis of the biofunctionality of the nutrients within dairy food structures. 6) Further research on the health effects of whole dairy foods is warranted alongside the more traditional approach of studying the health effects of single nutrients. Future diet assessments and recommendations should carefully consider the evidence of the effects of whole foods alongside the evidence of the effects of individual nutrients. Current knowledge gaps and

  3. Can donor aid for health be effective in a poor country? Assessment of prerequisites for aid effectiveness in Uganda.

    Science.gov (United States)

    Juliet, Nabyonga Orem; Freddie, Ssengooba; Okuonzi, Sam

    2009-10-22

    Inadequate funding for health is a challenge to attaining health-related Millennium Development Goals. Significant increase in health funding was recommended by the Commission for Macroeconomics and Health. Indeed Official Development Assistance has increased significantly in Uganda. However, the effectiveness of donor aid has come under greater scrutiny. This paper scrutinizes the prerequisites for aid effectiveness. The objective of the study was to assess the prerequisites for effectiveness of donor aid, specifically, its proportion to overall health funding, predictability, comprehensiveness, alignment to country priorities, and channeling mechanisms. Secondary data obtained from various official reports and surveys were analyzed against the variables mentioned under objectives. This was augmented by observations and participation in discussions with all stakeholders to discuss sector performance including health financing. Between 2004-2007, the level of aid increased from US$6 per capita to US$11. Aid was found to be unpredictable with expenditure varying between 174-8722;360 percent from budgets. More than 50% of aid was found to be off budget and unavailable for comprehensive planning. There was disproportionate funding for some items such as drugs. Key health system elements such as human resources and infrastructure have not been given due attention in investment. The government's health funding from domestic sources grew only modestly which did not guarantee fiscal sustainability. Although donor aid is significant there is need to invest in the prerequisites that would guarantee its effective use.

  4. Issues in risk assessment and modifications of the NRC health effects models

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, E.S.

    1992-07-02

    A report, Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, was published by the US Nuclear Regulatory Commission, in 1985, and revised in 1989. These reports provided models for estimating health effects that would be expected to result from the radiation exposure received in a nuclear reactor accident. Separate models were given for early occurring effects, late somatic effects, and genetic effects; however, this paper addresses only late somatic effects, or the risk of cancer expected to occur in the lifetimes of exposed individuals. The 1989 revision was prepared prior to the publication of the BEIR V, 1988 UNSCEAR, and ICRP 60 reports. For this reason, an addendum was needed that would provide modified risk models that took into account these recent reports, and, more generally, any new evidence that had appeared since the 1989 publication. Of special importance was consideration of updated analyses of the Japanese A-bomb survivor study data based on revised DS86 dosimetry. The process of preparing the addendum required thorough review and evaluation of the models used by the BEIR V, UNSCEAR, and ICRP committees, and also required thorough consideration of the various decisions that must be made in any risk assessment effort. This paper emphasizes general issues and problems that arise in risk assessment, and also indicates areas where additional development and application of statistical methods may be fruitful.

  5. Assessing the Effects of Tourist Provisioning on the Health of Wild Barbary Macaques in Morocco.

    Directory of Open Access Journals (Sweden)

    Laëtitia Maréchal

    Full Text Available Feeding wildlife is a very popular tourist activity, largely because it facilitates the close observation of animals in their natural habitat. Such provisioning may benefit animals by improving their survival and reproductive success, especially during periods of natural food shortage. However, provisioning by tourists may also have negative impacts on the health of the animals involved; to date such impacts are poorly understood. Here, we investigated the effects of tourist provisioning on the health of wild adult Barbary macaques, Macaca sylvanus, in Morocco. We compared health measures between a heavily provisioned group and a group that received negligible food from tourists and, in the former group, we also assessed health measures in relation to the intensity of provisioning. We used a broad range of non-invasive health measures relating to birth rate and survival, disease and injury risk, body size and condition, and physiological stress. Our findings indicate that feeding by tourists may overall have negative impacts on the health of Barbary macaques, being linked in particular to larger body size, elevated stress levels and more alopecia. Finally, we propose a framework to help consider the potential costs and benefits of provisioning, which may facilitate future research and management decisions on whether-and how much-provisioning is acceptable.

  6. Assessment of the effectiveness of physical activity interventions in the Brazilian Unified Health System.

    Science.gov (United States)

    Ribeiro, Evelyn Helena Corgosinho; Garcia, Leandro Martin Totaro; Salvador, Emanuel Péricles; Costa, Evelyn Fabiana; Andrade, Douglas Roque; Latorre, Maria do Rosario Dias de Oliveira; Florindo, Alex Antonio

    2017-06-26

    To assess the effect of interventions on the levels of physical activity of healthy adults, users of the Brazilian Unified Health System and attended by the Family Health Strategy. Non-randomized experimental study with 157 adults allocated in three groups: 1) physical exercise classes (n = 54), 2) health education (n = 54), 3) control (n = 49). The study lasted for18 months, with 12 months of interventions and six months of follow-up after intervention. Assessments took place at the beginning, in the 12 months, and in the 18 months of study. Physical activity has been assessed by questionnaires and accelerometry. For the analyses, we have used the intention-to-treat principle and generalized estimating equations. After 12 months, both intervention groups have increased the minutes of weekly leisure time physical activity and annual scores of physical exercise, leisure and transport-related physical activity. The exercise class group has obtained the highest average annual physical exercises score when compared to the other groups (p objetivos das equipes.

  7. Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health

    Directory of Open Access Journals (Sweden)

    Swapna Sridevi Beeraka

    2013-01-01

    Full Text Available Background: Corticosteroids (Cs are used widely for their anti-inflammatory and immunosuppressive properties. They have the potential to cause dramatic improvement as well as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug should be avoided. Long-term administration may cause many adverse effects leading to impaired oral health. Oral health is usually not considered during management of patients on long-term corticosteroid therapy. The aim of this study was to assess the oral health status and radiological changes in the jaw bones of the patients under long-term corticosteroid therapy. Materials and Methods: Oral health of 100 patients under long-term corticosteroid therapy with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy controls. The clinical examination included complete examination of the mouth and periodontal status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar were assessed. ′Chi-square test′, ′Kolmogorov-Smirnov test′ and ′Mann-Whitney U test′ were used for statistical analysis. P < 0.05 was considered significant. Results: Patients on steroids exhibited significantly higher levels of candidiasis and clinical attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly lower in the study group than that in the control group. Random blood glucose was significantly higher and significant lower levels of calcium were observed in patients on steroids. Conclusion: Long-term use of Cs may affect oral health adversely leading to candidiasis as well as impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density.

  8. Systematic Review Protocol to Assess the Effectiveness of Usability Questionnaires in mHealth App Studies.

    Science.gov (United States)

    Zhou, Leming; Bao, Jie; Parmanto, Bambang

    2017-08-01

    Usability questionnaires have a wide use in mobile health (mHealth) app usability studies. However, no systematic review has been conducted for assessing the effectiveness of these questionnaires. This paper describes a protocol for conducting a systematic review of published questionnaire-based mHealth app usability studies. In this systematic review, we will select recently published (2008-2017) articles from peer-reviewed journals and conferences that describe mHealth app usability studies and implement at least one usability questionnaire. The search strategy will include terms such as "mobile app" and "usability." Multiple databases such as PubMed, CINAHL, IEEE Xplore, ACM Digital Library, and INSPEC will be searched. There will be 2 independent reviewers in charge of screening titles and abstracts as well as determining those articles that should be included for a full-text review. The third reviewer will act as a mediator between the other 2 reviewers. Moreover, a data extraction form will be created and used during the full article data analysis. Notably, the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines will be followed in reporting this protocol. A preliminary search produced 1271 articles, 40 of which are duplicate records. The inclusion-exclusion criteria are being strictly followed in performing the ongoing study selection. Usability questionnaires are an important tool in mHealth app usability studies. This review will summarize the usability questionnaires used in published research articles while assessing the efficacy of these questionnaires in determining the usability of mHealth apps.

  9. Clinical methods for the assessment of the effects of environmental stress on fish health

    Science.gov (United States)

    Wedemeyer, Gary A.; Yasutake, William T.

    1977-01-01

    Clinical methods are presented for biological monitoring of hatchery and native fish populations to assess the effects of environmental stress on fish health. The choice of methods is based on the experience of the authors and the judgment of colleagues at fishery laboratories of the U.S. Fish and Wildlife Service. Detailed analysis methods, together with guidelines for sample collection and for the interpretation of results, are given for tests on blood (cell counts, chloride, cholesterol, clotting time, cortisol, glucose, hematocrit, hemoglobin, lactic acid, methemoglobin, osmolality, and total protein); water (ammonia and nitrite content); and liver and muscle (glycogen content).

  10. Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold

    Directory of Open Access Journals (Sweden)

    Griffiths EA

    2015-08-01

    Full Text Available Elizabeth A Griffiths, Janek K Hendrich, Samuel DR Stoddart, Sean CM Walsh HERON™ Commercialization, PAREXEL International, London, UK Objectives: In health technology assessment (HTA agencies where cost-effectiveness plays a role in decision-making, an incremental cost-effectiveness ratio (ICER threshold is often used to inform reimbursement decisions. The acceptance of submissions with ICERs higher than the threshold was assessed across different agencies and across indications, in order to inform future reimbursement submissions. Methods: All HTA appraisals from May 2000 to May 2014 from National Institute for Health and Care Excellence (NICE, Scottish Medicines Consortium (SMC, Pharmaceutical Benefits Advisory Committee (PBAC, and Canadian Agency for Drugs and Technologies in Health (CADTH were assessed. Multiple technology appraisals, resubmissions, vaccination programs, and requests for advice were excluded. Submissions not reporting an ICER, or for which an ICER could not be determined were also excluded. The remaining appraisals were reviewed, and the submitted ICER, recommendation, and reasoning behind the recommendation were extracted. Results: NICE recommended the highest proportion of submissions with ICERs higher than the threshold (34% accepted without restrictions; 20% with restrictions, followed by PBAC (16% accepted without restrictions; 4% with restrictions, SMC (11% accepted without restrictions; 14% accepted with restrictions, and CADTH (0% accepted without restrictions; 26% with restrictions. Overall, the majority of higher-than-threshold ICER submissions were classified into the "malignant disease and immunosuppression" therapeutic category; however, there was no notable variation in acceptance rates by disease area. Reasons for accepting submissions reporting ICERs above the threshold included high clinical benefit over the standard of care, and addressing an unmet therapeutic need. Conclusion: Acceptance of submissions

  11. Assessing health risk behaviors among adolescents: the effect of question wording and appeals for honesty.

    Science.gov (United States)

    Brener, Nancy D; Grunbaum, Jo Anne; Kann, Laura; McManus, Tim; Ross, Jim

    2004-08-01

    To understand how methodological factors influence prevalence estimates of health-risk behaviors obtained from surveys, we examined the effect of varying question wording and honesty appeals while holding other aspects of the surveys constant. A convenience sample of students (n = 4140) in grades 9 through 12 was randomly assigned to complete one of six versions of a paper-and-pencil questionnaire in classrooms. Each questionnaire version represented a different combination of honesty appeal (standard vs. strong) and questionnaire type. The questionnaire types varied in wording and in the number of questions assessing particular types of behaviors. The questionnaires were based on those used in three national surveys--the Youth Risk Behavior Survey, Monitoring the Future, and the National Household Survey on Drug Abuse. Logistic regression analyses examined how responses to each survey question assessing behavior were associated with questionnaire type, honesty appeal, and the interaction of those two variables. Among 32 behaviors with different question wording across questionnaire types, 12 showed a significant effect of questionnaire type. Among 45 behaviors with identical question wording across questionnaire types, five showed a significant main effect of questionnaire type. Among all 77 behaviors, one showed a significant main effect for honesty appeal and two showed a significant interaction between honesty appeal and questionnaire type. When population, setting, questionnaire context, mode of administration, and data-editing protocols are held constant, differences in question wording can create statistically significant differences in some prevalence estimates. Varying honesty appeals does not have an effect on prevalence estimates.

  12. Does consideration and assessment of effects on health equity affect the conclusions of systematic reviews? A methodology study.

    Science.gov (United States)

    Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter

    2012-01-01

    Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews.

  13. Effect of health risk assessment and counselling on health behaviour and survival in older people: a pragmatic randomised trial.

    Directory of Open Access Journals (Sweden)

    Andreas E Stuck

    2015-10-01

    Full Text Available Potentially avoidable risk factors continue to cause unnecessary disability and premature death in older people. Health risk assessment (HRA, a method successfully used in working-age populations, is a promising method for cost-effective health promotion and preventive care in older individuals, but the long-term effects of this approach are unknown. The objective of this study was to evaluate the effects of an innovative approach to HRA and counselling in older individuals for health behaviours, preventive care, and long-term survival.This study was a pragmatic, single-centre randomised controlled clinical trial in community-dwelling individuals aged 65 y or older registered with one of 19 primary care physician (PCP practices in a mixed rural and urban area in Switzerland. From November 2000 to January 2002, 874 participants were randomly allocated to the intervention and 1,410 to usual care. The intervention consisted of HRA based on self-administered questionnaires and individualised computer-generated feedback reports, combined with nurse and PCP counselling over a 2-y period. Primary outcomes were health behaviours and preventive care use at 2 y and all-cause mortality at 8 y. At baseline, participants in the intervention group had a mean ± standard deviation of 6.9 ± 3.7 risk factors (including unfavourable health behaviours, health and functional impairments, and social risk factors and 4.3 ± 1.8 deficits in recommended preventive care. At 2 y, favourable health behaviours and use of preventive care were more frequent in the intervention than in the control group (based on z-statistics from generalised estimating equation models. For example, 70% compared to 62% were physically active (odds ratio 1.43, 95% CI 1.16-1.77, p = 0.001, and 66% compared to 59% had influenza vaccinations in the past year (odds ratio 1.35, 95% CI 1.09-1.66, p = 0.005. At 8 y, based on an intention-to-treat analysis, the estimated proportion alive was 77.9% in

  14. Are we ready to consider transgenerational epigenetic effects in human health risk assessment?

    Science.gov (United States)

    Alyea, Rebecca A; Gollapudi, B Bhaskar; Rasoulpour, Reza J

    2014-04-01

    Recently, there has been a growing concern that chemically or nutritionally mediated epigenetic changes might lead to adverse health outcomes. The natural question is whether the existing chemical safety assessment paradigm is or is not protective of epigenetic-mediated effects, and if there is a need to incorporate new endpoints to specifically address epigenetics. Of particular interest are transgenerational epigenetic effects, which can be passed on through multiple generations. To investigate these questions, a comparison was performed between OECD guideline rat toxicology studies versus several rat transgenerational epigenetic studies. This analysis focused on vinclozolin owing to the availability of a comprehensive suite of dose-response data (NOAEL, reference dose, and human exposure estimates) for both conventional and epigenetic endpoints. This analysis revealed that vinclozolin transgenerational effects were demonstrated at a dose level (100 mg/kg/day) that was: (1) ∼40-fold higher than the overall lowest-observed-adverse-effect level (LOAEL) from rat guideline studies, (2) ∼80-fold higher than the lowest NOAEL from rat guideline studies, (3) ∼80,000-fold higher than the reference dose for the molecule, and (4) ∼1.2-million fold above human exposure estimates. Through this analysis, we conclude that additional research across a spectrum of doses is necessary to elucidate the interplay between epigenetics and apical endpoints before considering epigenetics in human health risk assessment. Therefore, we recommend focusing future research toward (1) examining for potential causal relationships between epigenetic alterations and adverse apical endpoints, and (2) understanding the dose-response relationship of these causal epigenetic alterations when compared with those of the apical endpoints. Copyright © 2013 Wiley Periodicals, Inc.

  15. Assessment of zero gravity effects on space worker health and safety

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    One objective of the study is to assess the effects of all currently known deviations from normal of medical, physiological, and biochemical parameters which appear to be due to zero gravity (zero-g) environment and to acceleration and deceleration to be experienced, as outlined in the reference Solar Power Satellite (SPS) design, by space worker. Study results include identification of possible health or safety effects on space workers - either immediate or delayed - due to the zero gravity environment and acceleration and deceleration; estimation of the probability that an individual will be adversely affected; description of the possible consequence to work efficiently in persons adversely affected; and description of the possible/probable consequences to immediate and future health of individuals exposed to this environment. A research plan, which addresses the uncertainties in current knowledge regarding the health and safety hazards to exposed SPS space workers, is presented. Although most adverse affects experienced during space flight soon disappeared upon return to the Earth's environment, there remains a definite concern for the long-term effects to SPS space workers who might spend as much as half their time in space during a possible five-year career period. The proposed 90-day up/90 day down cycle, coupled with the fact that most of the effects of weightlessness may persist throughout the flight along with the realization that recovery may occupy much of the terrestrial stay, may keep the SPS workers in a deviant physical condition or state of flux for 60 to 100% of their five-year career. (JGB)

  16. Health effects assessment of staff involved in medical practices of radiation exposures

    Energy Technology Data Exchange (ETDEWEB)

    Popescu, I.A.; Lacob, O. [Institute of Public Health Iasi, Radiation Hygiene Lab. (Romania); Roman, I.; Havarneanu, D. [Institute of Public Health Iasi, Occupational Medicine Dept. (Romania)

    2006-07-01

    This study aimed, starting from new national recommendation appearance, to detect health effects of medical staff from six counties of Moldavia region involved in radiation practices and to create a national register data for radiation-induce cancer. Staff involved in medical ionizing radiation uses in Romania - health care level I are monitored on recent new recommendations for three years. The micro nuclei high levels and morphological lymphocytes changes vs. clinical diagnostic can be considered as early possible malignant signs. The micro nuclei test, although unspecific, as a new exam in our legislation can bring useful information on staff exposure and provides a guidance to occupational physician in making his medical recommendations. This cytogenetic test does not seem to correlate with smoking habit or length of exposure. Micro nuclei test both in oral mucous epithelial cells and peripheral culture lymphocytes can be considered of much specificity and correlates with a recent acute exposure level. The conclusions of individual health status surveillance and assessment of personal dose equivalent are very useful data for recording in the radiation cancer-induced register.

  17. Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile.

    Science.gov (United States)

    Reissmann, Daniel R; Erler, Antje; Hirsch, Christian; Sierwald, Ira; Machuca, Carolina; Schierz, Oliver

    2017-10-23

    Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments. Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.

  18. Effectiveness of different methods of health education: A comparative assessment in a scientific conference

    Directory of Open Access Journals (Sweden)

    Poddar Era

    2005-08-01

    Full Text Available Abstract Background Every individual mode of health education has its own merits, drawbacks as well as their own sphere of effectiveness. A specific mode of communication is more useful in a specific setting on a specific group than others. To search for optimum mode of communication for a specific audience is a major area of research in health education. The issue of imparting health education to a gathering of educated people, representing different fields of knowledge has remained a relatively less lighted aspect of health education research. In this backdrop this study was initiated for making a comparative assessment of different methods of dissemination of health education among educated people. Methods A cross-sectional interviewer administered questionnaire survey was conducted involving 142 randomly selected subjects during the last session of a five-day conference having health as main theme when the opinion of the delegates regarding different communication methods was asked for. Collected data was analyzed not only to find out the optimum mode of education dissemination in such a setting but also to find the contribution of different factors in the preferences of the study subjects. Results The participants opted more (60% for focused programs of smaller audience (sectional program. In both broad area (main program and focused area programs (sectional, the participants preferred lectures (62% and 65.7% respectively. Specific topics were preferred both in lectures (67.6% and symposia (57.7%. In the exhibition, exhibits seemed to be more attractive (62% than the posters. Qualification has emerged to be a contributing factor in peoples' choice towards sectional programme and also in their affinity to symposia. Increased age was a significant contributor in participants' preference towards specific topics. Physical barriers of communication appeared to be a problem in the main program as well as in the exhibition. Lack of coherence among

  19. Effectiveness of different methods of health education: a comparative assessment in a scientific conference.

    Science.gov (United States)

    Saha, Asim; Poddar, Era; Mankad, Minal

    2005-08-22

    Every individual mode of health education has its own merits, drawbacks as well as their own sphere of effectiveness. A specific mode of communication is more useful in a specific setting on a specific group than others. To search for optimum mode of communication for a specific audience is a major area of research in health education. The issue of imparting health education to a gathering of educated people, representing different fields of knowledge has remained a relatively less lighted aspect of health education research. In this backdrop this study was initiated for making a comparative assessment of different methods of dissemination of health education among educated people. A cross-sectional interviewer administered questionnaire survey was conducted involving 142 randomly selected subjects during the last session of a five-day conference having health as main theme when the opinion of the delegates regarding different communication methods was asked for. Collected data was analyzed not only to find out the optimum mode of education dissemination in such a setting but also to find the contribution of different factors in the preferences of the study subjects. The participants opted more (60%) for focused programs of smaller audience (sectional program). In both broad area (main program) and focused area programs (sectional), the participants preferred lectures (62% and 65.7% respectively). Specific topics were preferred both in lectures (67.6%) and symposia (57.7%). In the exhibition, exhibits seemed to be more attractive (62%) than the posters. Qualification has emerged to be a contributing factor in peoples' choice towards sectional programme and also in their affinity to symposia. Increased age was a significant contributor in participants' preference towards specific topics. Physical barriers of communication appeared to be a problem in the main program as well as in the exhibition. Lack of coherence among the speakers was reported (69%) to be a major

  20. Applications of measures of cumulative exposure to assessing air pollution health effects

    Energy Technology Data Exchange (ETDEWEB)

    Abbey, D.E.; Euler, G.L.; Magie, A.R.; Hodgkin, J.E. (Loma Linda Univ., CA (USA))

    A method for assessing the health effects of long-term cumulative exposures to air pollutants or other environmental exposures is proposed and illustrated using self-reported symptoms of chronic obstructive pulmonary disease (COPD) for a population of 7,343 non-smokers. Using zip code by month, residence histories, and interpolated exposure estimates from the network of California air monitoring stations, two alternative exposure indices were calculated to estimate cumulative exposure over an 11-yr period above different threshold levels for each of four pollutants. The indices were used with multiple logistic regression models to form dose-response curves for relative risks adjusting for covariates. Statistically significant effects were noted for total suspended particulates, total oxidants, sulfur dioxide, and passive smoking. A description is also given of how the indices are currently being used in a 10-yr follow-up of the study population. This follow-up study is utilizing data collected by the National Cancer Institute-funded Adventist Health Study and has mortality, cancer incidence, heart disease incidence, and change in self-reported COPD symptoms as outcomes.

  1. Information resources for assessing health effects from chemical exposure: Challenges, priorities, and future issues

    Energy Technology Data Exchange (ETDEWEB)

    Seigel, S. [National Library of Medicine, Bethesda, MD (United States)

    1990-12-31

    Issues related to developing information resources for assessing the health effects from chemical exposure include the question of how to address the individual political issues relevant to identifying and determining the timeliness, scientific credibility, and completeness of such kinds of information resources. One of the important ways for agencies to share information is through connection tables. This type of software is presently being used to build information products for some DHHS agencies. One of the challenges will be to convince vendors of data of the importance of trying to make data files available to communities that need them. In the future, information processing will be conducted with neural networks, object-oriented database management systems, and fuzzy-set technologies, and meta analysis techniques.

  2. Assessing the Public Health Impact and Effectiveness of Interventions To Prevent Salmonella Contamination of Sprouts.

    Science.gov (United States)

    Ding, Hongliu; Fu, Tong-Jen

    2016-01-01

    Sprouts have been a recurring public health challenge due to microbiological contamination, and Salmonella has been the major cause of sprout-associated outbreaks. Although seed treatment and microbiological testing have been applied as risk reduction measures during sprout production, the extent to which their effectiveness in reducing the public health risks associated with sprouts has not been well investigated. We conducted a quantitative risk assessment to measure the risk posed by Salmonella contamination in sprouts and to determine whether and how mitigation strategies can achieve a satisfactory risk reduction based on the assumption that the risk reduction achieved by a microbiological sampling and testing program at a given sensitivity is equivalent to that achieved by direct inactivation of pathogens. Our results indicated that if the sprouts were produced without any risk interventions, the health impact caused by sprouts contaminated with Salmonella would be very high, with a median annual estimated loss of disability-adjusted life years (DALYs) of 691,412. Seed treatment (with 20,000 ppm of calcium hypochlorite) or microbiological sampling and testing of spent irrigation water (SIW) alone could reduce the median annual impact to 734 or 4,856 DALYs, respectively. Combining seed treatment with testing of the SIW would further decrease the risk to 58 DALYs. This number could be dramatically lowered to 3.99 DALYs if sprouts were produced under conditions that included treating seeds with 20,000 ppm of calcium hypochlorite plus microbiological testing of seeds, SIW, and finished products. Our analysis shows that the public health impact due to Salmonella contamination in sprouts could be controlled if seeds are treated to reduce pathogens and microbiological sampling and testing is implemented. Future advances in intervention strategies would be important to improve sprout safety further.

  3. Environmental epigenomics: Current approaches to assess epigenetic effects of endocrine disrupting compounds (EDC's) on human health.

    Science.gov (United States)

    Tapia-Orozco, Natalia; Santiago-Toledo, Gerardo; Barrón, Valeria; Espinosa-García, Ana María; García-García, José Antonio; García-Arrazola, Roeb

    2017-04-01

    Environmental Epigenomics is a developing field to study the epigenetic effect on human health from exposure to environmental factors. Endocrine disrupting chemicals have been detected primarily in pharmaceutical drugs, personal care products, food additives, and food containers. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with a high incidence and prevalence of many endocrine-related disorders in humans. Nevertheless, further evidence is needed to establish a correlation between exposure to EDC and human disorders. Conventional detection of EDCs is based on chemical structure and concentration sample analysis. However, substantial evidence has emerged, suggesting that cell exposure to EDCs leads to epigenetic changes, independently of its chemical structure with non-monotonic low-dose responses. Consequently, a paradigm shift in toxicology assessment of EDCs is proposed based on a comprehensive review of analytical techniques used to evaluate the epigenetic effects. Fundamental insights reported elsewhere are compared in order to establish DNA methylation analysis as a viable method for assessing endocrine disruptors beyond the conventional study approach of chemical structure and concentration analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Health equity impact assessment.

    Science.gov (United States)

    Povall, Susan L; Haigh, Fiona A; Abrahams, Debbie; Scott-Samuel, Alex

    2014-12-01

    The World Health Organization's Commission on Social Determinants of Health has called for 'health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, 'downstream' factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Assessment of chronic sublethal effects of imidacloprid on honey bee colony health.

    Directory of Open Access Journals (Sweden)

    Galen P Dively

    Full Text Available Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 μg/kg over multiple brood cycles. Various endpoints of colony performance and foraging behavior were measured during and after exposure, including winter survival. Imidacloprid residues became diluted or non-detectable within colonies due to the processing of beebread and honey and the rapid metabolism of the chemical. Imidacloprid exposure doses up to 100 μg/kg had no significant effects on foraging activity or other colony performance indicators during and shortly after exposure. Diseases and pest species did not affect colony health but infestations of Varroa mites were significantly higher in exposed colonies. Honey stores indicated that exposed colonies may have avoided the contaminated food. Imidacloprid dose effects was delayed later in the summer, when colonies exposed to 20 and 100 μg/kg experienced higher rates of queen failure and broodless periods, which led to weaker colonies going into the winter. Pooled over two years, winter survival of colonies averaged 85.7, 72.4, 61.2 and 59.2% in the control, 5, 20 and 100 μg/kg treatment groups, respectively. Analysis of colony survival data showed a significant dose effect, and all contrast tests comparing survival between control and treatment groups were significant, except for colonies exposed to 5 μg/kg. Given the weight of evidence, chronic exposure to imidacloprid at the higher range of field doses (20 to 100 μg/kg in pollen of certain treated crops could cause negative impacts on honey bee colony health and reduced overwintering success, but the most likely encountered high range of field doses relevant for seed-treated crops (5 μg/kg had negligible effects on colony health and are unlikely a sole cause of colony declines.

  6. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

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

    2007-01-01

    BACKGROUND: Intersectoral Action for Health (IAH) and its Health Impact Assessment (HIA) tool are built on collaboration between actors and sectors, requiring multidimensional and horizontal way of working. The study aims to analyse the enablers and barriers when such a new way of working and tool...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...

  7. Assessing cost-effectiveness in mental health: vocational rehabilitation for schizophrenia and related conditions.

    Science.gov (United States)

    Chalamat, Maturot; Mihalopoulos, Cathrine; Carter, Rob; Vos, Theo

    2005-08-01

    Existing evidence suggests that vocational rehabilitation services, in particular individual placement and support (IPS), are effective in assisting people with schizophrenia and related conditions gain open employment. Despite this, such services are not available to all unemployed people with schizophrenia who wish to work. Existing evidence suggests that while IPS confers no clinical advantages over routine care, it does improve the proportion of people returning to employment. The objective of the current study is to investigate the net benefit of introducing IPS services into current mental health services in Australia. The net benefit of IPS is assessed from a health sector perspective using cost-benefit analysis. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis of the net benefit, defined as the benefits of IPS (comprising transfer payments averted, income tax accrued and individual income earned) minus the costs. The second stage involves application of 'second-filter' criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using the multivariate probabilistic sensitivity analysis. The costs of IPS are 10.3M Australian dollars (95% uncertainty interval 7.4M-13.6M Australian dollars), the benefits are 4.7M (3.1M-6.5M Australian dollars), resulting in a negative net benefit of 5.6M Australian dollars (8.4M-3.4M Australian dollars). The current analysis suggests that IPS costs are greater than the monetary benefits. However, the evidence-base of the current analysis is weak. Structural conditions surrounding welfare payments in Australia create disincentives to full-time employment for people with disabilities.

  8. Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness.

    Science.gov (United States)

    Cleopas, A; Villaveces, A; Charvet, A; Bovier, P A; Kolly, V; Perneger, T V

    2006-04-01

    To assess whether patients' perceptions of a hypothetical medical error are influenced by staff responsiveness, disclosure of error, and health consequences of the error. Hypothetical scenario describing a medication error submitted by mail. Three factors were manipulated at random: rapid v slow staff responsiveness to error; disclosure v non-disclosure of the error; and occurrence of serious v minor health consequences. Patients discharged from hospital. Assessment of care described in the scenario as bad or very bad, rating of care as unsafe, and intent to not recommend the hospital. Of 1274 participants who evaluated the scenario, 71.4% rated health care as bad or very bad, 60.2% rated healthcare conditions as unsafe, and 25.5% stated that they would not recommend the hospital. Rating health care as bad or very bad was associated with slow reaction to error (odds ratio (OR) 2.8, 95% CI 2.1 to 3.6), non-disclosure of error (OR 2.0, 95% CI 1.5 to 2.6), and serious health consequences (OR 3.4, 95% CI 2.6 to 4.5). Similar associations were observed for rating healthcare conditions as unsafe and the intent to not recommend the hospital. Younger patients were more sensitive to non-disclosure than older patients. Former patients view medical errors less favorably when hospital staff react slowly, when the error is not disclosed to the patient, and when the patient suffers serious health consequences.

  9. Environmental assessment for the satellite power system-concept development and evaluation program-microwave health and ecological effects

    Science.gov (United States)

    1980-01-01

    Potential health and ecological effects of the microwave beam from the microwave power transmission system (MPTS) of the satellite power system (SPS) are discussed. A detailed critical review of selected scientific articles from the published literature on the biological effects of nonionizing electromagnetic radiation is provided followed by an assessment of the possible effects of the SPS, based on exposure values for the reference system.

  10. Environmental assessment for the satellite power system-concept development and evaluation program-microwave health and ecological effects

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    This report is concerned with the potential health and ecological effects of the microwave beam from the microwave power transmission system (MPTS) of the satellite power system (SPS). The report is written in the form of a detailed critical review of selected scientific articles from the published literature on the biological effects of nonionizing electromagnetic radiation, followed by an assessment of the possible effects of the SPS, based on exposure values for the reference system (US DOE and NASA, 1978).

  11. The potential health effects of phthalate esters in children's toys: a review and risk assessment.

    Science.gov (United States)

    Wilkinson, C F; Lamb, J C

    1999-10-01

    Diisononyl phthalate (DINP) is one of several dialkyl phthalate esters that are widely used as plasticizers to impart softness and flexibility to normally rigid polyvinyl chloride (PVC) products. During the past 2 years, concern has been voiced by public interest groups and regulatory agencies in Europe, Canada, and the United States regarding the potential adverse health effects of DINP migrating from children's toys during mouthing activities. Concern has focused on potential chronic effects on the kidney and liver. In chronic high-dose studies with rodents, DINP causes a dose-related decrease in body weight, an increase in liver weight, and changes in liver cell histopathology (hypertrophy). To a lesser extent, the rodent kidney is also a target for prolonged high-level exposures of DINP. Prolonged high-level exposure of rodents to DINP leads to an increased incidence of liver tumors (adenomas and carcinomas). The chronic cancer and noncancer effects of DINP on rodent liver are consistent with its known action as a peroxisome proliferator. Peroxisome proliferation is a threshold-based effect that is reversible on cessation of exposure to proliferators such as DINP. Because rodents are uniquely responsive and humans and nonhuman primates are particularly nonresponsive to peroxisome proliferators, rodents are very poor animal models for use in human risk assessment of adverse effects mediated through peroxisome proliferation. Because DINP exerts its effects on rodent liver through a known threshold-based mechanism of little, if any, relevance to humans, a highly conservative risk assessment can be conducted using a NOAEL uncertainty factor approach. Chronic rodent no-observed-effect levels (NOELs) based on end points such as increased liver weight and changes in liver pathology that are early indicators of peroxisome proliferation but should not be considered adverse range from about 100 to 400 mg/kg/day. Application of a 100-fold uncertainty factor yields

  12. Assessment of Noise Pollution and Its Effect on Residents Health in Ahvaz, Iran in 2011

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Yari

    2016-02-01

    Full Text Available Background & Aims of the Study: Among the environmental pollutions, noise pollution, due to the potential physiological and psychological effects on humans, is of a particular importance. Exposure to noise can result in hearing loss in citizens. Health risks from noise associated with road traffic. Noise health effects are the health consequences of elevated sound levels. This study was conducted to evaluate the noise pollution and health effects due to near roadway in Ahvaz, Iran. Materials & Methods: In this descriptive-cross sectional study, Equivalent sound pressure level was measured by sound level meters in 75 points in 4 roadways, which have high density of traffic in Ahvaz city during daytime. In them, at measuring stations, on 4 days of week, at three times totally 1038 measurements were recorded that including 6 parameters of traffic noise and each measurement was recorded for 30 minutes. SPSS software’s were applied for statistical analysis. Results: According to the research findings, the equivalent sound pressure levels in all stations were equal to 72.36±2.87 dB. Based on result of this study the highest noise health effects were the nervousness and sleep quality. Conclusions: Based on the results of this study, increasing trends of traffic load there is an increasing need for proper consideration plans organizations.

  13. Environmental assessment for the Satellite Power System concept development and evaluation program: Nonmicrowave health and ecological effects

    Science.gov (United States)

    White, M. R.

    1980-11-01

    A preliminary reference system was developed. The assessment is summarized as to scope, methodology, impacts of terrestrial development, launch and recovery of spacecraft, space activities (including health effects of the space environment, ionizing radiation, electromagnetic exposure, spacecraft charging and environmental interactions, occupational hazards, etc.) and construction and operation of rectenna (ground receiving station).

  14. Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol

    Directory of Open Access Journals (Sweden)

    Laan Eva K

    2012-03-01

    Full Text Available Abstract Background Physical inactivity, unhealthy dietary habits, smoking and high alcohol consumption are recognized risk factors for cardiovascular disease and cancer. Web-based health risk assessments with tailored feedback seem promising in promoting a healthy lifestyle. This study evaluates the effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour, conducted in a worksite setting. Methods/Design The web-based health risk assessment starts with a questionnaire covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. Prognostic models are used to estimate individual cardiovascular risks. In case of high risk further biometric and laboratory evaluation is advised. All participants receive individually-tailored feedback on their responses to the health risk assessment questionnaire. The study uses a quasi-experimental design with a waiting list control group. Data are collected at baseline (T0 and after six months (T1. Within each company, clusters of employees are allocated to either the intervention or the control group. Primary outcome is lifestyle behaviour, expressed as the sum of five indicators namely physical activity, nutrition, smoking behaviour, alcohol consumption, and symptoms of burnout. Multilevel regression analysis will be used to answer the main research question and to correct for clustering effects. Baseline differences between the intervention and control group in the distribution of characteristics with a potential effect on lifestyle change will be taken into account in further analyses using propensity scores. Discussion This study will increase insight into the effectiveness of health risk assessments with tailored feedback and into conditions that may modify the effectiveness. This information can be used to design effective interventions for lifestyle behaviour change among employees. Trial

  15. Comparative environmental health assessments.

    Science.gov (United States)

    Smith, Kirk R

    2008-10-01

    Conceptual and methodological issues in calculating and comparing the health impacts from environmental risk factors in ways that are not only compatible across environmental hazards but also can be fairly compared to burdens from nonenvironmental risk factors, such as poor nutrition, unsafe sex, and smoking, are discussed. It is emphasized that a focus on environmental health burden does not always produce priorities that correspond to those related to environmental quality alone. The methods when applied to China's environmental and other risks using the Chinese burden of disease in terms of lost healthy life years as the metric are illustrated. Household environmental risks are still quite important in China, because of rural poverty, but have been exceeded by community environmental risks nationally. Global risks from climate are small at present, but have the potential to rise. Although not a major greenhouse gas emitter on a per capita basis compared to rich countries, China has already passed the threshold of imposing more global risk than it receives. The study ends with the suggestion that environmental risk assessment should use as a baseline estimates that are based on methods developed in international collaborative assessments, such as those in the WHO Comparative Risk Assessment, in order to foster comparability and policy and public confidence in the methods.

  16. Methodological, political and legal issues in the assessment of the effects of nanotechnology on human health.

    Science.gov (United States)

    Guseva Canu, Irina; Schulte, Paul A; Riediker, Michael; Fatkhutdinova, Liliya; Bergamaschi, Enrico

    2017-12-04

    Engineered nanomaterials (ENMs) raise questions among the scientific community and public health authorities about their potential risks to human health. Studying a prospective cohort of workers exposed to ENMs would be considered the gold standard for identifying potential health effects of nanotechnology and confirming the 'no effect' levels derived from cellular and animal models. However, because only small, cross-sectional studies have been conducted in the past 5 years, questions remain about the health risks of ENMs. This essay addresses the scientific, methodological, political and regulatory issues that make epidemiological research in nanotechnology-exposed communities particularly complex. Scientific challenges include the array of physicochemical parameters and ENM production conditions, the lack of universally accepted definitions of ENMs and nanotechnology workers, and the lack of information about modes of action, target organs and likely dose-response functions of ENMs. Standardisation of data collection and harmonisation of research protocols are needed to eliminate misclassification of exposures and health effects. Forming ENM worker cohorts from a combination of smaller cohorts and overcoming selection bias are also challenges. National or international registries for monitoring the exposures and health of ENM workers would be helpful for epidemiological studies, but the creation of such a registry and ENM worker cohorts will require political support and dedicated funding at the national and international levels. Public authorities and health agencies should consider carrying out an ENM awareness campaign to educate and engage all stakeholders and concerned communities in discussion of such a project. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Assessing and changing organizational social contexts for effective mental health services.

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J

    2015-03-18

    Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

  18. Methodologies of health impact assessment as part of an integrated approach to reduce effects of air pollution

    Energy Technology Data Exchange (ETDEWEB)

    Aunan, K.; Seip, H.M.

    1995-12-01

    Quantification of average frequencies of health effects on a population level is an essential part of an integrated assessment of pollution effects. Epidemiological studies seem to provide the best basis for such estimates. This paper gives an introduction to a methodology for health impact assessment and also the results from selected parts of a case study in Hungary. This case study is aimed at testing and improving the methodology for integrated assessment and focuses on energy production and consumption and implications for air pollution. Using monitoring data from Budapest, the paper gives estimates of excess frequencies of respiratory illness, mortality and other health end-points. For a number of health end-points, particles probably may serve as a good indicator component. Stochastic simulation is used to illustrate the uncertainties imbedded in the exposure-response function applied. The paper uses the ``bottom up approach`` to find cost-effective abatement strategies against pollution damages, where specific abatement measures such as emission standards for vehicles are explored in detail. It is concluded that in spite of large uncertainties in every step of the analysis, an integrated assessment of costs and benefits of different abatement measures is valuable as it clarifies the main objectives of an abatement policy and explicitly describes the adverse impacts of different activities and their relative importance. 46 refs., 11 figs., 2 tabs.

  19. Environmental assessment for the satellite power system concept development and evaluation program: nonmicrowave health and ecological effects

    Energy Technology Data Exchange (ETDEWEB)

    White, M R

    1980-11-01

    A Concept Development and Evaluation Program is being carried out for a proposed Satellite Power System (SPS). For purposes of this evaluation, a preliminary reference system has been developed. SPS, as described in the reference system, would collect solar energy on satellites in geosychronous orbit in space. The energy would be converted to microwaves and beamed to an earth-receiving antenna (rectenna). One task in the environmental part of the program is the assessment of the nonmicrowave effects on health and the environment. These effects would result from all phases of SPS development and operation. This report covers the current knowledge regarding these effects, and is based on the reference system. The assessment is summarized as to scope, methodology, impacts of terrestrial development, launch and recovery of spacecraft, space activities (including health effects of the space environment, ionizing radiation, electromagnetic exposure, spacecraft charging and environmental interactions, occupational hazards, etc.) and construction and operation of rectenna (ground receiving station).

  20. Effects of a global health and risk assessment tool for prevention of ischemic heart disease in an individual health dialogue compared with a community health strategy only results from the Live for Life health promotion programme.

    Science.gov (United States)

    Lingfors, Hans; Persson, Lars-Göran; Lindström, Kjell; Bengtsson, Calle; Lissner, Lauren

    2009-01-01

    To evaluate the effect of an individual health dialogue on health and risk factors for ischemic heart disease in addition to that of a community based strategy. Inhabitants in four communities in the area of Skaraborg, Sweden were invited to a health examination including a health dialogue both at the age of 30 and 35 (target communities). In another four communities inhabitants were invited only at the age of 35 (reference communities). Health and risk factors in 35-year old inhabitants in the target communities who participated in the health dialogue in 1989-1991 and 1994-1996 were analysed and compared with 35-year olds in the reference communities participating during the same periods of time. Inhabitants in communities where there had been a previous individualised health intervention programme had, on the community level, a more favourable development concerning dietary habits, mental stress, body mass index, waist circumference, cholesterol, blood pressure and metabolic risk profile compared to inhabitants in communities with only a community based health intervention programme. An individual lifestyle oriented health dialogue supported by a global health and risk assessment pedagogic tool seems to be more effective than a community health strategy only.

  1. Using personal sensors to assess the exposome and acute health effects.

    Science.gov (United States)

    Nieuwenhuijsen, Mark J; Donaire-Gonzalez, David; Foraster, Maria; Martinez, David; Cisneros, Andres

    2014-08-06

    The exposome encompasses the totality of human environmental exposures. Recent developments in sensor technology have made it possible to better measure personal exposure to environmental pollutants and other factors. We aimed to discuss and demonstrate the recent developments in personal sensors to measure multiple exposures and possible acute health responses, and discuss the main challenges ahead. We searched for a range of sensors to measure air pollution, noise, temperature, UV, physical activity, location, blood pressure, heart rate and lung function and to obtain information on green space and emotional status/mood and put it on a person. We discussed the recent developments and main challenges for personal sensors to measure multiple exposures. We found and put together a personal sensor set that measures a comprehensive set of personal exposures continuously over 24 h to assess part of the current exposome and acute health responses. We obtained data for a whole range of exposures and some acute health responses, but many challenges remain to apply the methodology for extended time periods and larger populations including improving the ease of wear, e.g., through miniaturization and extending battery life, and the reduction of costs. However, the technology is moving fast and opportunities will come closer for further wide spread use to assess, at least part of the exposome.

  2. Using Personal Sensors to Assess the Exposome and Acute Health Effects

    Directory of Open Access Journals (Sweden)

    Mark J. Nieuwenhuijsen

    2014-08-01

    Full Text Available Introduction: The exposome encompasses the totality of human environmental exposures. Recent developments in sensor technology have made it possible to better measure personal exposure to environmental pollutants and other factors. We aimed to discuss and demonstrate the recent developments in personal sensors to measure multiple exposures and possible acute health responses, and discuss the main challenges ahead. Methods: We searched for a range of sensors to measure air pollution, noise, temperature, UV, physical activity, location, blood pressure, heart rate and lung function and to obtain information on green space and emotional status/mood and put it on a person. Results and Conclusions: We discussed the recent developments and main challenges for personal sensors to measure multiple exposures. We found and put together a personal sensor set that measures a comprehensive set of personal exposures continuously over 24 h to assess part of the current exposome and acute health responses. We obtained data for a whole range of exposures and some acute health responses, but many challenges remain to apply the methodology for extended time periods and larger populations including improving the ease of wear, e.g., through miniaturization and extending battery life, and the reduction of costs. However, the technology is moving fast and opportunities will come closer for further wide spread use to assess, at least part of the exposome.

  3. Health effects from indoor and outdoor exposure to fine particulate matter in life cycle impact assessment

    DEFF Research Database (Denmark)

    Fantke, Peter; McKone, T.E.; Jolliet, Olivier

    Exposure to fine particulate matter (PM2.5) pollution is a major contributor to human disease burden as continuously shown in the Global Burden of Disease study series. Exposures to PM2.5 concentration outdoors and indoors contribute almost equally to this burden. Despite the importance, health...... impacts from exposure to PM2.5 are often excluded from life cycle impact assessment (LCIA) characterization profiles. This is in large part because of the lack of well-vetted harmonized guidance about how to consistently assess the exposures and impacts of indoor and outdoor emissions of PM2.5 and its...... precursors. We present a framework for calculating characterization factors for indoor and outdoor emissions of primary PM2.5 and secondary PM2.5 precursors, and a roadmap for further refining this modelling framework for operational use in LCIA. The framework was developed over the last three years...

  4. Speciation Methods Used to Assess Potential Health Effects of Toxic Metals in Environmental Materials

    Science.gov (United States)

    Wolf, Ruth E.; Morman, Suzette A.; Plumlee, Geoffrey S.

    2008-01-01

    Assessing potential exposures to toxic metals or metalloids such as arsenic and chromium in environmental materials is important in protecting public health. The chemical form of an element in, or released from, a material is also important, since some forms, such as Cr(VI), are more toxic than others, for example, Cr(III). We have used a variety of procedures to assess potential exposures to hexavalent chromium in ash and burned soils from October 2007 southern California wildfires. Synthetic lung-fluid and de-ionized water extractions simulate release in the lungs and potential environmental releases due to rainfall. Extracts were analyzed for specific chromium and arsenic species using HPLC-ICP-MS methodology. Results indicate that the highly oxidizing environment in wildfires promotes some chromium conversion to Cr(VI), and that the caustic alkalinity of ash enhances Cr(VI) release and stability in lung fluids and rainfall.

  5. Assessment of chronic sublethal effects of imidacloprid on honey bee colony health

    Science.gov (United States)

    Here we present results of a three-year study to determine the fate of imidacloprid residues in hive matrices and to assess chronic sublethal effects on whole honey bee colonies fed supplemental pollen diet containing imidacloprid at 5, 20 and 100 µg/kg over multiple brood cycles. Various endpoints ...

  6. Health effects of coastal storms and flooding in urban areas: a review and vulnerability assessment.

    Science.gov (United States)

    Lane, Kathryn; Charles-Guzman, Kizzy; Wheeler, Katherine; Abid, Zaynah; Graber, Nathan; Matte, Thomas

    2013-01-01

    Coastal storms can take a devastating toll on the public's health. Urban areas like New York City (NYC) may be particularly at risk, given their dense population, reliance on transportation, energy infrastructure that is vulnerable to flood damage, and high-rise residential housing, which may be hard-hit by power and utility outages. Climate change will exacerbate these risks in the coming decades. Sea levels are rising due to global warming, which will intensify storm surge. These projections make preparing for the health impacts of storms even more important. We conducted a broad review of the health impacts of US coastal storms to inform climate adaptation planning efforts, with a focus on outcomes relevant to NYC and urban coastal areas, and incorporated some lessons learned from recent experience with Superstorm Sandy. Based on the literature, indicators of health vulnerability were selected and mapped within NYC neighborhoods. Preparing for the broad range of anticipated effects of coastal storms and floods may help reduce the public health burden from these events.

  7. Assessment and prevention of acute health effects of weather conditions in Europe, the PHEWE project: background, objectives, design

    Directory of Open Access Journals (Sweden)

    Anderson Hugh

    2007-04-01

    Full Text Available Abstract Background The project "Assessment and prevention of acute health effects of weather conditions in Europe" (PHEWE had the aim of assessing the association between weather conditions and acute health effects, during both warm and cold seasons in 16 European cities with widely differing climatic conditions and to provide information for public health policies. Methods The PHEWE project was a three-year pan-European collaboration between epidemiologists, meteorologists and experts in public health. Meteorological, air pollution and mortality data from 16 cities and hospital admission data from 12 cities were available from 1990 to 2000. The short-term effect on mortality/morbidity was evaluated through city-specific and pooled time series analysis. The interaction between weather and air pollutants was evaluated and health impact assessments were performed to quantify the effect on the different populations. A heat/health watch warning system to predict oppressive weather conditions and alert the population was developed in a subgroup of cities and information on existing prevention policies and of adaptive strategies was gathered. Results Main results were presented in a symposium at the conference of the International Society of Environmental Epidemiology in Paris on September 6th 2006 and will be published as scientific articles. The present article introduces the project and includes a description of the database and the framework of the applied methodology. Conclusion The PHEWE project offers the opportunity to investigate the relationship between temperature and mortality in 16 European cities, representing a wide range of climatic, socio-demographic and cultural characteristics; the use of a standardized methodology allows for direct comparison between cities.

  8. Evaluation of the effects of health impact assessment practice at the local level in Monteregie.

    Science.gov (United States)

    Nour, Kareen; Dutilly-Simard, Sarah; Brousselle, Astrid; Smits, Pernelle; Buregeya, Jean-Marie; Loslier, Julie; Denis, Jean-Louis

    2016-01-27

    In Quebec (Canada), the Monteregie Regional Public Health Department has chosen to use health impact assessment (HIA) to support municipalities through a knowledge exchange and collaborative process in order to positively influence decision-making regarding local policies and projects. The value of HIA is becoming increasingly recognized by municipalities interested in planning and managing their cities with an eco-systemic perspective. However, the knowledge and tools which support the use of the HIA at regional and local levels are still missing. The general objective is to evaluate the impact the collaborative HIA process used in Monteregie has had on the formulation, adoption and implementation of policies and projects favourable to health. The methodology is based on Mayne's CA design, which allows the identification of factors which contribute to a change process. It is described as one of the best approaches to reduce uncertainty regarding the observed results and the contribution of a program. All of the HIA processes realised between January 2013 and January 2016 in Monteregie will be studied following a case study strategy. Study populations include regional and local public health professionals, municipal officers and community members implicated in these HIAs. Various qualitative and quantitative methods will be used, including examination of documentation, observations on the city grounds, and individual or group interviews. A model of change will be constructed for each HIA process and will present the logical pathway which leads to the observed results, alternative explanations and hypothesises as to why these results were obtained, and contextual factors that could have influenced them. This model will allow the production of a refined contribution story for each HIA. A convergence and divergence analysis will be completed in order to identify differences or similitudes between the different HIAs studied. In addition to contributing to the

  9. Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country

    Science.gov (United States)

    Riumallo-Herl, Carlos Javier; Kawachi, Ichiro; Avendano, Mauricio

    2014-01-01

    In high-income countries, higher social capital is associated with better health. However, there is little evidence of this association in low- and middle-income countries. We examine the association between social capital (social support and trust) and both self-rated and biologically assessed health outcomes in Chile, a middle-income country that experienced a major political transformation and welfare state expansion in the last two decades. Based on data from the Chilean National Health Survey (2009–10), we modeled self-rated health, depression, measured diabetes and hypertension as a function of social capital indicators, controlling for socio-economic status and health behavior. We used an instrumental variable approach to examine whether social capital was causally associated with health. We find that correlations between social capital and health observed in high-income countries are also observed in Chile. All social capital indicators are significantly associated with depression at all ages, and at least one social capital indicator is associated with self-rated health, hypertension and diabetes at ages 45 and above. Instrumental variable models suggest that associations for depression may reflect a causal effect from social capital indicators on mental well-being. Using aggregate social capital as instrument, we also find evidence that social capital may be causally associated with hypertension and diabetes, early markers of cardiovascular risk. Our findings highlight the potential role of social capital in the prevention of depression and early cardiovascular disease in middle-income countries. PMID:24495808

  10. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Computational Cosmology Center

    2015-05-28

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  11. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-01

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  12. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

    Science.gov (United States)

    Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

    2016-01-01

    Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

  13. Assessment of the effects of the zero gravity environment on the health and safety of space workers. Summary report

    Energy Technology Data Exchange (ETDEWEB)

    1980-02-18

    A review was conducted of currently available information relating to adverse effects to the health and safety that SPS space workers may experience. Currently available information on the responses of humans to space flight is somewhat limited and was obtained under conditions which are grossly different from conditions to be experienced by future space workers. The limitations in information and differences in conditions have been considered in the assessment of potential health and safety hazards to the SPS space workers. The study did not disclose any adverse effects that would result in long term deviations to the medical or physiological health of space workers so long as proper preventive or ameleorating actions were taken.

  14. Health effects of fine particulate matter in life cycle impact assessment: findings from the Basel Guidance Workshop

    DEFF Research Database (Denmark)

    Fantke, Peter; Jolliet, Olivier; Evans, John S.

    2015-01-01

    )/Society for Environmental Toxicology and Chemistry(SETAC) Life Cycle Initiative, respiratory inorganics’ impacts expressed as health effects from PM2.5 exposure were selected as one of the initial impact categories to undergo review with the goal of providing global guidance for implementation in life cycle impact...... various elements of the health impact pathways for PM2.5. Within the next two years, our goal is to build a global guidance framework and to determine characterization factors that are more reliable for incorporating the health effects from exposure to PM2.5into LCIA. Ideally, this will allow......Purpose Fine particulate matter (PM2.5) is considered to be one of the most important environmental factors contributing to the global human disease burden. However, due to the lack of broad consensus and harmonization in the life cycle assessment (LCA) community, there is no clear guidance on how...

  15. [Obesity and overweight. An assessment of the effectiveness of a public health intervention].

    Science.gov (United States)

    Txakartegi Etxebarria, X; López Mateo, M; Aurrekoetxea, J J

    2014-06-01

    The prevalence of excess weight (obesity and overweight) is increasing in developed countries, with preventive measures not shown to be sufficiently effective. The aim of this study was to investigate the effectiveness of the sustained prevention and treatment by Primary Care Paediatrics of overweight from early childhood. The BMI of 1669 patients from two Paediatric Teams, were compared using four different age intervals between 4 and 14 years during 2007-2009. One of the teams had spent 15 years carrying out a systematic strategy aimed at the prevention and monitoring of overweight. The BMI means in this study were higher than those shown in the 1988 Orbegozo tables, particularly in older ages and in males. The prevalence of overweight was lower in the population with the systematic intervention team, and this was significant at the end of the paediatric age, 14 years (P=.043). The overweight problem is so great that the measures aimed at their prevention are clearly beyond the scope of health professionals. However, interventions by health professionals can be effective in maintaining a healthy weight, if they are carried out on an ongoing basis. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. Effects of team-based learning on perceived teamwork and academic performance in a health assessment subject.

    Science.gov (United States)

    Park, Hyung-Ran; Kim, Chun-Ja; Park, Jee-Won; Park, Eunyoung

    2015-01-01

    The purpose of this study was to examine the effectiveness of team-based learning (a well-recognized learning and teaching strategy), applied in a health assessment subject, on nursing students' perceived teamwork (team-efficacy and team skills) and academic performance (individual and team readiness assurance tests, and examination scores). A prospective, one-group, pre- and post-test design enrolled a convenience sample of 74 second-year nursing students at a university in Suwon, Korea. Team-based learning was applied in a 2-credit health assessment subject over a 16-week semester. All students received written material one week before each class for readiness preparation. After administering individual- and team-readiness assurance tests consecutively, the subject instructor gave immediate feedback and delivered a mini-lecture to the students. Finally, students carried out skill based application exercises. The findings showed significant improvements in the mean scores of students' perceived teamwork after the introduction of team-based learning. In addition, team-efficacy was associated with team-adaptability skills and team-interpersonal skills. Regarding academic performance, team readiness assurance tests were significantly higher than individual readiness assurance tests over time. Individual readiness assurance tests were significantly related with examination scores, while team readiness assurance tests were correlated with team-efficacy and team-interpersonal skills. The application of team-based learning in a health assessment subject can enhance students' perceived teamwork and academic performance. This finding suggests that team-based learning may be an effective learning and teaching strategy for improving team-work of nursing students, who need to collaborate and effectively communicate with health care providers to improve patients' health.

  17. Assessment of the effectiveness of ventilation types for reducing the occupational exposure to bioaerosols in health care staffs

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Jafari

    2015-11-01

    Full Text Available Background & Objectives : Hospital indoor air contains a wide range of airborne pathogenic bioaerosols which have a significant impact on health care staff’ health and welfare. The aim of this study was to assess the effects of ventilation system types on occupational exposure of the health care staffs to airborne bioaerosols in the isolation room based on the patient bed arrangements and the standing locations of the health care staff. Methods: Personal exposures were measured based on five given types of ventilation system, 2 patient bed arrangements (at a corner and in the middle of the room, and two different standing locations for the health care staff (standing close to the patient’s bed, and down a side section of the bed. For personal sampling, filtration method recommended by th e American conference of governmental industrial hygienists(ACGIH was used. Result: The highest exposure to airborne bioaerosols was observed when the ventilation system was switched off. There were significant decreases in the bioaerosols concentration after using all types of ventilation system (P value 0.05. Conclusions : The most effective ventilation system for decreasing health care staff’ exposures in the isolation room was associated with supplying of air from a circular grill located on the northern wall and exhausting it through a linear slot located on the southern wall (type 1 with the ventilation rate of 12 air changes per hour.

  18. Human exposure to mercury: A critical assessment of the evidence of adverse health effects

    Energy Technology Data Exchange (ETDEWEB)

    Ratcliffe, H.E.; Swanson, G.M.; Fischer, L.J. [Michigan State Univ., East Lansing, MI (United States)

    1996-10-25

    The ubiquitous nature of mercury in the environment, its global atmospheric cycling, and its toxicity to humans at levels that are uncomfortably close to exposures experienced by a proportion of the population are some of the current concerns associated with this pollutant. The purpose of this review is to critically evaluate the scientific quality of published reports involving human exposures to mercury and associated health outcomes as an aid in the risk evaluation of this chemical. A comprehensive review of the scientific literature involving human exposures to mercury was performed and each publication evaluated using a defined set of criteria that are considered standards in epidemiologic and toxicologic research. Severe, sometimes fatal, effects of mercury exposure at high levels were primarily reported as case studies. The disasters in Minamata, Japan, in the 1950s and in Iraq in 1971-1972 clearly demonstrated neurologic effects associated with ingestion of methylmercury both in adults and in infants exposed in utero. The effects were convincingly Associated with methylmercury ingestion, despite limitations of the study design. Several well-conducted studies have investigated the effects of methylmercury at levels below those in the Iraq incident but have not provided clear evidence of an effect. The lower end of the dose-response curve constructed from the Iraq data therefore still needs to be confirmed. The studies of mercury exposure in the workplace were mainly of elemental or inorganic mercury, and effects that were observed at relatively low exposure levels were primarily neurologic and renal. Several studies have investigated effects associated with dental amalgam but have been rated as inconclusive because of methodologic deficiencies. In our overall evaluation, 29 of 110 occupational studies and 20 of 54 studies where exposure occurred in the natural environment provided at least suggestive evidence of an exposure-related effect. 259 refs., 4 tabs.

  19. Western oil shale development: a technology assessment. Volume 8. Health effects of oil shale development

    Energy Technology Data Exchange (ETDEWEB)

    Rotariu, G.J.

    1982-02-01

    Information on the potential health effects of a developing oil shale industry can be derived from two major sources: (1) the historical experience in foreign countries that have had major industries; and (2) the health effects research that has been conducted in the US in recent years. The information presented here is divided into two major sections: one dealing with the experience in foreign countries and the second dealing with the more recent work associated with current oil shale development in the US. As a result of the study, several observations can be made: (1) most of the current and historical data from foreign countries relate to occupational hazards rather than to impacts on regional populations; (2) neither the historical evidence from other countries nor the results of current research have shown pulmonary neoplasia to be a major concern, however, certain types of exposure, particularly such mixed source exposures as dust/diesel or dust/organic-vapor have not been adequately studied and the lung cancer question is not closed; (3) the industry should be alert to the incidence of skin disease in the industrial setting, however, automated techniques, modern industrial hygiene practices and realistic personal hygiene should greatly reduce the hazards associated with skin contact; and (4) the entire question of regional water contamination and any resultant health hazard has not been adequately addressed. The industrial practice of hydrotreating the crude shale oil will diminish the carcinogenic hazard of the product, however, the quantitative reduction of biological activity is dependent on the degree of hydrotreatment. Both Soviet and American experimentalists have demonstrated a correlation betweed carcinogenicity/toxicity and retorting temperature; the higher temperatures producing the more carcinogenic or toxic products.

  20. Probabilistic accident consequence uncertainty analysis -- Late health effects uncertain assessment. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Little, M.P.; Muirhead, C.R. [National Radiological Protection Board (United Kingdom); Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M. [Delft Univ. of Technology (Netherlands); Harper, F.T. [Sandia National Labs., Albuquerque, NM (United States); Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States)

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the expert panel on late health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.

  1. Probabilistic accident consequence uncertainty analysis -- Early health effects uncertainty assessment. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Haskin, F.E. [Univ. of New Mexico, Albuquerque, NM (United States); Harper, F.T. [Sandia National Labs., Albuquerque, NM (United States); Goossens, L.H.J.; Kraan, B.C.P. [Delft Univ. of Technology (Netherlands)

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA early health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the panel on early health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.

  2. Confounder selection in environmental epidemiology: assessment of health effects of prenatal mercury exposure

    DEFF Research Database (Denmark)

    Budtz-Jørgensen, Esben; Keiding, Niels; Grandjean, Philippe

    2006-01-01

    PURPOSE: The purpose of the study is to compare different approaches to the identification of confounders needed for analyzing observational data. Whereas standard analysis usually is conducted as if the confounders were known a priori, selection uncertainty also must be taken into account. METHODS...... was considered. For each criterion, uncertainty in the estimated exposure effect was assessed by using bootstrap simulations for which confounders were selected in each sample. These methods were illustrated by using data for mercury neurotoxicity in Faroe Islands children. Point estimates and standard errors...... of mercury effects on confounder-sensitive neurobehavioral outcomes were calculated for each selection procedure. RESULTS: The full model and the empirical a priori model showed approximately the same precision, and these methods were (slightly) inferior to only modified ridge regression. Lower precisions...

  3. Assessing Job Satisfaction and Effective Factors In Health Centers Staff of Paveh, 1387

    Directory of Open Access Journals (Sweden)

    Farid Gharibi

    2015-07-01

    Full Text Available ​Background and Objectives : Human resource is the most important factor in the organization and job satisfaction of staff shows the access to their expectationsthrough their jobs. Since health services staff are directly in contact with people’s health, this study was conducted to determine the job satisfaction of governmental health centers staff and also individual, familial and occupational related factors in Paveh town in order to recommend  practical solutions to improve job satisfaction. Materials and Methods : This was a descriptive-analytical and cross-sectional study. The target group was the staff of studied community in 1387. Questionnaire was used to collect data (Spearman, Man Whitney or Kruskall-Wallis. Data were tested through descriptive and analytical methods. For data analysis, SPSS 12 was employed. In analytical method, depending on the variables, proper tests were used. Results : Among 110 participants in this study, %48.2 were female and %51.8 were male. Results indicated that there is a significant statistical relationship between job satisfaction and spouse’s job (significantly 0.015, employment status (significantly 0.042 and staff income (significantly 0/006. The results showed that% 64.5 were moderately satisfied, %31.8 highly satisfied and %3.7 were unsatisfied.  The researcher achieved valuable results based on descriptive findings. Conclusion: According to the results of this study, by job satisfaction attitude in the studied centers, there is a notable gap between existing and optimum conditions which requires the attention of the organization managers. By using the results of this study, managers can design efficient and effective interventions to improve the level of job satisfaction.

  4. Probabilistic accident consequence uncertainty analysis -- Early health effects uncertainty assessment. Volume 1: Main report

    Energy Technology Data Exchange (ETDEWEB)

    Haskin, F.E. [Univ. of New Mexico, Albuquerque, NM (United States); Harper, F.T. [Sandia National Labs., Albuquerque, NM (United States); Goossens, L.H.J.; Kraan, B.C.P. [Delft Univ. of Technology (Netherlands); Grupa, J.B. [Netherlands Energy Research Foundation (Netherlands)

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA early health effects models.

  5. Probabilistic accident consequence uncertainty analysis -- Late health effects uncertainty assessment. Volume 1: Main report

    Energy Technology Data Exchange (ETDEWEB)

    Little, M.P.; Muirhead, C.R. [National Radiological Protection Board (United Kingdom); Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M. [Delft Univ. of Technology (Netherlands); Harper, F.T. [Sandia National Labs., Albuquerque, NM (United States); Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States)

    1997-12-01

    The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library of uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models.

  6. Assessing the effectiveness of the Pesticides and Farmworker Health Toolkit: a curriculum for enhancing farmworkers' understanding of pesticide safety concepts.

    Science.gov (United States)

    LePrevost, Catherine E; Storm, Julia F; Asuaje, Cesar R; Arellano, Consuelo; Cope, W Gregory

    2014-01-01

    Among agricultural workers, migrant and seasonal farmworkers have been recognized as a special risk population because these laborers encounter cultural challenges and linguistic barriers while attempting to maintain their safety and health within their working environments. The crop-specific Pesticides and Farmworker Health Toolkit (Toolkit) is a pesticide safety and health curriculum designed to communicate to farmworkers pesticide hazards commonly found in their working environments and to address Worker Protection Standard (WPS) pesticide training criteria for agricultural workers. The goal of this preliminary study was to test evaluation items for measuring knowledge increases among farmworkers and to assess the effectiveness of the Toolkit in improving farmworkers' knowledge of key WPS and risk communication concepts when the Toolkit lesson was delivered by trained trainers in the field. After receiving training on the curriculum, four participating trainers provided lessons using the Toolkit as part of their regular training responsibilities and orally administered a pre- and post-lesson evaluation instrument to 20 farmworker volunteers who were generally representative of the national farmworker population. Farmworker knowledge of pesticide safety messages significantly (PPesticides and Farmworker Health Toolkit is an effective, research-based pesticide safety and health intervention for the at-risk farmworker population and identifies a testing format appropriate for evaluating the Toolkit and other similar interventions for farmworkers in the field.

  7. Using Integrated Assessment Models to Estimate the Economic Damages from Temperature Related Human Health Effects in the US

    Science.gov (United States)

    Gilmore, E.; Calvin, K. V.; Puett, R.; Sapkota, A.; Schwarber, A.

    2014-12-01

    Climate change is projected to increase risks to human health. One pathway that may be particularly difficult to manage is adverse human health impacts (e.g. premature mortality and morbidity) from increases in mean temperatures and changing patterns of temperature extremes. Modeling how these health risks evolve over decadal time-scales is challenging as the severity of the impacts depends on changes in climate as well as socioeconomic conditions. Here, we show estimates of health damages as well as both direct and indirect economic damages that span climate and socioeconomic dimensions for each US state to 2050. We achieve this objective by extending the integrated assessment model (IAM), Global Change Assessment Model (GCAM-USA). First, we quantify the change in premature mortality. We identify a range of exposure-response relationships for temperature related mortality through a critical review of the literature. We then implement these relationships in the GCAM by coupling them with projections of future temperature patterns and population estimates. Second, we monetize the effect of these adverse health effects, including both direct and indirect economic costs through labor force participation and productivity along a range of possible economic pathways. Finally, we evaluate how uncertainty in the parameters and assumptions affects the range of possible estimates. We conclude that the model is sensitive to assumptions regarding exposure-response relationship and population growth. The economic damages, however, are driven by the estimates of income and GDP growth as well as the potential for adaptation measures, namely the use and effectiveness of air conditioning.

  8. The Feasibility and Time Required for Routine Health Literacy Assessment in Surgical Practice and Effect on Patient Satisfaction.

    Science.gov (United States)

    Eubanks, Ryan D; Nodora, Jesse N; Hsu, Chiu-Hsieh; Bagley, Marian; Bouton, Marcia E; Martinez, Maria Elena; Komenaka, Ian K

    2017-05-01

    Patients with limited health literacy (HL) have higher likelihood of problems with communication and may decrease patient satisfaction. This study was performed to determine the time required for routine HL assessment and its effect on patient satisfaction. Retrospective review over four years of consecutive patients who attended a breast clinic who underwent HL assessment as part of routine care. A total of 3126 consecutive patients from 2010 to 2014. Of the 3126 patients (96.9%), 3030 of were capable of undergoing HL assessment. No patients refused assessment, but one patient was inadvertently missed [3029 of 3030 patients (99.9%)]. The average age was 45 years and 10.5 years of education. The average time required was 1:57 minutes. Only 19 per cent of patients had adequate HL. Per each 1000 patients the time decreased (2:07, 1:58, 1:47; P < 0.001). Newest Vital Sign score did not change with time (1.6, 1.8, 1.7; P = NS). Patient satisfaction ratings increased during each subsequent year of HL assessments (P = 0.002). Routine HL assessment is feasible in surgical practice. HL assessment allows for identification of patients at risk for miscommunication. Implementation of communication strategies as described on the AMA website can improve patient-clinician communication and improve patient satisfaction.

  9. Can donor aid for health be effective in a poor country? Assessment ...

    African Journals Online (AJOL)

    related Millennium Development Goals. Significant increase in health funding was recommended by the Commission for Macroeconomics and Health. Indeed Official Development Assistance has increased significantly in Uganda. However, the ...

  10. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

    Directory of Open Access Journals (Sweden)

    Colkesen

    2011-02-01

    Full Text Available Ersen B Colkesen1,2, Bart S Ferket2,3, Jan GP Tijssen1, Roderik A Kraaijenhagen2, Coenraad K van Kalken2, Ron JG Peters11Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2NDDO Institute for Prevention and Early Diagnostics (NIPED, Amsterdam, the Netherlands; 3Department of Epidemiology, Erasmus Medical Center, Rotterdam, the NetherlandsIntroduction: A large proportion of the cardiovascular disease (CVD burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.Results: A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001 in the high-risk category (baseline

  11. 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...

  12. Chemical Risk Assessment: Traditional vs Public Health ...

    Science.gov (United States)

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  13. Strengthening cost-effectiveness analysis in Thailand through the establishment of the health intervention and technology assessment program.

    Science.gov (United States)

    Tantivess, Sripen; Teerawattananon, Yot; Mills, Anne

    2009-01-01

    Capacity is limited in the developing world to conduct cost-effectiveness analysis (CEA) of health interventions. In Thailand, there have been concerted efforts to promote evidence-based policy making, including the introduction of economic appraisals within health technology assessment (HTA). This paper reviews the experience of this lower middle-income country, with an emphasis on the creation of the Health Intervention and Technology Assessment Program (HITAP), including its mission, management structures and activities. Over the past 3 decades, several HTA programmes were implemented in Thailand but not sustained or developed further into a national institute. As a response to increasing demands for HTA evidence including CEA information, the HITAP was created in 2007 as an affiliate unit of a semi-autonomous research arm of the Ministry of Public Health. An advantage of this HTA programme over previous initiatives was that it was hosted by a research institute with long-term experience in conducting health systems and policy research and capacity building of its research staff, and excellent research and policy networks. To deal with existing impediments to conducting health economics research, the main strategies of the HITAP were carefully devised to include not only capacity strengthening of its researchers and administrative staff, but also the development of essential elements for the country's health economic evaluation methodology. These included, for example, methodological guidelines, standard protocols and benchmarks for resource allocation, many of which have been adopted by national policy-making bodies including the three major public health insurance plans. Networks and collaborations with domestic and foreign institutes have been sought as a means of resource mobilization and exchange. Although the HITAP is well financed by a number of government agencies and international organizations, the programme is vulnerable to shortages of qualified

  14. The effect of private health insurance on medical care utilization and self-assessed health in Germany

    NARCIS (Netherlands)

    Hullegie, P.G.J.; Klein, T.J.

    2010-01-01

    In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance

  15. A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru

    Science.gov (United States)

    Rydberg, Henny; Marrone, Gaetano; Strömdahl, Susanne; von Schreeb, Johan

    2015-01-01

    Background Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity. Methods We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey’s ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case – an 8.4 magnitude earthquake that hit southern Peru in 2001. Results and conclusions Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post- earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters. PMID:26090999

  16. A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru.

    Science.gov (United States)

    Rydberg, Henny; Marrone, Gaetano; Strömdahl, Susanne; von Schreeb, Johan

    2015-01-01

    Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity. We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey's ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case--an 8.4 magnitude earthquake that hit southern Peru in 2001. Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post-earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters.

  17. Health Impact Assessment: Linking Public Health to ...

    Science.gov (United States)

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  18. The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005–2009

    Science.gov (United States)

    2013-01-01

    Background Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders

  19. Clustering patient mobility patterns to assess effectiveness of health-service delivery.

    Science.gov (United States)

    Delil, Selman; Çelik, Rahmi Nurhan; San, Sayın; Dundar, Murat

    2017-07-04

    Analysis of patient mobility in a country not only gives an idea of how the health-care system works, but also can be a guideline to determine the quality of health care and health disparity among regions. Even though determination of patient movement is important, it is not often realized that patient mobility could have a unique pattern beyond health-related endowments (e.g., facilities, medical staff). This study therefore addresses the following research question: Is there a way to identify regions with similar patterns using spatio-temporal distribution of patient mobility? The aim of the paper is to answer this question and improve a classification method that is useful for populous countries like Turkey that have many administrative areas. The data used in the study consist of spatio-temporal information on patient mobility for the period between 2009 and 2013. Patient mobility patterns based on the number of patients attracted/escaping across 81 provinces of Turkey are illustrated graphically. The hierarchical clustering method is used to group provinces in terms of the mobility characteristics revealed by the patterns. Clustered groups of provinces are analyzed using non-parametric statistical tests to identify potential correlations between clustered groups and the selected basic health indicators. Ineffective health-care delivery in certain regions of Turkey was determined through identifying patient mobility patterns. High escape values obtained for a large number of provinces suggest poor health-care accessibility. On the other hand, over the period of time studied, visualization of temporal mobility revealed a considerable decrease in the escape ratio for inadequately equipped provinces. Among four of twelve clusters created using the hierarchical clustering method, which include 64 of 81 Turkish provinces, there was a statistically significant relationship between the patterns and the selected basic health indicators of the clusters. The remaining

  20. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... 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.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, 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...

  1. Assessment of the health and environmental effects of power generation in the Midwest. Volume II. Ecological effects

    Energy Technology Data Exchange (ETDEWEB)

    Dvorak, A J; Pentecost, E D

    1977-04-01

    This report presents an initial evaluation of the major health and environmental issues associated with increased coal use in the six Midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for the period 1975 to 2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. Volume I of the report includes a characterization of the energy demand and siting scenarios, coal related technologies, and coal resources, and the related impacts on air quality, water quality, and human health. Volume II includes background information on the native ecosystems, climate, soils, and agricultural land use and a description of the ecological impacts expected from coal utilization in southern Illinois, which as ecosystems representative of a large segment of the six-state area.

  2. Preliminary assessment of the health and environmental effects of coal utilization in the midwest. Volume I. Energy scenarios, technology characterizations, air and water resource impacts, and health effects

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-01-01

    An initial evaluation of the major health and environmental issues associated with increased coal use in the six midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin is presented. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for the period 1975 to 2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. Included are: (1) a characterization of the energy demand and siting scenarios, coal related technologies, and coal resources, and (2) the related impacts on air quality, water availability, water quality, and human health.

  3. National Coal Utilization Assessment. a preliminary assessment of the health and environmental effects of coal utilization in the Midwest. Volume I. Energy scenarios, technology characterizations, air and water resource impacts, and health effects

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    This report presents an initial evaluation of the major health and environmental issues associated with increased coal use in the six midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for 1975-2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. The following are among the more significant issues identified and evaluated in this study: If environmental and related issues can be resolved, coal will continue to be a major source of energy for the Midwest; existing sulfur emission constraints will increase use of western coal; the resource requirements and environmental impacts of coal utilization will require major significant environmental and economic tradeoffs in site selection; short-term (24-hr) ambient standards for sulfur dioxide will limit the sizes of coal facilities or require advanced control technologies; an impact on public health may result from long-range transport of airborne sulfur emissions from coal facilities in the Midwest; inadequately controlled effluents from coal gasification may cause violations of water-quality standards; the major ecological effects of coal extraction are from pre-mining and post-reclamation land use; and sulfur dioxide is the major potential contributor to effects on vegetation of atmospheric emissions from coal facilities.

  4. Health risk assessments for alumina refineries.

    Science.gov (United States)

    Donoghue, A Michael; Coffey, Patrick S

    2014-05-01

    To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10(-6). The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries.

  5. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

    Science.gov (United States)

    Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

    2016-01-01

    An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for

  6. Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol

    NARCIS (Netherlands)

    Laan, Eva K.; Kraaijenhagen, Roderik A.; Peek, Niels; Busschers, Wim B.; Deutekom, Marije; Bossuyt, Patrick M.; Stronks, Karien; Essink-Bot, Marie-Louise

    2012-01-01

    Background: Physical inactivity, unhealthy dietary habits, smoking and high alcohol consumption are recognized risk factors for cardiovascular disease and cancer. Web-based health risk assessments with tailored feedback seem promising in promoting a healthy lifestyle. This study evaluates the

  7. Fine particulate matter in the tropical environment: monsoonal effects, source apportionment, and health risk assessment

    Directory of Open Access Journals (Sweden)

    M. F. Khan

    2016-01-01

    Full Text Available The health implications of PM2.5 in the tropical region of Southeast Asia (SEA are significant as PM2.5 can pose serious health concerns. PM2.5 concentration and sources here are strongly influenced by changes in the monsoon regime from the south-west quadrant to the north-east quadrant in the region. In this work, PM2.5 samples were collected at a semi-urban area using a high-volume air sampler at different seasons on 24 h basis. Analysis of trace elements and water-soluble ions was performed using inductively coupled plasma mass spectroscopy (ICP-MS and ion chromatography (IC, respectively. Apportionment analysis of PM2.5 was carried out using the United States Environmental Protection Agency (US EPA positive matrix factorization (PMF 5.0 and a mass closure model. We quantitatively characterized the health risks posed to human populations through the inhalation of selected heavy metals in PM2.5. 48 % of the samples collected exceeded the World Health Organization (WHO 24 h PM2.5 guideline but only 19 % of the samples exceeded 24 h US EPA National Ambient Air Quality Standard (NAAQS. The PM2.5 concentration was slightly higher during the north-east monsoon compared to south-west monsoon. The main trace metals identified were As, Pb, Cd, Ni, Mn, V, and Cr while the main ions were SO42−, NO3−, NH4+, and Na. The mass closure model identified four major sources of PM2.5 that account for 55 % of total mass balance. The four sources are mineral matter (MIN (35 %, secondary inorganic aerosol (SIA (11 %, sea salt (SS (7 %, and trace elements (TE (2 %. PMF 5.0 elucidated five potential sources: motor vehicle emissions coupled with biomass burning (31 % were the most dominant, followed by marine/sulfate aerosol (20 %, coal burning (19 %, nitrate aerosol (17 %, and mineral/road dust (13 %. The hazard quotient (HQ for four selected metals (Pb, As, Cd, and Ni in PM2.5 mass was highest in PM2.5 mass from the coal burning

  8. Climate Effects on Health

    Science.gov (United States)

    ... Guidance and Trainings Webinars Data and Tools Publications Climate Effects on Health Recommend on Facebook Tweet Share ... effects has been excerpted from the Third National Climate Assessment’s Health Chapter . Additional information regarding the health ...

  9. 42 CFR 90.3 - Procedures for requesting health assessments.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for requesting health assessments. 90.3... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.3 Procedures for requesting health assessments. (a) ATSDR will...

  10. Spiritual assessment in mental health recovery.

    Science.gov (United States)

    Gomi, Sachiko; Starnino, Vincent R; Canda, Edward R

    2014-05-01

    Mental health recovery-oriented and strengths model proponents recognize spirituality to be a key aspect of the recovery process. In order to incorporate spirituality in practice, practitioners need to know how to conduct spiritual assessment effectively. Although implicit and explicit spiritual assessment approaches have been identified as useful frameworks for conducting spiritual assessment, there is a gap in knowledge about what constitutes effective approaches and questions for addressing spirituality in the lives of people with psychiatric disabilities. To address this gap, focus group interviews were conducted with providers and consumers of mental health services in order to develop practical guidance for spiritual assessment. Focus group participants provided feedback about a list of sample spiritual assessment questions and then suggested principles and questions for practitioners to use. Collective insights from the focus groups formed the basis for recommendations for spiritual assessment.

  11. Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya.

    Science.gov (United States)

    Barasa, Edwine W; Maina, Thomas; Ravishankar, Nirmala

    2017-02-06

    Monitoring the incidence and intensity of catastrophic health expenditure, as well as the impoverishing effects of out of pocket costs to access healthcare, is a key part of benchmarking Kenya's progress towards reducing the financial burden that households experience when accessing healthcare. The study relies on data from the nationally-representative Kenya Household Expenditure and Utilization Survey conducted in 2013 (n =33,675). We undertook health equity analysis to estimate the incidence and intensity of catastrophic expenditure. Households were considered to have incurred catastrophic expenditures if their annual out of-pocket health expenditures exceeded 40% of their annual non-food expenditure. We assessed the impoverishing effects of out of pocket payments using the Kenya national poverty line. We distinguished between direct payments for healthcare such as payments for consultation, medicines, medical procedures, and total healthcare expenditure that includes direct healthcare payments and the cost of transportation to and from health facilities. We used logistic regression analysis to explore the factors associated with the incidence of catastrophic expenditures. When only direct payments to healthcare providers were considered, the incidence of catastrophic expenditures was 4.52%. When transport costs are included, the incidence of catastrophic expenditure increased to 6.58%. 453,470 Kenyans are pushed into poverty annually as a result of direct payments for healthcare. When the cost of transport is included, that number increases by more than one third to 619,541. Unemployment of the household head, presence of an elderly person, a person with a chronic ailment, a large household size, lower household social-economic status, and residence in marginalized regions of the country are significantly associated with increased odds of incurring catastrophic expenditures. Kenyan policy makers should prioritize extending pre-payment mechanisms to more

  12. Whole dairy matrix or single nutrients in assessment of health effects

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev; Bertram, Hanne Christine; Bonjour, Jean-Philippe

    2017-01-01

    Foods consist of a large number of different nutrients that are contained in a complex structure. The nature of the food structure and the nutrients therein (i.e., the food matrix) will determine the nutrient digestion and absorption, thereby altering the overall nutritional properties of the food...... structures and common processing methods may enhance interactions between nutrients in the dairy matrix, which may modify the metabolic effects of dairy consumption. 5) In conclusion, the nutritional values of dairy products should not be considered equivalent to their nutrient contents but, rather...

  13. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: A follow-up study

    NARCIS (Netherlands)

    E.B. Colkesen (Ersen); B.S. Ferket (Bart); J.G.P. Tijssen (Jan); R.A. Kraaijenhagen (Roderik); C.K. Kalken (Coenraad); R.J. Peters (Ron)

    2011-01-01

    textabstractIntroduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web- based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising

  14. Initial findings from the implementation of a community-based sentinel surveillance system to assess the health effects of climate change in Alaska.

    Science.gov (United States)

    Driscoll, David L; Sunbury, Tenaya; Johnston, Janet; Renes, Sue

    2013-01-01

    This report describes the results of a study to determine whether a community-based sentinel surveillance system can be developed and implemented to assess the health effects of climate change, and to contribute to local discussions to mitigate these health effects. The purpose of this report is to describe the process and outcomes of this innovative approach to identifying priority areas for adaptation investment. This report can be used to assist local, state and federal governments in determining how to develop actions and policies to promote adaptation to climate change. To evaluate the health effects of climate change in rural Alaska. We conducted an iterative and participatory process to develop metrics, an instrument and a protocol to collect sentinel surveillance data on the health effects of climate change in 3 ecologically distinct regions of the state. We collected surveillance data from 91 study participants over the course of 12 months. These data were analyzed and categorized by frequency and association between specific health outcomes or health-related factors (such as food security) and reported exposure to environmental effects of climate change. We found significant associations between several health outcomes and health outcome mediators and reported exposures. We presented these data to study participants in community settings and moderated discussions of likely causal factors for these measured associations, and helped community residents to identify specific adaption measures to mitigate those health effects. We conclude that community-based sentinel surveillance is an effective method for assessing health outcomes from exposure to environmental effects of climate change, and informing climate change health adaptation planning in Alaskan communities. We contend that it would be effective in other regions of the nation as well.

  15. 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...

  16. Effectiveness of pharmaceutical therapy of ADHD (Attention-Deficit/Hyperactivity Disorder in adults – health technology assessment

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2010-01-01

    Full Text Available Background: Attention-Deficit/Hyperactivity Disorder (ADHD is a mental disorder. Symptoms include hyperactivity, lack of attentiveness, and frivolousness. This disorder always begins in childhood, but can remain through adulthood. ADHD affects all areas of life and limits the quality of life due to its symptoms and the high rate of associated disorders that can develop. An established form of therapy is using stimulant medications, most commonly, containing Methylphenidate as the active ingredient. However, in Germany this ingredient is not approved for adults suffering from ADHD. Therefore, many adults cannot obtain appropriate medication to treat this disorder. Objective: The following report (Health Technology Assessment [HTA] examines the effectiveness and cost-effectiveness of the medical treatment of ADHD in adults as well as the ethical, social and legal aspects thereof. Methods: In August 2009, a systematic literature search is performed in all relevant scientific databases. The selected citations fulfill predetermined inclusion criteria. The data in the publications is then systematically extracted, reviewed and assessed. A manual search of citations is conducted as well. Results: Nineteen studies fulfill the inclusion criteria: nine randomised controlled studies (RCT, five meta-analyses, three economic studies and two studies relevant to the legal aspects of the HTA.All RCT reveal that adult patients who receive medication containing a stimulant (Methylphenidate and Amphetamine and Atomoxetine, see a reduction of ADHD symptoms compared to the placebo-treated patients. The drug response rate among the control group ranges from 7 to 42%; in the treatment group from 17 to 59.6%. The meta-analyses confirm the findings of the RCT. In light of the control group, it can be ascertained that there are higher annual costs (both direct and indirect for patients with ADHD. The average annual medical expenses for an adult with ADHD were 1,262 $ in

  17. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    standardised scientific methods to characterise the probability and magnitude of harm caused by a hazard, preferably in a quantitative manner. In turn, HIA is a process to assess future impacts of recent proposals and is dominated by qualitative evaluation. It makes a projection for a future scenario rather......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...... their relationship. The experiences accumulated during the preparation of several case studies in a large scale international project (RAPID) are used for argumentation and formulation of recommendations on how risk assessment can be systematically integrated into the HIA process. Risk assessment uses well...

  18. Assessing health professional education: workshop summary

    National Research Council Canada - National Science Library

    Cuff, Patricia A

    2014-01-01

    "Assessing health professional education is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health...

  19. Multipollutant health effect simulations

    Data.gov (United States)

    U.S. Environmental Protection Agency — Resulting betas (health effects) from a variety of copollutant epidemiologic models used to analyze the impact of exposure measurement error on health effect...

  20. Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters.

    Science.gov (United States)

    Cronjé, Frans J; Sommers, Levenda S; Faulkner, James K; Meintjes, W A J; Van Wijk, Charles H; Turner, Robert P

    2017-02-01

    The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27-76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18-84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p 1 year.

  1. Work or place? Assessing the concurrent effects of workplace exploitation and area-of-residence economic inequality on individual health.

    Science.gov (United States)

    Muntaner, Carles; Li, Yong; Ng, Edwin; Benach, Joan; Chung, Haejoo

    2011-01-01

    Building on previous multilevel studies in social epidemiology, this cross-sectional study examines, simultaneously, the contextual effects of workplace exploitation and area-of-residence economic inequality on social inequalities in health among low-income nursing assistants. A total of 868 nursing assistants recruited from 55 nursing homes in Kentucky, Ohio, and West Virginia were surveyed between 1999 and 2001. Using a cross-classified multilevel design, the authors tested the effects of area-of-residence (income inequality and racial segregation), workplace (type of nursing home ownership and managerial pressure), and individual-level (age, gender, race/ethnicity, health insurance, length of employment, social support, type of nursing unit, preexisting psychopathology, physical health, education, and income) variables on health (self-reported health and activity limitations) and behavioral outcomes (alcohol use and caffeine consumption). Findings reveal that overall health was associated with both workplace exploitation and area-of-residence income inequality; area of residence was associated with activity limitations and binge drinking; and workplace exploitation was associated with caffeine consumption. This study explicitly accounts for the multiple contextual structure and effects of economic inequality on health. More work is necessary to replicate the current findings and establish robust conclusions on workplace and area of residence that might help inform interventions.

  2. Is HIA the most effective tool to assess the impact on health of climate change mitigation policies at the local level? A case study in Geneva, Switzerland.

    Science.gov (United States)

    Diallo, Thierno; Cantoreggi, Nicola; Simos, Jean; Christie, Derek P T H

    2017-06-01

    This study aims to understand how the health dimension is integrated into four impact assessment tools used in Geneva, Switzerland: environmental impact assessment (EIA), strategic environmental assessment (SEA), sustainability assessment (SA) and health impact assessment (HIA). We have chosen as a case study greenhouse gas (GHG) emissions reduction policies chosen by the city of Geneva. The methodological approach consists in analysing EIA, SEA, SA and HIA conducted on three projects in three topic areas: urban planning, heating and transportation. These projects are: a complex urbanisation plan in an urban neighbourhood in Geneva (the Gare des Eaux-Vives project), a sustainable transportation plan for a central district in Geneva (the St-Gervais transportation project) and a strategy to encourage the City's employees to use sustainable transport for local business travel. The results show some shortcomings in the consideration of health in SEA, EIA and SA. This work highlights a narrow vision of health in SEA and EIA, limiting itself to a review of the effects of projects on the determinants of the physical environment as required by the legislation relating to these tools. EIA does not require the integration of the health dimension. As for SA, our research found that health is treated much more superficially than in HIA and primarily through the analysis of 'health and safety' criteria. It appears from this work that HIA is the tool which provides the most elaborate assessment, compared to SA, SEA or EIA, of the consequences for health of the GHG reduction policies chosen by the local decision-makers of a city. However, our study suggests that the HIA community should identify the situations in which HIA should be carried out and in which cases it is better to include health issues within an integrated analysis.

  3. Assessing Financial Health in Community Colleges

    Science.gov (United States)

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

    In this age of educational accountability, there is an increasing emphasis on assessment and institutional effectiveness, not only in the academic arena but also in other aspects of community college operation, such as fiscal health and stability, revenue generation, resource allocation, facilities, workforce development, and community enrichment…

  4. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  5. An assessment of health behavior peer effects in Peking University dormitories: a randomized cluster-assignment design for interference.

    Science.gov (United States)

    Yuan, Changzheng; Lv, Jun; VanderWeele, Tyler J

    2013-01-01

    Relatively little is known about the peer influence in health behaviors within university dormitory rooms. Moreover, in China, the problem of unhealthy behaviors among university students has not yet been sufficiently recognized. We thus investigated health behavior peer influence in Peking University dormitories utilizing a randomized cluster-assignment design. Cross-sectional in-dormitory survey. Current students from Peking University Health Science Center from April to June, 2009. Self-reported questionnaire on health behaviors: physical activity (including bicycling), dietary intake and tobacco use. Use of bicycle, moderate-intensity exercise, frequency of sweet food and soybean milk intake, frequency of roasted/baked/toasted food intake were behaviors significantly or marginally significantly affected by peer influence. Health behavior peer effects exist within dormitory rooms among university students. This could provide guidance on room assignment, or inform intervention programs. Examining these may demand attention from university administrators and policy makers.

  6. Health technology assessment in Belgium.

    Science.gov (United States)

    Cleemput, I; Kesteloot, K

    2000-01-01

    The Belgian healthcare system has a Bismarck-type compulsory health insurance, covering almost the entire population, combined with private provision of care. Providers are public health services, independent pharmacists, independent ambulatory care professionals, and hospitals and geriatric care facilities. Healthcare responsibilities are shared between the national Ministries of Public Health and Social Affairs, and the Dutch-, French-, and German-speaking Community Ministries of Health. The national ministries are responsible for sickness and disability insurance, financing, determination of accreditation criteria for hospitals and heavy medical care units, and construction of new hospitals. The six sickness and disability insurance funds are responsible for reimbursing health service benefits and paying disability benefits. The system's strength is that care is highly accessible and responsive to patients. However, the healthcare system's size remained relatively uncontrolled until recently, there is an excess supply of certain types of care, and there is a large number of small hospitals. The national government created a legal framework to modernize the insurance system to control budgetary deficits. Measures for reducing healthcare expenditures include regulating healthcare supply, healthcare evaluation, medical practice organization, and hospital budgets. The need to control healthcare facilities and quality of care in hospitals led to formal procedures for opening hospitals, acquiring expensive medical equipment, and developing highly specialized services. Reforms in payment and regulation are being considered. Health technology assessment (HTA) has played little part in the reforms so far. Belgium has no formal national program for HTA. The future of HTA in Belgium depends on a changing perception by providers and policy makers that health care needs a stronger scientific base.

  7. Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression

    DEFF Research Database (Denmark)

    Larsen, Klaus; Merlo, Juan

    2005-01-01

    The logistic regression model is frequently used in epidemiologic studies, yielding odds ratio or relative risk interpretations. Inspired by the theory of linear normal models, the logistic regression model has been extended to allow for correlated responses by introducing random effects. However......, the model does not inherit the interpretational features of the normal model. In this paper, the authors argue that the existing measures are unsatisfactory (and some of them are even improper) when quantifying results from multilevel logistic regression analyses. The authors suggest a measure...... of heterogeneity, the median odds ratio, that quantifies cluster heterogeneity and facilitates a direct comparison between covariate effects and the magnitude of heterogeneity in terms of well-known odds ratios. Quantifying cluster-level covariates in a meaningful way is a challenge in multilevel logistic...

  8. Health assessments for health governance-concepts and methodologies.

    Science.gov (United States)

    Fehr, Rainer; Alexanderson, Kristina; Favaretti, Carlo; de Jong, Judith; La Torre, Giuseppe; Lim, Tek-Ang; Martin-Olmedo, Piedad; Mekel, Odile C L; Michelsen, Kai; Rosenkötter, Nicole; Verschuuren, Marieke; de Waure, Chiara; Zeegers Paget, Dineke

    2017-08-01

    For better supporting the science-governance interface, the potential of health assessments appears underrated. To identify what various types of health assessment have in common; how they differ; which assessment(s) to apply for which purpose; and what needs and options there are for future joint development. This review is based on five types of health assessment: monitoring/surveillance/reporting, assessment of health impact, of health technology, of health systems performance, health-related economic assessment. The approach is exploratory and includes: applying an agreed set of comparative criteria; circulating and supplementing synoptic tables; and interpreting the results. Two of the assessments deal with the question 'Where do we stand?', two others with variants of 'What if' questions. Economic Assessment can take place in combination with any of the others. The assessments involve both overall 'procedures' and a variety of 'methods' which inescapably reflect some subjective assumptions and decisions, e.g. on issue framing. Resources and assistance exist for all these assessments. The paper indicates which type of assessment is appropriate for what purpose. Although scientific soundness of health assessments is not trivial to secure, existing types of health assessment can be interpreted as a useful 'toolkit' for supporting governance. If current traces of 'silo' thinking can be overcome, the attainability of a more unified culture of health assessments increases and such assessments might more widely be recognized as a prime, 'tried and tested' way to voice Public Health knowledge and to support rational governance and policy-making.

  9. Using a health informatics system to assess effect of a federal cigarette tax increase on readiness to quit among low-income smokers, Louisiana, 2009.

    Science.gov (United States)

    Tseng, Tung-Sung; Moody-Thomas, Sarah; Horswell, Ronald; Yi, Yong; Celestin, Michael D; Jones, Krysten D

    2014-04-04

    Health informatics systems are a proven tool for tobacco control interventions. To address the needs of low-income groups, the Tobacco Control Initiative was established in partnership with the Louisiana State University Health Care Services Division to provide cost-effective tobacco use cessation services through the health informatics system in the state public hospital system. In this study we used a Web-based, result-reporting application to monitor and assess the effect of the 2009 federal cigarette tax increase. We assessed readiness to quit tobacco use before and after a cigarette tax increase among low-income tobacco users who were outpatients in a public hospital system. Overall, there was an increase in readiness to quit, from 22% during the first week of February to 33% during the first week of April, when the tax went into effect. Smokers who were female, 31 or older, African American, and assessed at a clinic visit in April were more likely to report readiness to quit than were men, those aged 30 or younger, those who were white, and those who were assessed at a clinic visit in February. A health informatics system that efficiently tracks trends in readiness to quit can be used in combination with other strategies and thus optimize efforts to control tobacco use. Our data suggest that a cigarette tax increase affects smokers' readiness to quit and provides an opportunity to intervene at the most beneficial time.

  10. Ozone Health Risk Assessment for Selected Urban Areas

    Science.gov (United States)

    The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

  11. Effects of artificial light at night on human health: A literature review of observational and experimental studies applied to exposure assessment.

    Science.gov (United States)

    Cho, YongMin; Ryu, Seung-Hun; Lee, Byeo Ri; Kim, Kyung Hee; Lee, Eunil; Choi, Jaewook

    2015-01-01

    It has frequently been reported that exposure to artificial light at night (ALAN) may cause negative health effects, such as breast cancer, circadian phase disruption and sleep disorders. Here, we reviewed the literature assessing the effects of human exposure to ALAN in order to list the health effects of various aspects of ALAN. Several electronic databases were searched for articles, published through August 2014, related to assessing the effects of exposure to ALAN on human health; these also included the details of experiments on such exposure. A total of 85 articles were included in the review. Several observational studies showed that outdoor ALAN levels are a risk factor for breast cancer and reported that indoor light intensity and individual lighting habits were relevant to this risk. Exposure to artificial bright light during the nighttime suppresses melatonin secretion, increases sleep onset latency (SOL) and increases alertness. Circadian misalignment caused by chronic ALAN exposure may have negative effects on the psychological, cardiovascular and/or metabolic functions. ALAN also causes circadian phase disruption, which increases with longer duration of exposure and with exposure later in the evening. It has also been reported that shorter wavelengths of light preferentially disturb melatonin secretion and cause circadian phase shifts, even if the light is not bright. This literature review may be helpful to understand the health effects of ALAN exposure and suggests that it is necessary to consider various characteristics of artificial light, beyond mere intensity.

  12. Oral Histories as Critical Qualitative Inquiry in Community Health Assessment

    Science.gov (United States)

    Hernandez, Sarah Gabriella; Genkova, Ana; Castañeda, Yvette; Alexander, Simone; Hebert-Beirne, Jennifer

    2017-01-01

    Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories…

  13. Effect of a 4-week Nordic walking training on the physical fitness and self-assessment of the quality of health of women of the perimenopausal age.

    Science.gov (United States)

    Saulicz, Mariola; Saulicz, Edward; Myśliwiec, Andrzej; Wolny, Tomasz; Linek, Paweł; Knapik, Andrzej; Rottermund, Jerzy

    2015-06-01

    To determine the effect of a 4-week Nordic walking training on the physical fitness of women of the perimenopausal age and self-assessment of the quality of their health. Eighty-four women between 48 and 58 years of age were included in the study. Half of the group (42) was assigned to the control group and the other half was assigned to the experimental group. In both groups studied, physical fitness was evaluated using a modified Fullerton's test and a quality of life self-assessment SF-36 (Short Form of Health Status Questionnaire). Similar tests were repeated 4 weeks later. In the experimental group, a Nordic walking training was conducted between the two tests. During 4 weeks, 10 training sessions were performed, each session was 60 minutes long, and there was an interval of 2 days between the sessions. A 4-week Nordic walking training resulted in a significant improvement (p training also showed a significant improvement in health in terms of both physical health (p training has a positive effect on the physical fitness of the women in the perimenopausal age. Participation in training contributes also to a clearly higher self-assessment of the quality of health.

  14. Public assessment of key performance indicators of healthcare in a Canadian province: the effect of age and chronic health problems.

    Science.gov (United States)

    Nurullah, Abu Sadat; Northcott, Herbert C; Harvey, Michael D

    2014-01-15

    This study explores the effect of age and chronic conditions on public perceptions of the health system, as measured by the Key Performance Indicators (KPIs) of healthcare, in the province of Alberta in Canada. Drawing from data collected by Government of Alberta's Department of Health and Wellness, this research examines two key questions: (1) Do people in the 65+ age group rate the KPIs of healthcare (i.e., availability, accessibility, quality, outcome, and satisfaction) more favorably compared to people in younger age groups in Alberta? (2) Does the rating of KPIs of healthcare in Alberta vary with different chronic conditions (i.e., no chronic problem, chronic illnesses without pain, and chronic pain)? The findings indicate that people in the older age group tend to rate the KPIs of healthcare more favorably compared to younger age groups in Alberta, net of socio-demographic factors, self-reported health status, and knowledge and utilization of health services. However, people experiencing chronic pain are less likely to rate the KPIs of healthcare favorably compared to people with no chronic health problem in Alberta. Discussion includes implications of the findings for the healthcare system in the province.

  15. An assessment of health behavior peer effects in Peking University dormitories: a randomized cluster-assignment design for interference.

    Directory of Open Access Journals (Sweden)

    Changzheng Yuan

    Full Text Available BACKGROUND: Relatively little is known about the peer influence in health behaviors within university dormitory rooms. Moreover, in China, the problem of unhealthy behaviors among university students has not yet been sufficiently recognized. We thus investigated health behavior peer influence in Peking University dormitories utilizing a randomized cluster-assignment design. METHODS: STUDY DESIGN: Cross-sectional in-dormitory survey. STUDY POPULATION: Current students from Peking University Health Science Center from April to June, 2009. MEASUREMENT: Self-reported questionnaire on health behaviors: physical activity (including bicycling, dietary intake and tobacco use. RESULTS: Use of bicycle, moderate-intensity exercise, frequency of sweet food and soybean milk intake, frequency of roasted/baked/toasted food intake were behaviors significantly or marginally significantly affected by peer influence. CONCLUSION: Health behavior peer effects exist within dormitory rooms among university students. This could provide guidance on room assignment, or inform intervention programs. Examining these may demand attention from university administrators and policy makers.

  16. An economic assessment of the health effects and crop yield losses caused by air pollution in mainland China.

    Science.gov (United States)

    Miao, Weijie; Huang, Xin; Song, Yu

    2017-06-01

    Air pollution is severe in China, and pollutants such as PM2.5 and surface O3 may cause major damage to human health and crops, respectively. Few studies have considered the health effects of PM2.5 or the loss of crop yields due to surface O3 using model-simulated air pollution data in China. We used gridded outputs from the WRF-Chem model, high resolution population data, and crop yield data to evaluate the effects on human health and crop yield in mainland China. Our results showed that outdoor PM2.5 pollution was responsible for 1.70-1.99 million cases of all-cause mortality in 2006. The economic costs of these health effects were estimated to be 151.1-176.9 billion USD, of which 90% were attributed to mortality. The estimated crop yield losses for wheat, rice, maize, and soybean were approximately 9, 4.6, 0.44, and 0.34 million tons, respectively, resulting in economic losses of 3.4 billion USD. The total economic losses due to ambient air pollution were estimated to be 154.5-180.3 billion USD, accounting for approximately 5.7%-6.6% of the total GDP of China in 2006. Our results show that both population health and staple crop yields in China have been significantly affected by exposure to air pollution. Measures should be taken to reduce emissions, improve air quality, and mitigate the economic loss. Copyright © 2016. Published by Elsevier B.V.

  17. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  18. Assessing theEffects of Nitrogen Dioxide in Urban Air on Health of West and Southwest Cities of Iran

    Directory of Open Access Journals (Sweden)

    Zallaghi

    2014-10-01

    Full Text Available Background Nitrogen dioxide (NO2 is a corrosive, strong oxidant and a physiologic stimulant of lower respiratory tract. Every human being inhales an average of 10-m3 air per day; therefore, assessment of the effect of inhaled air on health is a vital issue. The main source NO2 in urban regions is intra-urban public transport system. The annual average of determined air quality for NO2 is 40 μg/m3. Objectives The present study aimed to estimate and compare epidemiologic indices attributed to the pollutant NO2 in the urban air of southwest cities of Iran, namely, Ahvaz, Kermanshah, and Bushehr, in 2011. Materials and Methods In the present study, data relevant to the air-pollutant NO2 in 2011 was obtained from the Iranian Department of Environment and meteorological organizations of the studied cities. Raw data processing by Excel software included instruction set correction of averaging, coding, and filtering. Then the meteorological parameters were converted as input file to the Air Q model. Finally, by using epidemiologic formulas, relative risk (RR and attributed part to NO2 in the three studied cites were estimated. Results The results showed that in summer, winter, and the whole year, Kermanshah and Bushehr had on average the maximum and minimum NO2 concentration, respectively, in 2011. In addition, accumulative number of cases attributed to exposure with NO2 in the studied cities was maximum in Kermanshah (21 cases and minimum in Bushehr (one case. The results revealed that approximately, the maximum number of death cases attributed to NO2 were observed in Kermanshah due to heart problems (1.06%, acute infarction (1.8%, and obstructive pulmonary disease (1.9% with concentration > 20 μg/m3. Conclusions Every 10 μg/m3 increase in the concentration of the pollutant NO2 in the studied cities led to increase in the RR of myocardial infarction, cardiovascular diseases, and obstructive pulmonary disease by 0.4%, 0.2%, and 0.4%, respectively, in

  19. Assessment of health and economic effects by PM2.5 pollution in Beijing: a combined exposure-response and computable general equilibrium analysis.

    Science.gov (United States)

    Wang, Guizhi; Gu, SaiJu; Chen, Jibo; Wu, Xianhua; Yu, Jun

    2016-12-01

    Assessment of the health and economic impacts of PM2.5 pollution is of great importance for urban air pollution prevention and control. In this study, we evaluate the damage of PM2.5 pollution using Beijing as an example. First, we use exposure-response functions to estimate the adverse health effects due to PM2.5 pollution. Then, the corresponding labour loss and excess medical expenditure are computed as two conducting variables. Finally, different from the conventional valuation methods, this paper introduces the two conducting variables into the computable general equilibrium (CGE) model to assess the impacts on sectors and the whole economic system caused by PM2.5 pollution. The results show that, substantial health effects of the residents in Beijing from PM2.5 pollution occurred in 2013, including 20,043 premature deaths and about one million other related medical cases. Correspondingly, using the 2010 social accounting data, Beijing gross domestic product loss due to the health impact of PM2.5 pollution is estimated as 1286.97 (95% CI: 488.58-1936.33) million RMB. This demonstrates that PM2.5 pollution not only has adverse health effects, but also brings huge economic loss.

  20. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed.

  1. Health Impact Assessment as a Student Service Learning Experience

    Science.gov (United States)

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

    Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

  2. 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

    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 impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... 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...

  3. Effects of health risk assessment and counselling on physical activity in older people: A pragmatic randomised trial.

    Science.gov (United States)

    Herghelegiu, Anna Marie; Moser, André; Prada, Gabriel Ioan; Born, Stephan; Wilhelm, Matthias; Stuck, Andreas E

    2017-01-01

    Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling. The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA. Counselling also addressed the older persons' concomitant health risks and problems. The primary outcome was PA at six months (November 2014 to February 2015) evaluated with the International Physical Activity Questionnaire. At baseline, PA levels were similar in intervention and control groups (median 1089.0, and 1053.0 MET [metabolic equivalent of task] minutes per week, interquartile ranges 606.0-1401.7, and 544.5-1512.7 MET minutes per week, respectively). Persons in the intervention group had an average of 11.2 concomitant health problems and risks (e.g., pain, depressive mood, hypertension). At six months, PA increased in the intervention group by a median of 180.0 MET minutes per week (95% confidence interval (CI) 43.4-316.6, p = 0.01) to 1248.8 MET minutes per week. In the control group, PA decreased by a median of 346.5 MET minutes per week (95% CI 178.4-514.6, pcounselling is a promising method for achieving improvements in PA, and ultimately health and longevity among large groups of community-dwelling older persons. International Standard Randomized Controlled Trial Number: ISRCTN11166046.

  4. A Health and Environmental Effects Data Base Assessment of U.S. Army Waste Material, Phase 2

    Science.gov (United States)

    1986-03-04

    MD 21701-5012 --_____451._____ 14. MoAt-YORIlie G JSIOICY NAE # APODRESS( 01ttio",I hus. Z.tInte m~g oWl) Is. X&C50R~y CLASS. (4,1 ship n~ art U.S...include state-of-the- art knowledge about both health, and environmental effects of release of these substances, chemical and physical properties...Charles P. Carpenter, Ph.D., Carrol S. " Weil, Urbano C. Pozzani, Jean A. Striegll, and Judith S. Nycum. 1969. Range-Finding Toxicity Data: List VII

  5. Health risk assessment of drinking arsenic-containing groundwater in Hasilpur, Pakistan: effect of sampling area, depth, and source.

    Science.gov (United States)

    Tabassum, Riaz Ahmad; Shahid, Muhammad; Dumat, Camille; Niazi, Nabeel Khan; Khalid, Sana; Shah, Noor Samad; Imran, Muhammad; Khalid, Samina

    2018-02-10

    Currently, several news channels and research publications have highlighted the dilemma of arsenic (As)-contaminated groundwater in Pakistan. However, there is lack of data regarding groundwater As content of various areas in Pakistan. The present study evaluated As contamination and associated health risks in previously unexplored groundwater of Hasilpur-Pakistan. Total of 61 groundwater samples were collected from different areas (rural and urban), sources (electric pump, hand pump, and tubewell) and depths (35-430 ft or 11-131 m). The water samples were analyzed for As level and other parameters such as pH, electrical conductivity, total dissolved solids, cations, and anions. It was found that 41% (25 out of 61) water samples contained As (≥ 5 μg/L). Out of 25 As-contaminated water samples, 13 water samples exceeded the permissible level of WHO (10 μg/L). High As contents have been found in tubewell samples and at high sampling depths (> 300 ft). The major As-contaminated groundwater in Hasilpur is found in urban areas. Furthermore, health risk and cancer risk due to As contamination were also assessed with respect to average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR). The values of HQ and CR of As in Hasilpur were up to 58 and 0.00231, respectively. Multivariate analysis revealed a positive correlation between groundwater As contents, pH, and depth in Hasilpur. The current study proposed the proper monitoring and management of well water in Hasilpur to minimize the As-associated health hazards.

  6. Assessing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Cuff, Patricia A.

    2014-01-01

    "Assessing Health Professional Education" is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and…

  7. Mobile health: assessing the barriers.

    Science.gov (United States)

    Terry, Nicolas P

    2015-05-01

    Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.

  8. Health technology assessment (HTA): ethical aspects.

    Science.gov (United States)

    Sacchini, Dario; Virdis, Andrea; Refolo, Pietro; Pennacchini, Maddalena; de Paula, Ignacio Carrasco

    2009-11-01

    "HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value" (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA.

  9. IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior.

    Science.gov (United States)

    Mummah, Sarah Ann; Robinson, Thomas N; King, Abby C; Gardner, Christopher D; Sutton, Stephen

    2016-12-16

    Developing effective digital interventions to change health behavior has been a challenging goal for academics and industry players alike. Guiding intervention design using the best combination of approaches available is necessary if effective technologies are to be developed. Behavioral theory, design thinking, user-centered design, rigorous evaluation, and dissemination each have widely acknowledged merits in their application to digital health interventions. This paper introduces IDEAS, a step-by-step process for integrating these approaches to guide the development and evaluation of more effective digital interventions. IDEAS is comprised of 10 phases (empathize, specify, ground, ideate, prototype, gather, build, pilot, evaluate, and share), grouped into 4 overarching stages: Integrate, Design, Assess, and Share (IDEAS). Each of these phases is described and a summary of theory-based behavioral strategies that may inform intervention design is provided. The IDEAS framework strives to provide sufficient detail without being overly prescriptive so that it may be useful and readily applied by both investigators and industry partners in the development of their own mHealth, eHealth, and other digital health behavior change interventions. ©Sarah Ann Mummah, Thomas N Robinson, Abby C King, Christopher D Gardner, Stephen Sutton. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.12.2016.

  10. Health Effects of Tsunamis

    Science.gov (United States)

    ... Pet Shelters Protect Your Pets Health Effects of Tsunamis Language: English Español (Spanish) Recommend on Facebook Tweet ... environmental hazards. The majority of deaths associated with tsunamis are related to drownings, but traumatic injuries are ...

  11. Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China.

    Science.gov (United States)

    Yang, Xiaowei; Gao, Jianmin; Zhou, Zhongliang; Yan, Jue; Lai, Sha; Xu, Yongjian; Chen, Gang

    2016-01-01

    Disease has become one of the key causes of falling into poverty in rural China. The poor households are even more likely to suffer. The New Cooperative Medical Scheme (NCMS) has been implemented to provide rural residents financial protection against health risks. This study aims to assess the effect of the NCMS on alleviating health payment-induced poverty in the Shaanxi Province of China. The data was drawn from the 5th National Health Service Survey of Shaanxi Province, conducted in 2013. In total, 41,037 individuals covered by NCMS were selected. Poverty headcount ratio (HCR), poverty gap and mean positive poverty gap were used for measuring the incidence, depth and intensity of poverty, respectively. The differences on poverty measures pre- and post- insurance reimbursement indicate the effectiveness of alleviating health payment-induced poverty under NCMS. For the general insured, 5.81% of households fell below the national poverty line owing to the health payment; this HCR dropped to 4.84% after insurance reimbursement. The poverty HCRs for the insured that had hospitalization in the past year dropped from 7.50% to 2.09% after reimbursement. With the NCMS compensation, the poverty gap declined from 42.90 Yuan to 34.49 Yuan (19.60% decreased) for the general insured and from 57.48 Yuan to 10.01 Yuan (82.59% decreased) for the hospital admission insured. The mean positive poverty gap declined 3.56% and 37.40% for two samples, respectively. The NCMS could alleviate the health payment-induced poverty. The effectiveness of alleviating health payment-induced poverty is greater for hospital admission insured than for general insured, mainly because NCMS compensates for serious diseases. Our study suggests that a more comprehensive insurance benefit package design could further improve the effectiveness of poverty alleviation.

  12. Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China.

    Directory of Open Access Journals (Sweden)

    Xiaowei Yang

    Full Text Available Disease has become one of the key causes of falling into poverty in rural China. The poor households are even more likely to suffer. The New Cooperative Medical Scheme (NCMS has been implemented to provide rural residents financial protection against health risks. This study aims to assess the effect of the NCMS on alleviating health payment-induced poverty in the Shaanxi Province of China.The data was drawn from the 5th National Health Service Survey of Shaanxi Province, conducted in 2013. In total, 41,037 individuals covered by NCMS were selected. Poverty headcount ratio (HCR, poverty gap and mean positive poverty gap were used for measuring the incidence, depth and intensity of poverty, respectively. The differences on poverty measures pre- and post- insurance reimbursement indicate the effectiveness of alleviating health payment-induced poverty under NCMS.For the general insured, 5.81% of households fell below the national poverty line owing to the health payment; this HCR dropped to 4.84% after insurance reimbursement. The poverty HCRs for the insured that had hospitalization in the past year dropped from 7.50% to 2.09% after reimbursement. With the NCMS compensation, the poverty gap declined from 42.90 Yuan to 34.49 Yuan (19.60% decreased for the general insured and from 57.48 Yuan to 10.01 Yuan (82.59% decreased for the hospital admission insured. The mean positive poverty gap declined 3.56% and 37.40% for two samples, respectively.The NCMS could alleviate the health payment-induced poverty. The effectiveness of alleviating health payment-induced poverty is greater for hospital admission insured than for general insured, mainly because NCMS compensates for serious diseases. Our study suggests that a more comprehensive insurance benefit package design could further improve the effectiveness of poverty alleviation.

  13. Health Risk Assessments for Alumina Refineries

    OpenAIRE

    Donoghue, A Michael; Coffey, Patrick S.

    2014-01-01

    Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The ...

  14. Quality assessment of health counseling: performance of health advisors in cardiovascular prevention

    NARCIS (Netherlands)

    Harting, Janneke; van Assema, Patricia; van der Molen, Henk T.; Ambergen, Ton; de Vries, Nanne K.

    2004-01-01

    Quality assessments of interventions are seen as essential in optimizing their implementation, interpreting their effectiveness, and illuminating their underlying processes. In Hartslag Limburg, a cardiovascular prevention project, the quality of a health counseling intervention was assessed as part

  15. Assessment of Air Pollution and its Effects on Health of Workers of Steel Re-Rolling Mills in Hyderabad

    Directory of Open Access Journals (Sweden)

    Altaf Alam Noonari

    2016-04-01

    Full Text Available The SRRMs (Steel Re-Rolling Mills are being releasing air pollutants in the environment. In order to evaluate their effect on the health of the workers, health and safety issues were analyzed by first measuring the concentrations of SO x (OIxides of Sulphur, NO x (Oxides of Nitrogen, CO (Carbon Monoxide and O2 (Oxygen produced in the three SRRMs located in SITE area Hyderabad. The mean concentration of SO x , NO x and CO were in the order of 0.35, 0.280, 6.333 ppm, respectively, whereas the mean concentration of O 2 was 203.53 thousand ppm. As per results, the concentration ofair pollutants, including SOx and NO x were significantly higher than to the NEQS (National Environmental Quality Standards and NAAQS (National Ambient Air Quality Standards. The concentration ofCO was lower than to the NAAQS, but higher than to the NEQs, while the concentration of O2 was slightly lower than to the standard value. The workers who were exposed to these air pollutants are being suffering from chronic diseases related to breathing and allergies. Moreover, labour staff was lifting heavy loads manually, which causes them to muscular and joint problems. In all the SRRMs under study, the electrical and mechanical equipments were used without any safety. The MSDS were not displayed on the workstations, the housekeeping was inadequate and most of the workers were performing their jobs without personal protective equipment. In addition to these, the other serious issues related to the occupational health and safety were an unhygienic supply of water, higher noise level, placement of explosive cylinders in the open atmosphere and unavailability of the first aid facilities in the Mill premises.

  16. ECHO: health care performance assessment in several European health systems.

    Science.gov (United States)

    Bernal-Delgado, E; Christiansen, T; Bloor, K; Mateus, C; Yazbeck, A M; Munck, J; Bremner, J

    2015-02-01

    Strengthening health-care effectiveness, increasing accessibility and improving resilience are key goals in the upcoming European Union health-care agenda. European Collaboration for Health-Care Optimization (ECHO), an international research project on health-care performance assessment funded by the seventh framework programme, has provided evidence and methodology to allow the attainment of those goals. This article aims at describing ECHO, analysing its main instruments and discussing some of the ECHO policy implications. Using patient-level administrative data, a series of observational studies (ecological and cross-section with associated time-series analyses) were conducted to analyze population and patients' exposure to health care. Operationally, several performance dimensions such as health-care inequalities, quality, safety and efficiency were analyzed using a set of validated indicators. The main instruments in ECHO were: (i) building a homogeneous data infrastructure; (ii) constructing coding crosswalks to allow comparisons between countries; (iii) making geographical units of analysis comparable; and (iv) allowing comparisons through the use of common benchmarks. ECHO has provided some innovations in international comparisons of health-care performance, mainly derived from the massive pooling of patient-level data and thus: (i) has expanded the usual approach based on average figures, providing insight into within and across country variation at various meaningful policy levels, (ii) the important effort made on data homogenization has increased comparability, increasing stakeholders' reliance on data and improving the acceptance of findings and (iii) has been able to provide more flexible and reliable benchmarking, allowing stakeholders to make critical use of the evidence. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  17. 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.

  18. 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...

  19. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  20. Assessment of health benefits and cost-effectiveness of 10-valent and 13-valent pneumococcal conjugate vaccination in Kenyan children.

    Science.gov (United States)

    Ayieko, Philip; Griffiths, Ulla K; Ndiritu, Moses; Moisi, Jennifer; Mugoya, Isaac K; Kamau, Tatu; English, Mike; Scott, J Anthony G

    2013-01-01

    The GAVI Alliance supported 10-valent pneumococcal conjugate vaccine (PCV10) introduction in Kenya. We estimated the cost-effectiveness of introducing either PCV10 or the 13-valent vaccine (PCV13) from a societal perspective and explored the incremental impact of including indirect vaccine effects. The costs and effects of pneumococcal vaccination among infants born in Kenya in 2010 were assessed using a decision analytic model comparing PCV10 or PCV13, in turn, with no vaccination. Direct vaccine effects were estimated as a reduction in the incidence of pneumococcal meningitis, sepsis, bacteraemic pneumonia and non-bacteraemic pneumonia. Pneumococcal disease incidence was extrapolated from a population-based hospital surveillance system in Kilifi and adjustments were made for variable access to care across Kenya. We used vaccine efficacy estimates from a trial in The Gambia and accounted for serotype distribution in Kilifi. We estimated indirect vaccine protection and serotype replacement by extrapolating from the USA. Multivariable sensitivity analysis was conducted using Monte Carlo simulation. We assumed a vaccine price of US$ 3.50 per dose. The annual cost of delivering PCV10 was approximately US$14 million. We projected a 42.7% reduction in pneumococcal disease episodes leading to a US$1.97 million reduction in treatment costs and a 6.1% reduction in childhood mortality annually. In the base case analysis, costs per discounted DALY and per death averted by PCV10, amounted to US$ 59 (95% CI 26-103) and US$ 1,958 (95% CI 866-3,425), respectively. PCV13 introduction improved the cost-effectiveness ratios by approximately 20% and inclusion of indirect effects improved cost-effectiveness ratios by 43-56%. The break-even prices for introduction of PCV10 and PCV13 are US$ 0.41 and 0.51, respectively. Introducing either PCV10 or PCV13 in Kenya is highly cost-effective from a societal perspective. Indirect effects, if they occur, would significantly improve the cost-effectiveness.

  1. Assessment of health benefits and cost-effectiveness of 10-valent and 13-valent pneumococcal conjugate vaccination in Kenyan children.

    Directory of Open Access Journals (Sweden)

    Philip Ayieko

    Full Text Available BACKGROUND: The GAVI Alliance supported 10-valent pneumococcal conjugate vaccine (PCV10 introduction in Kenya. We estimated the cost-effectiveness of introducing either PCV10 or the 13-valent vaccine (PCV13 from a societal perspective and explored the incremental impact of including indirect vaccine effects. METHODS: The costs and effects of pneumococcal vaccination among infants born in Kenya in 2010 were assessed using a decision analytic model comparing PCV10 or PCV13, in turn, with no vaccination. Direct vaccine effects were estimated as a reduction in the incidence of pneumococcal meningitis, sepsis, bacteraemic pneumonia and non-bacteraemic pneumonia. Pneumococcal disease incidence was extrapolated from a population-based hospital surveillance system in Kilifi and adjustments were made for variable access to care across Kenya. We used vaccine efficacy estimates from a trial in The Gambia and accounted for serotype distribution in Kilifi. We estimated indirect vaccine protection and serotype replacement by extrapolating from the USA. Multivariable sensitivity analysis was conducted using Monte Carlo simulation. We assumed a vaccine price of US$ 3.50 per dose. FINDINGS: The annual cost of delivering PCV10 was approximately US$14 million. We projected a 42.7% reduction in pneumococcal disease episodes leading to a US$1.97 million reduction in treatment costs and a 6.1% reduction in childhood mortality annually. In the base case analysis, costs per discounted DALY and per death averted by PCV10, amounted to US$ 59 (95% CI 26-103 and US$ 1,958 (95% CI 866-3,425, respectively. PCV13 introduction improved the cost-effectiveness ratios by approximately 20% and inclusion of indirect effects improved cost-effectiveness ratios by 43-56%. The break-even prices for introduction of PCV10 and PCV13 are US$ 0.41 and 0.51, respectively. CONCLUSIONS: Introducing either PCV10 or PCV13 in Kenya is highly cost-effective from a societal perspective. Indirect

  2. 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

  3. Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

    Science.gov (United States)

    Chinchilla, Melissa; Arcaya, Mariana C

    2017-07-08

    Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

  4. Exploration Health Risks: Probabilistic Risk Assessment

    Science.gov (United States)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  5. NIEHS/EPA Children’s Environmental Health Centers: Novel Methods to Assess Effects of Chemicals on Child Development

    Science.gov (United States)

    The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

  6. Assessing the Impact of Homophobic Name Calling on Early Adolescent Mental Health: A Longitudinal Social Network Analysis of Competing Peer Influence Effects.

    Science.gov (United States)

    DeLay, Dawn; Hanish, Laura D; Zhang, Linlin; Martin, Carol Lynn

    2017-05-01

    The goal of the current study was to improve our understanding of why adolescence is a critical period for the consideration of declining mental health. We did this by focusing on the impact of homophobic name calling on early adolescent mental health after the transition to middle school. Because we know that homophobic name calling emerges within a dynamic peer group structure, we used longitudinal social network analysis to assess the relation between homophobic name calling, depressive symptoms, and self-esteem while simultaneously limiting bias from alternative peer socialization mechanisms. A sample of adolescents who recently transitioned to a large public middle school (N = 299; 53 % girls; M age = 11.13 years, SD = 0.48) were assessed. Longitudinal assessments of peer relationship networks, depressive symptoms, and self-esteem were collected during the fall and spring of the academic year. The results suggest that, after accounting for the simultaneous effect of alternative peer socialization processes, adolescent experiences of homophobic name calling in the fall predict higher levels of depressive symptoms and lower levels of self-esteem over the course of the academic year. These findings provide evidence of a significant influence of homophobic name calling on adolescent mental health.

  7. A Geospatial Assessment of Mountain Pine Beetle Infestations and Their Effect on Forest Health in Okanogan-Wenatchee National Forest

    Science.gov (United States)

    Allain, M.; Nguyen, A.; Johnson, E.; Williams, E.; Tsai, S.; Prichard, S.; Freed, T.; Skiles, J. W.

    2010-12-01

    Fire-suppression over the past century has resulted in an accumulation of forest litter and increased tree density. As nutrients are sequestered in forest litter and not recycled by forest fires, soil nutrient concentrations have decreased. The forests of Northern Washington are in poor health as a result of these factors coupled with sequential droughts. The mountain pine beetle (MPB) thrives in such conditions, giving rise to an outbreak in Washington’s Okanogan-Wenatchee National Forest. These outbreaks occur in three successive stages— the green, red, and gray stages. Beetles first infest the tree in the green phase, leading to discoloration of needles in the red phase and eventually death in the gray phase. With the use of geospatial technology, these outbreaks can be better mapped and assessed to evaluate forest health. Field work on seventeen randomly selected sites was conducted using the point-centered quarter method. The stratified random sampling technique ensured that the sampled trees were representative of all classifications present. Additional measurements taken were soil nutrient concentrations (sodium [Na+], nitrate [NO3-], and potassium [K+]), soil pH, and tree temperatures. Satellite imagery was used to define infestation levels and geophysical parameters, such as land cover, vegetation classification, and vegetation stress. ASTER images were used with the Ratio Vegetation Index (RVI) to explore the differences in vegetation, while MODIS images were used to analyze the Disturbance Index (DI). Four other vegetation indices from Landsat TM5 were used to distinguish the green, red and gray phases. Selected imagery from the Hyperion sensor was used to run a minimum distance supervised classification in ENVI, thus testing the ability of Hyperion imagery to detect the green phase. The National Agricultural Imagery Program (NAIP) archive was used to generate accurate maps of beetle-infested regions. This algorithm was used to detect bark beetle

  8. Health Effects of Environmental Exposures, Occupational Hazards and Climate Change in Ethiopia: Synthesis of Situational Analysis, Needs Assessment and the Way Forward.

    Science.gov (United States)

    Berhane, Kiros; Kumie, Abera; Samet, Jonathan

    2016-01-01

    The burden of diseases caused by environmental and occupational health hazards and the effects of global climate change are of growing concerns in Ethiopia. However, no adequate information seems to be available on the current situation. This means there is a critical gap in research, policy framework and implementation in the country. The purpose of this paper was to synthesize evidence from a systematic situational analysis and needs assessment to help establish a hub for research and training on three major themes and their related policy frameworks: air pollution and health, occupational health and safety and climate change and health. The methods used in this work include a systematic review of secondary data from peer-reviewed literature, thesis reports from academia, government and national statistical reports. Limited primary data based on key informant interviews held with major stakeholders were also used as sources of data. Exposures to high levels of indoor and outdoor air pollutants were found to be major sources of public health challenges. Lack of occupational safety and health due to agricultural activities and exposure to industries was found to be substantial. Worse is the growing fear that climate change will pose increasingly significant multidimensional challenges to the environment and public health. Across all three areas of focus, there was a paucity of information on local scientific evidence. There is also very limited trained skilled manpower and physical infrastructure to monitor the environment and enforce regulatory guidelines. Research, policy frameworks and regulatory mechanisms were among the cross-cutting issues that needed urgent attention. Critical gaps were observed in research and training across the three themes. Also, there is a limitation in implementing the link between policy and related regulations in the environment and health.

  9. Health Behaviour and Health Assessment: Evidence from German Microdata

    Directory of Open Access Journals (Sweden)

    Brit S. Schneider

    2012-01-01

    Full Text Available The importance of the individual’s health behaviour for the health production process is beyond controversy. Health relevant behaviour can be viewed as a key variable in the health production process. Changes in the behaviour may influence individual’s assessment of health. Following this idea, we use German microdata to identify determinants of smoking, drinking, and obesity and their impact on health. Our empirical approach allows for the simultaneity of behaviours and self-reported health. In addition, we account for endogeneity of health behaviours and take aspects of reporting heterogeneity of self-reported health into account. We find that health behaviour is directly related to the socioeconomic status and observe gender-specific differences in the determinants of drinking, smoking, and heavy body weight in particular. The influence on health is also gender specific. While we do not find any impact of smoking, overweight is relevant only for males and no clear pattern for alcohol exists.

  10. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation.

    Science.gov (United States)

    Smed, S; Scarborough, P; Rayner, M; Jensen, J D

    2016-06-01

    The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective of this study is to evaluate the effect of the Danish tax on saturated fat in terms of changes in nutritional quality of the diet, that is, changes in saturated fat consumption, as well as other non-targeted dietary measures, and to model the associated changes in mortality for different age groups and genders. On the basis of household scanner data, we estimate the impact of the tax on consumption of saturated fat, unsaturated fat, salt, fruit, vegetables and fibre. The resultant changes in dietary quality are then used as inputs into a comparative risk assessment model (PRIME (Preventable Risk Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark.

  11. Health literacy assessment and patient satisfaction in surgical practice.

    Science.gov (United States)

    Komenaka, Ian K; Nodora, Jesse N; Machado, Lorenzo; Hsu, Chiu-Hsieh; Klemens, Anne E; Martinez, Maria Elena; Bouton, Marcia E; Wilhelmson, Krista L; Weiss, Barry D

    2014-03-01

    Individuals with limited health literacy have barriers to patient-physician communication. Problems in communication are known to contribute to malpractice litigation. Concern exists, however, about the feasibility and patient acceptance of a health literacy assessment. This study was performed to determine the feasibility of health literacy assessment in surgical practice and its effect on patient satisfaction. Every patient seen in a Breast Surgery Clinic during a 2-year period was asked to undergo a health literacy assessment with the Newest Vital Sign (NVS) as part of the routine history and physical examination. During the year before routine NVS assessments and during the 2-year study period, all patients were asked to rate their "overall satisfaction with clinic visit" on a 5-point scale. A total of 2,026 of 2,097 patients (96.6%) seen during the study were eligible for the health literacy assessment. Of those, no patients refused assessment, and only one patient was missed. Therefore, 2,025 of 2,026 eligible patients (99.9%) underwent the assessment. The average time for NVS assessment was 2:02 minutes. Only 19% of patients had adequate health literacy. Patient satisfaction ratings were slightly greater during the first year of the health literacy assessment (3.8 vs 3.7, P = .049) compared with the year prior to health literacy assessment and greater during the second year of health literacy assessment (4.1 vs 3.7, P < .0001). Routine health literacy assessment is feasible in surgical practice and results in no decrease in patient satisfaction. In fact, satisfaction was greater during the years when health literacy assessments were performed. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. Focus on CSIR research in water resources: CSIR’S environmental human health risk assessment

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2007-08-01

    Full Text Available Environmental health risk assessment deals with risks associated with manmade and natural environmental hazards. Environmental health risk assessment provides a means of estimating the probability of adverse health effects associated with hazards...

  13. Team health, an assessment approach to engage first year students in cross-cultural and cross-discipline teams towards more effective team-working

    Directory of Open Access Journals (Sweden)

    Kathy Egea

    Full Text Available Specialists who work in a globalised environment, need to work in teams, if they are to be continuously effective. The challenge for IT educators is to design and implement inter-cultural teamwork practices into their curriculum. Investigating this challenge, this case study describes Team Health, an assessment approach designed to skill students to be more effective in team working in cross-cultural and cross-discipline teams. The educational context is teamwork practice within a first year introductory web design course. Framed by Saunders\\'s virtual team lifecycle model (relationship building and team processes and Hofstede\\'s cultural dimensions (communication and working cross-culturally, the assessment approach utilises reflective and iterative strategies to support team working. At three points in the semester, students complete a survey on these four concepts, identify team strengths and weaknesses from the results of the surveys and work towards addressing one team weakness. The final assessment activity requires students to reflect on team working for the semester. Key attributes for effective team working are identified from the three surveys and the final reflective summaries. This paper compares course outcomes such as team cohesion and student grades to the previous course offering and shows that with the introduction of Team Health, the more complex student cohorts under this study achieve equally well. It is concluded that the guided reflective practices underpinning Team Health can prepare students for first year approaches to teamwork, and thereby provide starting points for working in future global teams where members are both culturally diverse and from different discipline areas.

  14. Assessment of health informatics competencies in undergraduate ...

    African Journals Online (AJOL)

    Assessment of health informatics competencies in undergraduate training of healthcare professionals in Rwanda. ... Furthermore, the establishment of continuous on-the-job training in health informatics for those who are already practicing is also essential. Keywords: Health informatics, competencies, undergraduate ...

  15. Alcohol Gel Ingestion Among Homeless Eastern and Central Europeans in London: Assessing the Effects on Cognitive Functioning and Psychological Health.

    Science.gov (United States)

    Soar, Kirstie; Papaioannou, Grammati; Dawkins, Lynne

    2016-08-23

    Intentional consumption of alcohol-based hand gels has been reported especially amongst non-UK national, alcohol dependent, homeless individuals in London. Whilst alcohol misuse is known to be associated with impaired cognitive functioning and mental health problems, the effects of additional ingestion of alcohol gel are unknown. To explore cognitive and psychological functioning in users who intentionally ingest alcohol gel compared with ethyl-alcohol only misusers and controls. Male, Central and Eastern European alcohol only misusers, (n = 14; mean age 39 years), alcohol gel users (n = 14; mean age 43 years) and controls (n = 12; mean age 31 years) were recruited from a London Homeless Service during 2013/14. Alcohol misusers, alcohol gel users and controls were compared on the Forwards and Backwards Digit Span Test; Block Design test; Retrospective and Prospective Memory Questionnaire (PRMQ) and the Hospital and Anxiety Depression Scale (HADS). Alcohol gel users performed significantly worse on the Block Design task (p alcohol only and control groups, and significantly worse on the digit span relative to controls (p = .01). Both alcohol misusing groups scored comparatively on digit span backwards (p alcohol gel group reported significantly higher levels of anxiety relative to controls (p = .02). Whilst there could be constitutional differences between alcohol misusers who additionally abuse alcohol gel, the findings suggest that alcohol gel ingestion may have a greater impact on psychological functioning than traditional alcohol misuse.

  16. 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.

    Science.gov (United States)

    Rosenkötter, 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 impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could 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 medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to 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 applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

  17. Mobile technology for mental health assessment.

    Science.gov (United States)

    Areàn, Patricia A; Hoa Ly, Kien; Andersson, Gerhard

    2016-06-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making.

  18. Assessing the effectiveness of a patient-centred computer-based clinic intervention,Health-E You/Salud iTu,to reduce health disparities in unintended pregnancies among Hispanic adolescents: study protocol for a cluster randomised control trial.

    Science.gov (United States)

    Tebb, Kathleen P; Rodriguez, Felicia; Pollack, Lance M; Trieu, Sang Leng; Hwang, Loris; Puffer, Maryjane; Adams, Sally; Ozer, Elizabeth M; Brindis, Claire D

    2018-01-10

    Teen pregnancy rates in the USA remain higher than any other industrialised nation, and pregnancies among Hispanic adolescents are disproportionately high. Computer-based interventions represent a promising approach to address sexual health and contraceptive use disparities. Preliminary findings have demonstrated that the Health-E You/Salud iTu, computer application (app) is feasible to implement, acceptable to Latina adolescents and improves sexual health knowledge and interest in selecting an effective contraceptive method when used in conjunction with a healthcare visit. The app is now ready for efficacy testing. The purpose of this manuscript is to describe patient-centred approaches used both in developing and testing the Health-E You app and to present the research methods used to evaluate its effectiveness in improving intentions to use an effective method of contraception as well as actual contraceptive use. This study is designed to assess the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud  iTu, on its ability to reduce health disparities in unintended pregnancies among Latina adolescent girls. This study uses a cluster randomised control trial design in which 18 school-based health centers from the Los Angeles Unified School District were randomly assigned, at equal chance, to either the intervention ( Health-E You app) or control group. Analyses will examine differences between the control and intervention group's knowledge of and attitudes towards contraceptive use, receipt of contraception at the clinic visit and self-reported use of contraception at 3-month and 6-month follow-ups. The study began enrolling participants in August 2016, and a total of 1400 participants (700 per treatment group) are expected to be enrolled by March 2018. Ethics approval was obtained through the University of California, San Francisco Institutional Review Board. Results of this trial will be submitted for publication in peer

  19. Health technology assessment in South Korea.

    Science.gov (United States)

    Kim, Chang-yup

    2009-07-01

    To analyze evolution of the health technology assessment (HTA) at the national level in South Korea. Analysis of public documents, personal communication, and literative review. HTA in South Korea has been developed since 1990s, first introduced by academia and institutionalized within the National Health Insurance (NHI). Rapidly increasing expenditure had been a challenge of the NHI, which considered health technology management as a cost controlling measure. An amendment was made to the NHI Law in 2000, and provision was made to regulate the process of determining new insurance benefits including procedures, drugs, and equipment. This requirement made the NHI agencies to promote HTA approaches in connection with the government and professional organizations. Also the Healthcare Act was revised in October 2006 ruling that HTA focusing on safety and effectiveness be responsible for new health technologies. Currently, the HTA process is governed by a governmental committee comprising twenty members and technically supported by the HTA center created in the NHI structure. Institutionalized HTA in Korea has been driven mainly by the requirements of the NHI and manifested strengths as well as weaknesses. The government is establishing a new organization for HTA, independent from the NHI.

  20. Health related quality of life assessment in acute coronary syndrome patients: the effectiveness of early phase I cardiac rehabilitation.

    Science.gov (United States)

    Anchah, Lawrence; Hassali, Mohamed Azmi; Lim, Melissa Siaw Han; Ibrahim, Mohamed Izham Mohamed; Sim, Kui Hian; Ong, Tiong Kiam

    2017-01-13

    Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia. We recruited 112 patients who were newly diagnosed with ACS and treated at the referral hospital, Sarawak General Hospital, Malaysia. In the intervention group (modified CRP), all medication was reviewed by the clinical pharmacists, focusing on drug indication; understanding of secondary prevention therapy and adherence to treatment strategy. We compared the "pre-post" quality of life (QoL) of three groups (intervention, conventional and control) at baseline, 6 months and 12 months post-discharge with Malaysian norms. QoL data was obtained using a validated version of Short-Form 36 Questionnaire (SF-36). Analysis of variance (ANOVA) with repeated measure tests was used to compare the mean differences of scores over time. A pre-post quasi-experimental non-equivalent group comparison design was applied to 112 patients who were followed up for one year. At baseline, the physical and mental health summaries reported poor outcomes in all three groups. However, these improved gradually but significantly over time. After the 6-month follow-up, the physical component summary reported in the modified CRP (MCRP) participants was higher, with a mean difference of 8.02 (p = 0.015) but worse in the mental component summary, with a mean difference of -4.13. At the 12-month follow-up, the MCRP participants performed better in their physical component (PCS) than those in the

  1. Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments

    Directory of Open Access Journals (Sweden)

    Bethany Shinkins

    2017-04-01

    Full Text Available Abstract Background Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1 what evidence aside from test accuracy was searched for and synthesised, 2 which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3 how/whether threshold effects were explored, 4 how the potential dependency between multiple tests in a pathway was accounted for, and 5 for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings

  2. Quantitative methods for stochastic high frequency spatio-temporal and non-linear analysis: Assessing health effects of exposure to extreme ambient temperature

    Science.gov (United States)

    Liss, Alexander

    Extreme weather events, such as heat waves and cold spells, cause substantial excess mortality and morbidity in the vulnerable elderly population, and cost billions of dollars. The accurate and reliable assessment of adverse effects of extreme weather events on human health is crucial for environmental scientists, economists, and public health officials to ensure proper protection of vulnerable populations and efficient allocation of scarce resources. However, the methodology for the analysis of large national databases is yet to be developed. The overarching objective of this dissertation is to examine the effect of extreme weather on the elderly population of the Conterminous US (ConUS) with respect to seasonality in temperature in different climatic regions by utilizing heterogeneous high frequency and spatio-temporal resolution data. To achieve these goals the author: 1) incorporated dissimilar stochastic high frequency big data streams and distinct data types into the integrated data base for use in analytical and decision support frameworks; 2) created an automated climate regionalization system based on remote sensing and machine learning to define climate regions for the Conterminous US; 3) systematically surveyed the current state of the art and identified existing gaps in the scientific knowledge; 4) assessed the dose-response relationship of exposure to temperature extremes on human health in relatively homogeneous climate regions using different statistical models, such as parametric and non-parametric, contemporaneous and asynchronous, applied to the same data; 5) assessed seasonal peak timing and synchronization delay of the exposure and the disease within the framework of contemporaneous high frequency harmonic time series analysis and modification of the effect by the regional climate; 6) modeled using hyperbolic functional form non-linear properties of the effect of exposure to extreme temperature on human health. The proposed climate

  3. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...

  4. Using Statewide Data on Health Care Quality to Assess the Effect of a Patient-Centered Medical Home Initiative on Quality of Care.

    Science.gov (United States)

    Shippee, Nathan D; Finch, Michael; Wholey, Douglas

    2017-06-13

    Patient-centered medical homes comprise a large portion of modern health care redesign. However, most efforts have reflected rigid, limited models of transformation. In addition, evaluations of their impact on quality of care have relied on data designed for other purposes. Minnesota's Health Care Home (HCH) initiative is a statewide medical home model relying on state-run, adaptive certification and supportive data infrastructure. This longitudinal study leverages a unique statewide system of clinic-reported, patient-level quality data (2010-2013) to assess the effect of being in a HCH clinic on health care quality. Measures included optimal quality (meeting all targets) and average quality (number of targets met) for asthma, vascular, and diabetes care; colorectal cancer screening; depression follow-up; and depression remission. Depending on measure and year, the analytic sample included 246,023 - 3,335,994 child and adult patients in 404-651 clinics. Using endogenous treatment effects models to address endogeneity, and including patient- and clinic-level covariates and clinic-level selection bias corrections, the authors produced potential outcomes means and average treatment effects (ATEs). HCH patients received better quality versus non-HCH patients for most outcomes. For example, the adjusted rate receiving optimal diabetes care was 453.7/1000 adult HCH patients versus 327.2/1000 non-HCH adult patients (ATE = 126.5; P quality generally echoed optimal care findings. These findings indicate the usefulness of statewide quality data and support the effectiveness of adaptive, state-run medical home programs. Additional integration of services may be needed for mental health conditions.

  5. Using a Total Environment Framework (Built, Natural, Social Environments) to Assess Life-long Health Effects of Chemical Exposures

    Science.gov (United States)

    EPAseeks applications for research on how pollution affects human health in the context of the total environment – built, natural, and social environments interacting together with inherent characteristics and interactions.

  6. The role of health impact assessment in promoting population health and health equity.

    Science.gov (United States)

    Wise, Marilyn; Harris, Patrick; Harris-Roxas, Ben; Harris, Elizabeth

    2009-12-01

    Within the discipline of health promotion there has been long-standing understanding of the social determinants of health and life expectancy.1-3 There is also long-standing evidence of the unfair, unjust distribution of these resources within and among societies. It has proven difficult to translate this evidence of the need for the fairer distribution of socially-distributed resources into powerful action by the range of sectors through whose policies and programs/services much of this inequitable distribution is created.4 Health promotion has proven effective in contributing to significant improvements in the health of populations. It is, now, based on well-developed theory and a comprehensive body of evidence. However, health promotion in particular and the health sector in general have found it difficult to work with other sectors to influence public policy to create the social, economic, environmental and cultural conditions necessary for health equity. Health Impact Assessment (HIA) is outlined as an approach that offers the health sector a structured, transparent method and process to work with other sectors to predict the impact of policy proposals on the health of populations (and on the determinants of health), and to predict the distribution of these impacts in advance of adoption and implementation of the policy. Based on Australian experience of conducting HIAs, the paper outlines contributions that HIA can make to formulating and implementing of healthy public policy. It describes the steps in HIA and illustrates the use of these in practice.

  7. Assessment of air pollution and its effects on the health status of the workers in beam rolling mills factory (Iran National Steel Industrial Group) from Ahvaz-Iran.

    Science.gov (United States)

    Rafiei, Masoud; Gadgil, Alaka S; Ghole, Vikram S; Gore, Sharad D; Jaafarzadeh, Neemat; Mirkazemi, Roksana

    2009-04-01

    Air pollutants of iron- and steel-making operations have historically been an environmental and health hazard. These pollutants include gaseous substances such as sulfur oxide, nitrogen dioxide, and carbon monoxide. The Iran National Steel Industrial Group beam rolling mills factory has two production lines viz. line 630 and line 650, with different beam production capabilities and is capable of producing different types of beams. A retrospective cross-sectional study on 400 workers in different exposure levels to environmental pollution was performed during 2005 to determine the mean value of respirable particulate matter (RPM) concentrations and its effects on the health status of workers. To elicit information regarding the health status of the worker, the National Institute for Occupational Safety and Health standard questionnaire was used. Fisher's exact test was performed to assess the relative risk (RR) of exposure to air pollution on cardiovascular diseases, chest tightness, cough, difficulty in retention, i.e. loss of memory, tension, occupational fatigue, and occupational stress in exposed workers. There was significant difference in RPM pollution level between two product lines. The RR of exposure to air pollution on cardiovascular diseases, chest tightness, cough, difficulty in retention, i.e. loss of memory, tension, occupational fatigue, and occupational stress in exposed workers were 2.78, 2.44, 2.15, 1.92, 1.57, 3.90, and 2.09, respectively.

  8. 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.

  9. Assessment of the effect of welding fumes on welders' cognitive failure and health-related quality of life.

    Science.gov (United States)

    Rahmani, Abdolrasoul; Golbabaei, Farideh; Dehghan, Somayeh Farhang; Mazlomi, Adel; Akbarzadeh, Arash

    2016-09-01

    This study examined whether cognitive symptoms and health-related quality of life can be affected by welding fume exposure. Participants consisted of welders (n = 40) and welder assistants (n = 25) from welding units as the exposed group, and office workers (n = 44) as the non-exposed group. All participants were studied using ambient air monitoring and two types of questionnaires: the Cognitive Failures Questionnaire (CFQ) and the 36-item Short Form Health Survey (SF-36). Welders and welder assistants were exposed to higher concentrations of all airborne metals than office employees, except for aluminum and chromium (p health-related quality of life were not related to the measures of welding fume exposure and further research should be performed to find other influencing factors.

  10. Chemical Risk Assessment: Traditional vs Public Health Perspectives.

    Science.gov (United States)

    Gwinn, Maureen R; Axelrad, Daniel A; Bahadori, Tina; Bussard, David; Cascio, Wayne E; Deener, Kacee; Dix, David; Thomas, Russell S; Kavlock, Robert J; Burke, Thomas A

    2017-07-01

    Preventing adverse health effects of environmental chemical exposure is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and effects of environmentally induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Considering these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease.

  11. 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.

  12. Study protocol for a randomized, controlled, superiority trial comparing the clinical and cost- effectiveness of integrated online mental health assessment-referral-care in pregnancy to usual prenatal care on prenatal and postnatal mental health and infant health and development: the Integrated Maternal Psychosocial Assessment to Care Trial (IMPACT).

    Science.gov (United States)

    Kingston, Dawn; Austin, Marie-Paule; Hegadoren, Kathy; McDonald, Sheila; Lasiuk, Gerri; McDonald, Sarah; Heaman, Maureen; Biringer, Anne; Sword, Wendy; Giallo, Rebecca; Patel, Tejal; Lane-Smith, Marie; van Zanten, Sander Veldhuyzen

    2014-03-06

    Stress, depression, and anxiety affect 15 to 25% of pregnant women. However, fewer than 20% of prenatal care providers assess and treat mental health problems and fewer than 20% of pregnant women seek mental healthcare. For those who seek treatment, the lack of health system integration and existing barriers frequently prevent treatment access. Without treatment, poor prenatal mental health can persist for years and impact future maternal, child, and family well-being. The purpose of this randomized controlled trial is to evaluate the effectiveness of an integrated process of online psychosocial assessment, referral, and cognitive behavior therapy (CBT) for pregnant women compared to usual prenatal care (no formal screening or specialized care). The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6 to 8 weeks postrandomization. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. Pregnant women are eligible if they: 1) are prenatal mental healthcare and the use of highly accessible computer-based psychosocial assessment and CBT on maternal, infant, and family-based outcomes. ClinicalTrials.gov Identifier: NCT01901796.

  13. Assessing Human Health Risk from Pesticides

    Science.gov (United States)

    EPA protects human health and the environment by evaluating the risk associated with pesticides before allowing them to be used in the United States. Learn about the tools and processes used in risk assessment for pesticides.

  14. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

    Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

    2001-01-01

    This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

  15. Holes in the safety net? Assessing the effects of targeted benefits upon the health care utilization of poor New Zealanders.

    Science.gov (United States)

    Barnett, J. Ross; Coyle, Philip; Kearns, Robin A.

    2000-05-01

    This paper examines the issue of targeting primary health-care benefits in favour of low-income recipients and other high users of health care. Specifically we examine the New Zealand case where, despite the introduction of such benefits in 1992, financial barriers appear to remain a significant determinant of utilization. We address this issue through a case study conducted in the city of Christchurch. Through a survey-based research design, we seek to determine the extent to which price barriers remain important by comparing patient utilization of a free community health clinic (n = 202) with a low-income control sample of patients who continue to use conventional (for New Zealand) fee-for-service providers (n = 148). We found that a large proportion of respondents delayed seeking care because of cost. Further, for respondents using the fee-for-service providers, levels of use were not related to need, whereas at the free clinic there was an inverse relationship between income and consultation rates. We conclude that if a universality of benefits is not possible, then there is a need for better targeting of primary care benefits. We believe there is a danger in such initiatives being evaluated primarily in terms of their validity as funding mechanisms, rather than in terms of their success in meeting the health-care needs of the disdavantaged.

  16. 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.

  17. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    Background Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable, complete, consistent and timely health data to inform effective planning and resource management. Methods A cross-sectional survey was conducted wherein ...

  18. Cost-effectiveness of quantitative ultrasound as a technique for screening of osteoporotic fracture risk: report on a health technology assessment conducted in 2001

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2004-03-01

    Full Text Available Aim: On behalf of the German Agency for Health Technology Assessment (DAHTA@DIMDI a rapid economic HTA was conducted. Aim of the HTA was to evaluate the cost-effectiveness of quantitative ultrasound (QUS for screening of osteoporotic fracture risk. Study population was formed by postmenopausal women. QUS was compared to the dual X-ray absorptiometry (DXA as the most frequently used method of measurement. Methods: According to the recommendations for rapid economic HTA a comprehensive literature search was conducted. Data of identified and relevant publications have been extracted in form of a qualitative and quantitative information synthesis. The authors calculated incremental cost-effectiveness ratios for different screening procedures: (1 one-step proceeding comparing QUS with DXA, (2 two-step proceeding starting with QUS followed by DXA in pathologic cases. Results: An additional case diagnosed by DXA in a one-step proceeding rises additional costs of about 1,000 EURO. A two-step proceeding with QUS is cost-effective as long as the costs of one QUS examination are lower than 31%-51% of the costs of one DXA examination. Discussion: All considered studies showed methodological limitations. None of them included long term effects like avoided bone fractures. Considering long-term effects probably would change the results. Due to the weakness of data no concluding judgement about the cost-effectiveness of QUS can be given.

  19. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. 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.

  1. 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.

  2. Risk assessment in support of plant health

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... 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...

  3. 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 < .05 and for the HD case r = .700, p < .01. The SPs scored students higher than the other raters. Students' self-assessments were most closely aligned with the investigator. Effects were apparent due to case. Content validity was gathered in the 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

  4. Assessment of soil health in the central claypan region, Missouri

    Science.gov (United States)

    Assessment of soil health involves determining how well a soil is performing its biological, chemical, and physical functions relative to its inherent potential. Within the Central Claypan Region of Missouri, the Salt River Basin was selected as a benchmark watershed to assess long-term effects of c...

  5. 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.

  6. Methodology for assessing exposure and impacts of air pollutants in school children: Data collection, analysis and health effects - A literature review

    Science.gov (United States)

    Mejía, Jaime F.; Choy, Samantha Low; Mengersen, Kerrie; Morawska, Lidia

    2011-02-01

    pollutant dose intake is affected by daily patterns of physical and traffic activity during and outside school hours which make it difficult to compare the contribution of school-based and non-school-based exposures to the health effect under investigation. Finally, there is strong evidence that low socioeconomic level is highly correlated with the proximity of the school to pollution sources, yet this area of socioeconomic research has been largely unexplored in the assessment of traffic emission exposure.

  7. Public health nutrition practice in Canada: a situational assessment.

    Science.gov (United States)

    Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

    2008-08-01

    Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

  8. In Vivo Toxicity Assessment of Occupational Components of the Carbon Nanotube Life Cycle To Provide Context to Potential Health Effects.

    Science.gov (United States)

    Bishop, Lindsey; Cena, Lorenzo; Orandle, Marlene; Yanamala, Naveena; Dahm, Matthew M; Birch, M Eileen; Evans, Douglas E; Kodali, Vamsi K; Eye, Tracy; Battelli, Lori; Zeidler-Erdely, Patti C; Casuccio, Gary; Bunker, Kristin; Lupoi, Jason S; Lersch, Traci L; Stefaniak, Aleksandr B; Sager, Tina; Afshari, Aliakbar; Schwegler-Berry, Diane; Friend, Sherri; Kang, Jonathan; Siegrist, Katelyn J; Mitchell, Constance A; Lowry, David T; Kashon, Michael L; Mercer, Robert R; Geraci, Charles L; Schubauer-Berigan, Mary K; Sargent, Linda M; Erdely, Aaron

    2017-09-26

    Pulmonary toxicity studies on carbon nanotubes focus primarily on as-produced materials and rarely are guided by a life cycle perspective or integration with exposure assessment. Understanding toxicity beyond the as-produced, or pure native material, is critical, due to modifications needed to overcome barriers to commercialization of applications. In the first series of studies, the toxicity of as-produced carbon nanotubes and their polymer-coated counterparts was evaluated in reference to exposure assessment, material characterization, and stability of the polymer coating in biological fluids. The second series of studies examined the toxicity of aerosols generated from sanding polymer-coated carbon-nanotube-embedded or neat composites. Postproduction modification by polymer coating did not enhance pulmonary injury, inflammation, and pathology or in vitro genotoxicity of as-produced carbon nanotubes, and for a particular coating, toxicity was significantly attenuated. The aerosols generated from sanding composites embedded with polymer-coated carbon nanotubes contained no evidence of free nanotubes. The percent weight incorporation of polymer-coated carbon nanotubes, 0.15% or 3% by mass, and composite matrix utilized altered the particle size distribution and, in certain circumstances, influenced acute in vivo toxicity. Our study provides perspective that, while the number of workers and consumers increases along the life cycle, toxicity and/or potential for exposure to the as-produced material may greatly diminish.

  9. 42 CFR 90.4 - Contents of requests for health assessments.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Contents of requests for health assessments. 90.4... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES § 90.4 Contents of requests for health assessments. (a) Each request...

  10. The influence of effective microorganisms (EM) and yeast on the degradation of strobilurins and carboxamides in leafy vegetables monitored by LC-MS/MS and health risk assessment.

    Science.gov (United States)

    Wołejko, Elżbieta; Łozowicka, Bożena; Kaczyński, Piotr; Jankowska, Magdalena; Piekut, Jolanta

    2016-01-01

    The aim of this study was to determine the behaviour of strobilurin and carbocyamides commonly used in chemical protection of lettuce depending on carefully selected effective microorganisms (EM) and yeast (Y). Additionally, the assessment of the chronic health risk during a 2-week experiment was performed. The statistical method for correlation of physico-chemical parameters and time of degradation for pesticides was applied. In this study, the concentration of azoxystrobin, boscalid, pyraclostrobin and iprodione using liquid chromatography-mass spectrometry (LC-MS/MS) in the matrix of lettuce plants was performed, and there was no case of concentration above maximum residues levels. Before harvest, four fungicides and their mixture with EM (1 % and 10 %) and/or yeast 5 % were applied. In our work, the mixtures of 1%EM + Y and 10%EM + Y both stimulated and inhibited the degradation of the tested active substances. Adding 10%EM to the test substances strongly inhibited the degradation of iprodione, and its concentration decreased by 30 %, and in the case of other test substances, the degradation was approximately 60 %. Moreover, the addition of yeast stimulated the distribution of pyraclostrobin and boscalid in lettuce leaves. The risk assessment for the pesticides ranged from 0.4 to 64.8 % on day 1, but after 14 days, it ranged from 0.0 to 20.9 % for children and adults, respectively. It indicated no risk of adverse effects following exposure to individual pesticides and their mixtures with EM and yeast.

  11. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  12. Assessing Entrepreneurship in Governmental Public Health

    Science.gov (United States)

    Wasserman, Jeffrey; Wu, Helen W.; Lauer, Johanna R.

    2015-01-01

    Objectives. We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Methods. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Results. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Conclusions. Ongoing PHE activity has the potential to reduce LHDs’ reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs’ current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative. PMID:25689182

  13. ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

    Directory of Open Access Journals (Sweden)

    john frimpong manso

    2013-08-01

    Full Text Available Ghana Public Health Sector runs a three-tier system of managing health commodities. Suppliers, the Central Medical Store, The Regional Medical Store, Service Delivery Points and the transportation system form the supply chain.  Ghana Health Service logistics system is centralized and the health care delivery system is decentralized. Logistics management in the health system is crucial. This is because there are instances where medicines and health commodities are not available at the Central Medical Stores and the Regional Medical Stores. Consequently, there is no commodity security at the service delivery points. Upon this backdrop the study seeks to assess the logistics management system in order to bring efficiency in the system. The study adopts a multi-case study approach to assess the practices of logistics management, the causes of inadequacy of logistics and the strengths and weaknesses in Ghana Health Service logistics system.  Two categories of participants that is, the key players of health logistics management and end-users were involved in the study.  Four variables; finance for procurement of health commodities, evenly distribution of health commodities, effective supervision and constant monitoring and evaluation were found crucial in effective and efficient logistics management. Moreover, it was found that poor procurement planning and budgeting, lack of financial resources for procurement, poor quantification and forecasting, delay in procurement process and order processing, and delay in receiving insurance claims are some of the causes of inadequacy of logistics in the health systems. It is recommended that Ghana Health Service logistics or supply system must receive constant monitoring and evaluation. Further, Ghana Health Service must ensure that there is effective top-down supervision in the system to bring up efficiency. Again, Ghana Health Service and Ministry of Health must ensure enough funds are secured from the

  14. Health care policy: qualitative evidence and health technology assessment.

    Science.gov (United States)

    Leys, Mark

    2003-09-01

    Since the late 1990s health technology assessment (HTA) has gained influence as a research and evaluation approach supporting health care policy. The focus on this methodology is congruent with the growing importance of evidence-based health care. Although HTA is a multidisciplinary discipline from a theoretical point of view, practice shows that social, ethical and psychological aspects are seldom truly integrated into the assessment of health technology. HTA is still very much biased by the medical and pharmaceutical research traditions. This contribution focuses on the question of how qualitative research findings could be useful as an additional source of information or as 'evidence' in HTA. Medical and health care scientists are seldom acquainted with qualitative research or judge it as a less (or un-)reliable form of research. 'Qualitative dimensions' of health care are not considered 'real' evidence. This contribution argues that qualitative findings could be put higher in the hierarchy of evidence generating research in health care. First it can be realized by improving the knowledge of the nature of qualitative research. Second qualitative findings can become more trustworthy information, if researchers themselves respect methodological prerequisites and clarify their theoretical perspective, research aims and use of research methods. Some methodological characteristics of qualitative research and 'evidence' are discussed for their contribution to HTA and evidence-based health care.

  15. Health consequence scales for use in health impact assessments of climate change.

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery

    2014-09-16

    While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed.

  16. Health Consequence Scales for Use in Health Impact Assessments of Climate Change

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery

    2014-01-01

    While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed. PMID:25229697

  17. Realising the potential of health needs assessments.

    Science.gov (United States)

    Anstey, Matthew; Burgess, Paul; Angus, Lisa

    2017-05-15

    Population-level assessment and planning has traditionally been the role of public health departments but in establishing Primary Health Networks (PHNs), the Australian Government has instituted a new mechanism for identifying community needs and commissioning services to meet those needs. If PHNs are to achieve the vision of nimble organisations capable of identifying and addressing local health needs via integrated health and social services, several things need to occur. First, PHN funding schedules must become more flexible. Second, the Federal health department must maintain an open dialogue with PHNs, permit waivers in funding schedules to suit local conditions and be prepared to back innovations with seed investment. Third, health data exchange and linkage must be accelerated to better inform community needs assessments and commissioning. Finally, PHNs must be encouraged and supported to develop collaborations both within and outside the health sector in order to identify and address a broad set of health issues and determinants. By following these principles, PHNs may become leading change agents in the Australian healthcare system.

  18. Cancer and non-cancer health effects from food contaminant exposures for children and adults in California: a risk assessment

    Directory of Open Access Journals (Sweden)

    Vogt Rainbow

    2012-11-01

    Full Text Available 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, n=157, parents of young children (n=446, and older adults (n=149. We compared exposure estimates for eleven toxic compounds (acrylamide, arsenic, lead, mercury, chlorpyrifos, permethrin, endosulfan, dieldrin, chlordane, DDE, and dioxin based on self-reported food frequency data by age group. To determine if cancer and non-cancer benchmark levels were exceeded, chemical levels in food were derived from publicly available databases including the Total Diet Study. Results Cancer benchmark levels were exceeded by all children (100% for arsenic, dieldrin, DDE, and dioxins. Non-cancer benchmarks were exceeded by >95% of preschool-age children for acrylamide and by 10% of preschool-age children for mercury. Preschool-age children had significantly higher estimated intakes of 6 of 11 compounds compared to school-age children (p Conclusions Dietary strategies to reduce exposure to toxic compounds for which cancer and non-cancer benchmarks are exceeded by children vary by compound. These strategies include consuming organically produced dairy and selected fruits and vegetables to reduce pesticide intake, consuming less animal foods (meat, dairy, and fish to reduce intake of persistent organic pollutants and metals, and consuming lower quantities of chips, cereal, crackers, and other processed carbohydrate foods to reduce acrylamide intake.

  19. Cancer and non-cancer health effects from food contaminant exposures for children and adults in California: a risk assessment.

    Science.gov (United States)

    Vogt, Rainbow; Bennett, Deborah; Cassady, Diana; Frost, Joshua; Ritz, Beate; Hertz-Picciotto, Irva

    2012-11-09

    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. 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, n=157), parents of young children (n=446), and older adults (n=149). We compared exposure estimates for eleven toxic compounds (acrylamide, arsenic, lead, mercury, chlorpyrifos, permethrin, endosulfan, dieldrin, chlordane, DDE, and dioxin) based on self-reported food frequency data by age group. To determine if cancer and non-cancer benchmark levels were exceeded, chemical levels in food were derived from publicly available databases including the Total Diet Study. Cancer benchmark levels were exceeded by all children (100%) for arsenic, dieldrin, DDE, and dioxins. Non-cancer benchmarks were exceeded by >95% of preschool-age children for acrylamide and by 10% of preschool-age children for mercury. Preschool-age children had significantly higher estimated intakes of 6 of 11 compounds compared to school-age children (pfoods included in this analysis were tomatoes, peaches, apples, peppers, grapes, lettuce, broccoli, strawberries, spinach, dairy, pears, green beans, and celery. Dietary strategies to reduce exposure to toxic compounds for which cancer and non-cancer benchmarks are exceeded by children vary by compound. These strategies include consuming organically produced dairy and selected fruits and vegetables to reduce pesticide intake, consuming less animal foods (meat, dairy, and fish) to reduce intake of persistent organic pollutants and metals, and consuming lower quantities of chips, cereal, crackers, and other processed carbohydrate foods to reduce acrylamide intake.

  20. Potential harmful health effects of inhaling nicotine-free shisha-pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol.

    Science.gov (United States)

    Kienhuis, Anne S; Soeteman-Hernandez, Lya G; Bos, Peter Mj; Cremers, Hans Wjm; Klerx, Walther N; Talhout, Reinskje

    2015-01-01

    A shisha-pen is an electronic cigarette variant that is advertised to mimic the taste of a water pipe, or shisha. The aim of this study was to assess the potential harmful health effects caused by inhaling the vapor of a nicotine-free shisha-pen. Gas chromatography analysis was performed to determine the major components in shisha-pen vapor. Risk assessment was performed using puff volumes of e-cigarettes and "normal" cigarettes and a 1-puff scenario (one-time exposure). The concentrations that reached the airways and lungs after using a shisha-pen were calculated and compared to data from published toxicity studies. The main components in shisha-pen vapor are propylene glycol and glycerol (54%/46%). One puff (50 to 70 mL) results in exposure of propylene glycol and glycerol of 430 to 603 mg/m(3) and 348 to 495 mg/m(3), respectively. These exposure concentrations were higher than the points of departure for airway irritation based on a human study (propylene glycol, mean concentration of 309 mg/m(3)) and a rat study (glycerol, no-observed adverse effect level of 165 mg/m(3)). Already after one puff of the shisha-pen, the concentrations of propylene glycol and glycerol are sufficiently high to potentially cause irritation of the airways. New products such as the shisha-pen should be detected and risks should be assessed to inform regulatory actions aimed at limiting potential harm that may be caused to consumers and protecting young people to take up smoking.

  1. Lack of data drives uncertainty in PCB health risk assessments.

    Science.gov (United States)

    Cogliano, Vincent James

    2016-02-01

    Health risk assessments generally involve many extrapolations: for example, from animals to humans or from high doses to lower doses. Health risk assessments for PCBs involve all the usual uncertainties, plus additional uncertainties due to the nature of PCBs as a dynamic, complex mixture. Environmental processes alter PCB mixtures after release into the environment, so that people are exposed to mixtures that might not resemble the mixtures where there are toxicity data. This paper discusses the evolution of understanding in assessments of the cancer and noncancer effects of PCBs. It identifies where a lack of data in the past contributed to significant uncertainty and where new data subsequently altered the prevailing understanding of the toxicity of PCB mixtures, either qualitatively or quantitatively. Finally, the paper identifies some uncertainties remaining for current PCB health assessments, particularly those that result from a lack of data on exposure through nursing or on effects from inhalation of PCBs.

  2. High Spatial Resolution Thermal Remote Sensing of the Urban Heat Island Effect: Assessment of Risks to Human Health and Development of Mitigation Strategies for Sustainable Cities

    Science.gov (United States)

    Quattrochi, Dale A.; Luvall, Jeffrey C.; Rickman, Douglas L.; Estes, Maurice G., Jr.; Laymon, Charles A.; Crosson, William; Howell, Burgess F.; Gillani, Noor V.; Arnold, James E. (Technical Monitor)

    2002-01-01

    The growth of cities, both in population and in areal extent, appears as an inexorable process. Urbanization continues at a rapid rate, and it is estimated that by the year 2025, 80% of the world's population will live in cities. One of the more egregious side effects of urbanization is the deterioration in air quality as a result of increased vehicular traffic, industrialization and related activities. In the United States alone, under the more stringent air quality guidelines established by the U.S. Environmental Protection Agency (EPA) in 1997, nearly 300 counties in 34 states will not meet the new air quality standards for ground level ozone. The mitigation of one the physical/environmental characteristics of urbanization known as the urban heat island (UHI) effect, is now being looked at more closely as a possible way to bring down ground level ozone levels in cities and assist states in improving air quality. The UHI results from the replacement of "natural" land covers (e.g., trees, grass) with urban land surface types, such as pavement and buildings. Heat stored in these surfaces is released into the air and results in a "dome" of elevated air temperatures that presides over cities. The effect of this dome of elevated air temperatures is known as the UHI, which is most prevalent about 2-3 hours after sunset on days with intense solar radiation and calm winds. Given the local and regional impacts of the UHI, there are significant potential affects on human health, particularly as related to heat stress and ozone on body temperature regulation and on the cardiovascular and respiratory systems. In this study we are using airborne and satellite remote sensing data to analyze how differences in the urban landscape influence or drive the development of the UHI over four U.S. cities. Additionally, we are assessing what the potential impact is on risks to human health, and developing mitigation strategies to make urban areas more environmentally sustainable.

  3. Remote Sensing of the Urban Heat Island Effect: Assessment of Risks to Human Health and Development of Mitigation Strategies for Sustainable Cities

    Science.gov (United States)

    Quattrochi, Dale A.; Luvall, Jeffrey C.; Rickman, Douglas L.; Estes, Maurice G., Jr.; Laymon, Charles A.; Crosson, William; Howell, Burgess F.; Gillani, Noor V.; Arnold, James E. (Technical Monitor)

    2001-01-01

    The growth of cities, both in population and in areal extent, appears as an inexorable process. Urbanization continues at a rapid rate, and it is estimated that by the year 2025, 80% of the world's population will live in cities. One of the more egregious side effects of urbanization is the deterioration in air quality as a result of increased vehicular traffic, industrialization and related activities. In the United States alone, under the more stringent air quality guidelines established by the U.S. Environmental Protection Agency (EPA) in 1997, nearly 300 counties in 34 states will not meet the new air quality standards for ground level ozone. The mitigation of one the physical/environmental characteristics of urbanization known as the urban heat island (UHI) effect, is now being looked at more closely as a possible way to bring down ground level ozone levels in cities and assist states in improving air quality. The UHI results from the replacement of "natural" land covers (e.g., trees, grass) with urban land surface types, such as pavement and buildings. Heat stored in these surfaces is released into the air and results in a "dome" of elevated air temperatures that presides over cities. The effect of this dome of elevated air temperatures is known as the UHI, which is most prevalent about 2-3 hours after sunset on days with intense solar radiation and calm winds. Given the local and regional impacts of the UHI, there are significant potential affects on human health, particularly as related to heat stress and ozone on body temperature regulation and on the cardiovascular and respiratory systems. In this study we are using airborne and satellite remote sensing data to analyze how differences in the urban landscape influence or drive the development of the UHI over four U.S. cities. Additionally, we are assessing what the potential impact is on risks to human health, and developing mitigation strategies to make urban areas more environmentally sustainable.

  4. [Theoretical basis for health system performance assessment].

    Science.gov (United States)

    Sebai, Jihane

    2015-01-01

    In France, the search for improved performance in the public sector, considered to reflect optimization of public services, has undergone various phases since the second World War. Public policy assessment has also considerably developed since the 1990s. The various reforms and resulting programmes have contributed to changing the French public administration from a means-based approach to a results-based approach, an essential step to improve performance according to the New Public Management paradigm. Other theories have also been proposed concerning performance assessment in the public sector, especially the medical care sector. The primary objective of this article is to propose a theoretical framework for the concept of performance and performance assessment in the health sector. The authors also propose a reading grid of the main theories concerning application of performance assessment in the health care sector.

  5. Utilizing a combination of molecular and spatial tools to assess the effect of a public health intervention.

    Science.gov (United States)

    Muellner, P; Marshall, J C; Spencer, S E F; Noble, A D; Shadbolt, T; Collins-Emerson, J M; Midwinter, A C; Carter, P E; Pirie, R; Wilson, D J; Campbell, D M; Stevenson, M A; French, N P

    2011-12-01

    Until recently New Zealand had one of the highest rates of human campylobacteriosis reported by industrialized countries. Since the introduction of a range of control measures in the poultry production chain a reduction in human cases of around 50% has been observed nationwide. To inform risk managers a combination of spatial, temporal and molecular tools - including minimum spanning trees, risk surfaces, rarefaction analysis and dynamic source attribution modelling - was used in this study to formally evaluate the reduction in disease risk that occurred after the implementation of control measures in the poultry industry. Utilizing data from a sentinel surveillance site in the Manawatu region of New Zealand, our analyses demonstrated a reduction in disease risk attributable to a reduction in the number of poultry-associated campylobacteriosis cases. Before the implementation of interventions poultry-associated cases were more prevalent in urban than rural areas, whereas for ruminant-associated cases the reverse was evident. In addition to the overall reduction in prevalence, this study also showed a stronger intervention effect in urban areas where poultry sources were more dominant. Overall a combination of molecular and spatial tools has provided evidence that the interventions aimed at reducing Campylobacter contamination of poultry were successful in reducing poultry-associated disease and this will inform the development of future control strategies. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Chemical Mixtures Health Risk Assessment: Overview of Exposure Assessment, Whole Mixtures Assessments; Basic Concepts

    Science.gov (United States)

    This problems-based, half-day, introductory workshop focuses on methods to assess health risks posed by exposures to chemical mixtures in the environment. Chemical mixtures health risk assessment methods continue to be developed and evolve to address concerns over health risks f...

  7. Health-related quality of life assessed by the effect of bepotastine besilate in patients with pruritus: importance of emotions score in atopic dermatitis.

    Science.gov (United States)

    Kawakami, Tamihiro; Kimura, Satoko; Haga, Tsuneo; Doi, Risako; Kyoya, Mikiko; Nakagawa, Keiko; Soma, Yoshinao

    2012-06-01

    The Skindex-16 questionnaire was recently developed as a measure of dermatological health-related quality of life (HRQoL), including symptoms, emotions and functional aspects. Bepotastine besilate is a selective histamine H(1) -receptor antagonist and a second-generation non-sedating antihistamine to treat various dermatological disorders. We assessed changes of the HRQoL instrument (Skindex-16) on patients with pruritus, including those with atopic dermatitis (AD) over bepotastine treatment period. The patients' personal assessment of the intensity of pruritus was determined using the Visual Analog Scale (VAS) for pruritus. Patients answered the Skindex-16 at baseline and at week 4. Forty-eight of 51 enrolled dermatological patients completed the Skindex-16. Of the 48 patients, 11 had AD and 37 had other conditions. Improvement in the clinical evaluation and VAS score was significant in all patients, the AD group and the other disorders group between baseline and week 4. Skindex-16 showed significantly lower scores for each of the three scales (symptoms, emotions and functioning) and the global score at baseline compared to that at week 4 in all patients and the other disorders. In contrast, there was a significant reduction in the emotions and global score among the AD patients. We found a significant correlation between falls in emotions score of Skindex-16 and falls in VAS scores for pruritus in the AD group. Bepotastine could be effective in the management of patients' HRQoL and useful in patients suffering with pruritus. We suggested that pruritus of AD patients could exert a stronger emotional effect due to the skin condition compared to the symptomatic or functional effects. © 2011 Japanese Dermatological Association.

  8. National Built Environment Health Impact Assessment Model ...

    Science.gov (United States)

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

  9. Interpretation of World Health Organization growth charts for assessing infant malnutrition: a randomised controlled trial.

    OpenAIRE

    Ahmad, UN; Yiwombe, M; Chisepo, P; Cole, TJ; Heikens, GT; Kerac, M

    2014-01-01

    AIMS The study aims to assess the effects of switching from National Center for Health Statistics (NCHS) growth references to World Health Organization (WHO) growth standards on health-care workers' decisions about malnutrition in infants aged

  10. Effects of Mental Health Benefits Legislation

    Science.gov (United States)

    Sipe, Theresa Ann; Finnie, Ramona K.C.; Knopf, John A.; Qu, Shuli; Reynolds, Jeffrey A.; Thota, Anilkrishna B.; Hahn, Robert A.; Goetzel, Ron Z.; Hennessy, Kevin D.; McKnight-Eily, Lela R.; Chapman, Daniel P.; Anderson, Clinton W.; Azrin, Susan; Abraido-Lanza, Ana F.; Gelenberg, Alan J.; Vernon-Smiley, Mary E.; Nease, Donald E.

    2015-01-01

    Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence is limited for other mental health outcomes. PMID:25998926

  11. Phytochemicals: Health Protective Effects.

    Science.gov (United States)

    Craig, Winston; Beck, Leslie

    1999-01-01

    Consuming a diet rich in plant foods will provide a milieu of phytochemicals, non-nutritive substances in plants that possess health-protective benefits. Vegetables, fruits, whole grains, herbs, nuts and seeds contain an abundance of phenolic compounds, terpenoids, sulfur compounds, pigments, and other natural antioxidants that have been associated with protection from and/or treatment of conditions such as cardiovascular disease and cancer. The foods and herbs with the highest anticancer activity include garlic, soybeans, cabbage, ginger, licorice root, and the umbelliferous vegetables. Citrus, in addition to providing an ample supply of vitamin C, folic acid, potassium, and soluble fibre, contains a host of active phytochemicals. Clinical trials have not yet been able to demonstrate the same protective effects from taking supplements. It is difficult to estimate how many Canadians achieve an adequate level of consumption, but it seems reasonable to assume that many Canadians could benefit from substantially increasing their intake of vegetables and fruit.

  12. 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

  13. 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

  14. Health Risk Assessment for Organotins in Textiles

    NARCIS (Netherlands)

    Janssen PJCM; Veen MP van; Speijers GJA; CSR; LBM

    2000-01-01

    In January 1998 RIVM was asked to carry out a preliminary risk assessment on organic tin compounds (organotins) in textiles. Measurements carried out by the Dutch Health Protection Inspectorate had shown these potentially toxic compounds to be present in several consumer products, including items of

  15. Quality assessment of occupational health services instruments

    NARCIS (Netherlands)

    van Dijk, F. J.; de Kort, W. L.; Verbeek, J. H.

    1993-01-01

    Interest in the quality of instruments for occupational health services is growing as a result of European legislation on preventive services stressing, for example, risk identification and assessment. The quality of the services can be enhanced when the quality of the applied instruments can be

  16. Health Impact Assessment: a useful tool for decision makers

    Directory of Open Access Journals (Sweden)

    Livia Turco

    2007-09-01

    Full Text Available Health Impact Assessment is defined as ‘the combination of procedures, methods and tools through which it is possible to evaluate a policy, a program or a development plan concerning possible effects on public health and their distribution in the general population’. In a constructive debate this definition points out some interesting observations: - health is not the result of health policies alone, but it is often defined by the attention given to it in other contexts; - health is however the result of policies and it therefore must deserve the attention of Decision Makers; - health must not be taken into consideration without taking into account an evaluation of its distribution and its determinants within a population. Particular attention must therefore be paid into inequalities; - following the Council of the European Union recent conclusions on Health in All Policies we have to consider that everyday environments such as day-care centers, schools,workplaces,neighborhoods and the commute between them have significant effects on health and that health, in turn, has an effect on the economy by enabling active and productive participation in working life. In the past 20 years huge progress has been achieved in the epidemiological contest to define risks. Nowadays, it is known that a low cultural level lowers the capacity to respond to prevention, that elevated pollution levels do represent a health risk, and that the scarce social relationships that elderly people have in our society have strong consequences on their health and their quality of life.

  17. An interprofessional health assessment program in rural amateur sport.

    Science.gov (United States)

    Grace, Sandra; Coutts, Rosanne

    2017-01-01

    Effective interprofessional learning (IPL) in multisectoral collaborations such as those linking health services within communities can provide an authentic experience for students and also appears to be the most effective way to achieve health changes in targeted population groups. The aim of this study was to facilitate the IPL of students at a rural university in a multisectoral health assessment programme and to promote health in players of rural amateur sport. Two rural rugby league teams took part in three pre-season health assessments conducted by general medical practitioners, practice nurses, and nursing, osteopathy, and exercise science students. The Readiness for Interprofessional Learning Scale questionnaire and a series of focus groups were used to evaluate participants' experiences of the programme. Results indicated that students saw the benefits for patients and 93% valued the opportunity to improve interprofessional communication, problem-solving and team skills. Some students felt they needed to learn more about their own professional role before learning about others, and instances of stereotyping were identified. The programme also enabled early detection of potential health risks and referral for medical care, management of musculoskeletal conditions, and health promotion. These health assessments would be readily transferred to other multisectoral sporting settings.

  18. Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

    Science.gov (United States)

    Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. This poster will illustrate how a Health Impact Assessment, a process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making proces

  19. Gestalt Effect of Self Assessment

    Science.gov (United States)

    McDonald, Betty

    2012-01-01

    Defining self assessment as the involvement of students in identifying standards and/or criteria to apply to their work and making judgements about the extent to which they have met these criteria and standards, this paper seeks to highlight the gestalt effect of self assessment. The total effect of self assessment on the learner is greater than…

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

    Science.gov (United States)

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

    2014-05-14

    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.

  1. 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.

  2. Health Effects of Climate Change

    Science.gov (United States)

    ... is known about the actual and potential human health impacts of climate change, many effects are speculative and targeted research efforts ... extensive research needs, particularly regarding adaptive responses to climate ... Examples of key research needs include: Identifying health ...

  3. Health Effects of Air Pollution

    Science.gov (United States)

    ... and your health: Green living Sun Water Air Health effects of air pollution How to protect yourself from air pollution Chemicals Noise Quizzes Links to more information girlshealth glossary girlshealth. ...

  4. 42 CFR 90.6 - Notification of determination to conduct a health assessment in response to a request from the...

    Science.gov (United States)

    2010-10-01

    ... assessment in response to a request from the public. 90.6 Section 90.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES... determination to conduct a health assessment in response to a request from the public. (a) Following a...

  5. Assessment-based health informatics curriculum improvement.

    Science.gov (United States)

    Berner, Eta S; Dorsey, Amanda D; Garrie, Robert L; Qu, Haiyan

    2016-07-01

    Informatics programs need assurance that their curricula prepare students for intended roles as well as ensuring that students have mastered the appropriate competencies. The objective of this study is to describe a method for using assessment data to identify areas for curriculum, student selection, and assessment improvement. A multiple-choice examination covering the content in the Commission for Health Accreditation of Informatics and Information Management Education curricular facets/elements was developed and administered to 2 cohorts of entering students prior to the beginning of the program and to the first cohort after completion of the first year's courses. The reliability of the examination was assessed using Cronbach's alpha. Content validity was assessed by having 2 raters assess the match of the items to the Commission for Health Accreditation of Informatics and Information Management Education requirements. Construct validation included comparison of exam performance of instructed vs uninstructed students. Criterion-related validity was assessed by examining the relationship of background characteristics to exam performance and by comparing examination performance to graduate Grade Point Average (GPA). Reliability of the examination was 0.91 and 0.82 (Cohort 1 pre/post-tests) and 0.43 (Cohort 2 pretest). Both raters judged 76% of the test items as appropriate. There were statistically significant differences between the instructed (Cohort 1 post-test) and uninstructed (Cohort 2 pretest) students (t = 2.95 P Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. [Efficiency assessment of investment in workers' health--economic issues].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela; Dawydzik, Lech T

    2002-01-01

    The economic analysis of efficiency of investment in health care and health at large by means of cost-benefit or cost-effectiveness techniques is the subject of implementation work in a number of countries. Poland's integration with the countries of the European Union justifies the need to understand and to use economic analyses. Unfortunately, these activities encounter many methodological and executive barriers. The investments in workers' health are not only investments in health care and the improvement of working conditions, but also in compensations, including financial ones, resulting from adverse effects of factors influencing the health of working population. The financial reporting system that exists in Poland does not ensure the possibility of full presentation of the aggregated data on the financing of activities for workers' health and diminishing of the adverse effects of factors present in the work environment. The information on the outcome of the investments in workers' health come from different sources, which means that it applies to different groups subjected to the analysis. The problem lies not only in the assessment of profitability of health investments but also in the social problem of the division of the resultant costs and benefits among various branches of the national economy. Therefore, the analyses involving mutual relations between individual sectors that invest in workers' health and those that bear consequences is essential in the terms of economic analyses. The authors present the determinants of economic evaluation in regard to health of working population in Poland.

  7. Untapped potential of health impact assessment.

    Science.gov (United States)

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-04-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure.

  8. Effects of method of administration on oral health-related quality of life assessment using the Child Perceptions Questionnaire (CPQ-G11-14).

    Science.gov (United States)

    Malter, Sandra; Hirsch, Christian; Reissmann, Daniel R; Schierz, Oliver; Bekes, Katrin

    2015-11-01

    Questionnaires that measure oral health-related quality of life (OHRQoL) in children and adolescents have emerged in recent years as an important source of patient-reported outcomes. The aim of this study was to investigate potential effects of the method of administration (face-to-face interview, telephone interview, or self-administered questionnaire) in 11- to 14-year-old children and adolescents on OHRQoL information obtained using the Child Perceptions Questionnaire (CPQ). OHRQoL was measured using the German version of the CPQ (CPQ-G11-14). The instrument was administered to 42 children and adolescents aged 11 to 14 years using the three different methods in a randomized order with an interval of 1 week between each administration. Test-retest reliability for the repeated CPQ-G11-14 assessments across the three methods of administration, internal consistency, and convergent validity were determined. The CPQ-G11-14 mean summary scores did not vary statistically significantly across the three administration methods (P = 0.274). Test-retest reliability was moderate to good (ICC 0.69-0.82), internal consistency was satisfactory (Cronbach's alpha 0.85-0.88), and CPQ-G11-14 mean summary scores were correlated in the expected direction with a global measure of self-reported oral health for all the three administration methods. In conclusion, the method of administration (face-to-face interview, telephone interview, or self-administered questionnaire) did not influence CPQ-G11-14 scores in 11- to 14-year-old children and adolescents to a significant extent. Investigators in German-speaking countries can choose between all three methods of administration to obtain valid and reliable OHRQoL information.

  9. 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.

  10. Is this normal? Assessing mental health in young people.

    Science.gov (United States)

    McGorry, Patrick D; Goldstone, Sherilyn

    2011-03-01

    Mental ill-health is a key health issue facing young Australians today. While the physical health of young people has improved in recent decades, their mental health appears to have worsened. Mental health and substance use disorders now account for over 50% of the burden of disease in the 15-25 years age group, and 75% of mental health disorders that will affect people across the lifespan will have emerged for the first time by the age of 25 years. This article provides the general practitioner with key factors in assessing the young person with a mental illness: when to worry and what the early stages of mental illness look like; and provides guidance and tips for effective treatment. Mental ill-health in young people is all too often accepted as a 'normal' feature of adolescence. However, the short and long term consequences of mental illness include impaired social functioning, poor educational achievement, substance abuse, self harm, suicide and violence. Distinguishing between what represents transitory and normative changes in behaviour and disturbances that may represent the early signs of the onset of a potentially serious mental illness is difficult, particularly in young people, where emotional disturbance and distress is such a common experience. The primary goal of initial assessment is not to make a definitive diagnosis but rather to assess risk and the need for clinical care. The GP has an important role to play in longitudinal assessment and ongoing review, and facilitating access to treatment and mobilising support networks.

  11. Health technology assessment, value-based decision making, and innovation.

    Science.gov (United States)

    Henshall, Chris; Schuller, Tara

    2013-10-01

    Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

  12. Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana.

    Science.gov (United States)

    Akazili, James; Ataguba, John Ele-Ojo; Kanmiki, Edmund Wedam; Gyapong, John; Sankoh, Osman; Oduro, Abraham; McIntyre, Di

    2017-05-22

    There is a global concern regarding how households could be protected from relatively large healthcare payments which are a major limitation to accessing healthcare. Such payments also endanger the welfare of households with the potential of moving households into extreme impoverishment. This paper examines the impoverishing effects of out-of-pocket (OOP) healthcare payments in Ghana prior to the introduction of Ghana's national health insurance scheme. Data come from the Ghana Living Standard Survey 5 (2005/2006). Two poverty lines ($1.25 and $2.50 per capita per day at the 2005 purchasing power parity) are used in assessing the impoverishing effects of OOP healthcare payments. We computed the poverty headcount, poverty gap, normalized poverty gap and normalized mean poverty gap indices using both poverty lines. We examine these indicators at a national level and disaggregated by urban/rural locations, across the three geographical zones, and across the ten administrative regions in Ghana. Also the Pen's parade of "dwarfs and a few giants" is used to illustrate the decreasing welfare effects of OOP healthcare payments in Ghana. There was a high incidence and intensity of impoverishment due to OOP healthcare payments in Ghana. These payments contributed to a relative increase in poverty headcount by 9.4 and 3.8% using the $1.25/day and $2.5/day poverty lines, respectively. The relative poverty gap index was estimated at 42.7 and 10.5% respectively for the lower and upper poverty lines. Relative normalized mean poverty gap was estimated at 30.5 and 6.4%, respectively, for the lower and upper poverty lines. The percentage increase in poverty associated with OOP healthcare payments in Ghana is highest among households in the middle zone with an absolute increase estimated at 2.3% compared to the coastal and northern zones. It is clear from the findings that without financial risk protection, households can be pushed into poverty due to OOP healthcare payments. Even

  13. Teaching pediatric health assessment: using Internet capabilities.

    Science.gov (United States)

    Kieckhefer, Gail M; Stevens, Anne; Frkonja, Jeff

    2002-01-01

    Changes brought about by rapidly expanding information technology are affecting many aspects of life, including nursing education. Graduates must be comfortable and flexible with the use of information technology because they will be required to use it in their practice and continuing education activities. In this article, the authors describe their experience in implementing and refining the use of World Wide Web-based technology to teach pediatric health assessment to pediatric and family nurse practitioner students. The article includes reflections on preparation, implementation, and evaluation. The students' level of confidence in their ability to perform pediatric health assessment rose, as did their test scores, and faculty deemed the revision successful and timesaving for them.

  14. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  15. [Application of three risk assessment models in occupational health risk assessment of dimethylformamide].

    Science.gov (United States)

    Wu, Z J; Xu, B; Jiang, H; Zheng, M; Zhang, M; Zhao, W J; Cheng, J

    2016-08-20

    Objective: To investigate the application of United States Environmental Protection Agency (EPA) inhalation risk assessment model, Singapore semi-quantitative risk assessment model, and occupational hazards risk assessment index method in occupational health risk in enterprises using dimethylformamide (DMF) in a certain area in Jiangsu, China, and to put forward related risk control measures. Methods: The industries involving DMF exposure in Jiangsu province were chosen as the evaluation objects in 2013 and three risk assessment models were used in the evaluation. EPA inhalation risk assessment model: HQ=EC/RfC; Singapore semi-quantitative risk assessment model: Risk= (HR×ER) 1/2; Occupational hazards risk assessment index=2Health effect level×2exposure ratio×Operation condition level. Results: The results of hazard quotient (HQ>1) from EPA inhalation risk assessment model suggested that all the workshops (dry method, wet method and printing) and work positions (pasting, burdening, unreeling, rolling, assisting) were high risk. The results of Singapore semi-quantitative risk assessment model indicated that the workshop risk level of dry method, wet method and printing were 3.5 (high) , 3.5 (high) and 2.8 (general) , and position risk level of pasting, burdening, unreeling, rolling, assisting were 4 (high) , 4 (high) , 2.8 (general) , 2.8 (general) and 2.8 (general) . The results of occupational hazards risk assessment index method demonstrated that the position risk index of pasting, burdening, unreeling, rolling, assisting were 42 (high) , 33 (high) , 23 (middle) , 21 (middle) and 22 (middle) . The results of Singapore semi-quantitative risk assessment model and occupational hazards risk assessment index method were similar, while EPA inhalation risk assessment model indicated all the workshops and positions were high risk. Conclusion: The occupational hazards risk assessment index method fully considers health effects, exposure, and operating conditions and

  16. Awareness assessment of harmful effects of mercury in a health care set-up in India: A survey-based study.

    Science.gov (United States)

    Halder, Nabanita; Peshin, Sharda Shah; Pandey, Ravindra Mohan; Gupta, Yogendra Kumar

    2015-12-01

    Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills. © The Author(s) 2013.

  17. Assessing value-for-money in maternal and newborn health.

    Science.gov (United States)

    Banke-Thomas, Aduragbemi; Madaj, Barbara; Kumar, Shubha; Ameh, Charles; van den Broek, Nynke

    2017-01-01

    Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four components: economy, efficiency, effectiveness and cost-effectiveness. Both 'economy' and 'efficiency' can be assessed with detailed cost analysis utilising costs obtained from programme accounting data or generic cost databases. Before-and-after studies, case-control studies or randomised controlled trials can be used to assess 'effectiveness'. To assess 'cost-effectiveness', cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-benefit analysis (CBA) or social return on investment (SROI) analysis are applicable. Generally, costs can be obtained from programme accounting data or existing generic cost databases. As such 'economy' and 'efficiency' are relatively easy to assess. However, 'effectiveness' and 'cost-effectiveness' which require establishment of the counterfactual are more difficult to ascertain. Either a combination of CEA or CUA with tools for assessing other VfM components, or the independent use of CBA or SROI are alternative approaches proposed to strengthen VfM assessments. Cross-cutting themes such as equity, sustainability, scalability and cultural acceptability should also be assessed, as they provide critical contextual information for interpreting VfM assessments. To select an assessment approach, consideration should be given to the purpose, data availability, stakeholders requiring the findings and perspectives of programme beneficiaries. Implementers and researchers should work together to improve the quality of assessments. Standardisation around definitions, methodology and effectiveness measures to be assessed would help.

  18. 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…

  19. Implementation of the Community Health Assessment Program in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This five-year study will develop and test the Community Health Assessment Program's effectiveness in decreasing the incidence of diabetes in rural communities in the Zamboanga Peninsula of the Philippines. The goal is to improve the prevention and management of type 2 diabetes. Research that saves lives This ...

  20. Health technology assessment of asthma disease management programs

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Lemmens, Karin; Vrijhoef, Bert

    2007-01-01

    Purpose of review: To provide a critical opinion on the extent to which asthma disease management programs currently improve the effectiveness and efficiency of care and directions for future policy and research. Recent findings: The methodological quality of health technology assessment of asthma

  1. Health Information: What Can Mobile Phone Assessments Add?

    OpenAIRE

    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.

  2. 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.

  3. Evaluating the impact of equity focused health impact assessment on health service planning: three case studies.

    Science.gov (United States)

    Harris-Roxas, Ben; Haigh, Fiona; Travaglia, Joanne; Kemp, Lynn

    2014-09-05

    Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs. Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports). The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants' understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs. EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.

  4. Use of the community assessment for public health emergency response to conduct community health assessments for public health accreditation.

    Science.gov (United States)

    Conley, Ashley M; Vagi, Sara; Horney, Jennifer A

    2014-01-01

    A community health assessment (CHA) is a collaborative process of collecting and analyzing data to learn about the health status of a community. Community health assessments are also a requirement of public health accreditation for state and local health departments and of the Affordable Care Act for nonprofit hospitals. One element of a CHA is primary data collection. This article describes the use of the Community Assessment for Public Health Emergency Response (CASPER) method for primary data collection to meet public health accreditation requirements in 2 case study communities--Nashua, New Hampshire, and Davidson County, North Carolina; CASPER is a flexible and efficient method for the collection of population-based primary data in an urban or rural setting.

  5. Efficiently assessing patient health literacy: the BHLS instrument.

    Science.gov (United States)

    Sand-Jecklin, Kari; Coyle, Sue

    2014-12-01

    Although health literacy limitations are common among patient populations, no efficient yet comprehensive health literacy assessment tool is available to nurses for use in busy health care settings. This study presents beginning evidence for the validity and reliability of a new health literacy assessment tool, the Brief Health Literacy Screen (BHLS). One hundred patients attending four primary care clinics completed the BHLS and the Test of Functional Health Literacy in Adults (TOFHLA) short form and answered questions about the health literacy tools. Findings indicated significant correlations between BHLS and shortened version of the TOFHLA (S-TOFHLA) scores, with higher correlations between BHLS items addressing written health literacy and the S-TOFHLA. Comparative discrimination findings were significant at BHLS cut point of 18 and S-TOFHLA cut point less than 23. Patients rated the BHLS significantly less difficult to complete than the S-TOFHLA. Results of preliminary testing indicate the BHLS is a potentially efficient, effective, and patient-friendly screening tool for health literacy. © The Author(s) 2013.

  6. Health effects of electromagnetic fields.

    OpenAIRE

    Peter Gajšek

    1990-01-01

    Abstract: Devices that emit electromagnetic fields (EMF) have become a part of our daily life and can be found in telecommunications, industry, traffic, science, medicine and in every household. Due to the fact that general public is massively exposed to the EMF, even very small health effects could become a serious public health problem. Many studies show that the EMF above a certain threshold can have a negative health impact. The studies, which could explain the question of health risks as...

  7. 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

  8. Towards a multidisciplinary and integrated strategy in the assessment of adverse health effects related to air pollution: the case study of Cracow (Poland) and asthma.

    Science.gov (United States)

    Oudinet, Jean-Paul; Méline, Julie; Chełmicki, Wojciech; Sanak, Marek; Magdalena, Dutsch-Wicherek; Besancenot, Jean-Pierre; Wicherek, Stanislas; Julien-Laferrière, Bertrand; Gilg, Jean-Paul; Geroyannis, Hélène; Szczeklik, Andrew; Krzemień, Kazimierz

    2006-09-01

    Complex interaction between anthropogenic activities, air quality and human health in urban areas, such as in Cracow sustains the need for the development of an interdisciplinary and integrated risk-assessment methodology. In such purpose, we propose a pilot study performed on asthmatics and based on a combined use of a biomarker, such as metallothionein 2A (MT-2A) in the characterization of human exposure to one or a mixture of pollutants and of Geographical Information Systems (G.I.S.) which integrates climatic and urban anthropogenic parameters in the assessment of spatio-temporal dispersion of air pollutants. Considering global incidence of air pollution on asthma and on peripheral blood lymphocytes MT-2A expression should provide a complementary information on biological risks linked to urban anthropogenic activities. Such study would help for the establishment of a sustainable development in urban areas that can maintain the integrity of air quality and preserve human health.

  9. Health technology assessment: Off-site sterilization

    OpenAIRE

    Dehnavieh, Reza; Mirshekari, Nadia; Ghasemi, Sara; Goudarzi, Reza; Haghdoost, AliAkbar; Mehrolhassani, Mohammad Hossain; Moshkani, Zahra; Noori Hekmat, Somayeh

    2016-01-01

    Background: Every year millions of dollars are expended to equip and maintain the hospital sterilization centers, and our country is not an exception of this matter. According to this, it is important to use more effective technologies and methods in health system in order to reach more effectiveness and saving in costs. This study was conducted with the aim of evaluating the technology of regional sterilization centers. Methods: This study was done in four steps. At the first step, safety an...

  10. Health Technology Assessment of laparoscopic compared to conventional surgery with and without mesh for incisional hernia repair regarding safety, efficacy and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Willich, Stefan

    2008-03-01

    Medical Documentation and Information (DIMDI as well as by a manual search. The former included the following electronic resources: SOMED (SM78, Cochrane Library – Central (CCTR93, MEDLINE Alert (ME0A, MEDLINE (ME95, CATFILEplus (CATLINE (CA66, ETHMED (ED93, GeroLit (GE79, HECLINET (HN69, AMED (CB85, CAB Abstracts (CV72, GLOBAL Health (AZ72, IPA (IA70, Elsevier BIOBASE (EB94, BIOSIS Previews (BA93, EMBASE (EM95, EMBASE Alert (EA08, SciSearch (IS90, Cochrane Library – CDSR (CDSR93, NHS-CRD-DARE (CDAR94, NHS-CRD-HTA (INAHTA as well as NHSEED (NHSEED. The present report includes German and English literature published until 31.08.2005. The search parameters can be found in the appendix. No limits were placed on the target population. The methodological quality of the included clinical studies was assessed using the criteria recommended by the “Scottish Intercollegiate Guidelines Network Grading Review Group“. Economic studies were evaluated by the criteria of the German Scientific Working Group Technology Assessment for Health Care. Results: The literature search identified 17 relevant medical publications. One of these studies compared laparoscopic and conventional surgery with and without mesh for incisional hernia repair, while 16 studies compared laparoscopic and conventional surgery with mesh for incisional hernia repair. Among these studies were 14 primary studies (one randomised controlled trial (RCT, two systematic reviews and one HTA-Report. The only study comparing laparoscopic and conventional surgery without mesh found substantial differences in terms of baseline characteristics between treatment groups. The outcome parameters showed decreased recurrence rates for the laparoscopic repair and similar safety of the procedures. Studies comparing laparoscopic and conventional surgery with mesh found similar outcome in terms of medical efficacy and safety. However, there was a trend towards lower recurrence rates, length of hospital stay, and postoperative

  11. Waste Management: DOD Has Generally Addressed Legislative Requirements on the Use of Burn Pits but Needs to Fully Assess Health Effects

    Science.gov (United States)

    2016-09-01

    health risks of burn pit use. GAO compared DOD’s report to elements required in section 313, reviewed policies and procedures and interviewed DOD...to create the report and analyzed the content of DOD’s report to determine the extent to which it addresses each of seven elements required in...address in its report. We determined , based on our assessment, that DOD’s report fully addressed four of the seven reporting requirements and partially

  12. 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). © 2016 Society for Risk Analysis.

  13. Health impact assessment of active transportation: A systematic review.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Cole-Hunter, Tom; de Nazelle, Audrey; Dons, Evi; Gerike, Regine; Götschi, Thomas; Int Panis, Luc; Kahlmeier, Sonja; Nieuwenhuijsen, Mark

    2015-07-01

    Walking and cycling for transportation (i.e. active transportation, AT), provide substantial health benefits from increased physical activity (PA). However, risks of injury from exposure to motorized traffic and their emissions (i.e. air pollution) exist. The objective was to systematically review studies conducting health impact assessment (HIA) of a mode shift to AT on grounds of associated health benefits and risks. Systematic database searches of MEDLINE, Web of Science and Transportation Research International Documentation were performed by two independent researchers, augmented by bibliographic review, internet searches and expert consultation to identify peer-reviewed studies from inception to December 2014. Thirty studies were included, originating predominantly from Europe, but also the United States, Australia and New Zealand. They compromised of mostly HIA approaches of comparative risk assessment and cost-benefit analysis. Estimated health benefit-risk or benefit-cost ratios of a mode shift to AT ranged between -2 and 360 (median=9). Effects of increased PA contributed the most to estimated health benefits, which strongly outweighed detrimental effects of traffic incidents and air pollution exposure on health. Despite different HIA methodologies being applied with distinctive assumptions on key parameters, AT can provide substantial net health benefits, irrespective of geographical context. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Reporting heterogeneity in self-assessed health among elderly Europeans

    Science.gov (United States)

    2012-01-01

    Introduction Self-assessed health (SAH) is a frequently used measure of individuals’ health status. It is also prone to reporting heterogeneity. To control for reporting heterogeneity objective measures of true health need to be included in an analysis. The topic becomes even more complex for cross-country comparisons, as many key variables tend to vary strongly across countries, influenced by cultural and institutional differences. This study aims at exploring the key drivers for reporting heterogeneity in SAH in an international context. To this end, country specific effects are accounted for and the objective health measure is concretized, distinguishing effects of mental and physical health conditions. Methods We use panel data from the SHARE-project which provides a rich dataset on the elderly European population. To obtain distinct indicators for physical and mental health conditions two indices are constructed. Finally, to identify potential reporting heterogeneity in SAH a generalized ordered probit model is estimated. Results We find evidence that in addition to health behaviour, health care utilization, mental and physical health condition as well as country characteristics affect reporting behaviour. We conclude that observed and unobserved heterogeneity play an important role when analysing SAH and have to be taken into account. PMID:23036352

  15. Reporting heterogeneity in self-assessed health among elderly Europeans.

    Science.gov (United States)

    Pfarr, Christian; Schmid, Andreas; Schneider, Udo

    2012-10-05

    Self-assessed health (SAH) is a frequently used measure of individuals' health status. It is also prone to reporting heterogeneity. To control for reporting heterogeneity objective measures of true health need to be included in an analysis. The topic becomes even more complex for cross-country comparisons, as many key variables tend to vary strongly across countries, influenced by cultural and institutional differences. This study aims at exploring the key drivers for reporting heterogeneity in SAH in an international context. To this end, country specific effects are accounted for and the objective health measure is concretized, distinguishing effects of mental and physical health conditions. We use panel data from the SHARE-project which provides a rich dataset on the elderly European population. To obtain distinct indicators for physical and mental health conditions two indices are constructed. Finally, to identify potential reporting heterogeneity in SAH a generalized ordered probit model is estimated. We find evidence that in addition to health behaviour, health care utilization, mental and physical health condition as well as country characteristics affect reporting behaviour. We conclude that observed and unobserved heterogeneity play an important role when analysing SAH and have to be taken into account.

  16. Health effects of indoor odorants.

    Science.gov (United States)

    Cone, J E; Shusterman, D

    1991-01-01

    People assess the quality of the air indoors primarily on the basis of its odors and on their perception of associated health risk. The major current contributors to indoor odorants are human occupant odors (body odor), environmental tobacco smoke, volatile building materials, bio-odorants (particularly mold and animal-derived materials), air fresheners, deodorants, and perfumes. These are most often present as complex mixtures, making measurement of the total odorant problem difficult. There is no current method of measuring human body odor, other than by human panel studies of expert judges of air quality. Human body odors have been quantitated in terms of the "olf" which is the amount of air pollution produced by the average person. Another quantitative unit of odorants is the "decipol," which is the perceived level of pollution produced by the average human ventilated by 10 L/sec of unpolluted air or its equivalent level of dissatisfaction from nonhuman air pollutants. The standard regulatory approach, focusing on individual constituents or chemicals, is not likely to be successful in adequately controlling odorants in indoor air. Besides the current approach of setting minimum ventilation standards to prevent health effects due to indoor air pollution, a standard based on the olf or decipol unit might be more efficacious as well as simpler to measure. PMID:1821378

  17. [Indirect costs in health technology assessment].

    Science.gov (United States)

    Jakubczyk, Michał; Wrona, Witold; Macioch, Tomasz; Golicki, Dominik; Niewada, Maciej; Hermanowski, Tomasz

    2010-01-01

    In the health technology assessment it is crucial to define the perspective of the analysis. When the societal perspective is chosen it is necessary to include all the costs incurred by the society, also the costs of lost productivity resulting from absence of sick employees from work or their reduced efficiency at work. The aim of this article is to present the notion of indirect costs, their importance in health technology assessment and the methods of calculation. The economic literature has been reviewed for the state of knowledge on indirect costs. Three methods of calculation are described: human capital method, friction cost method or health state valuation. Indirect costs in Western European countries can amount to more than half of total costs attributed to the illness and its treatment. In the literature there is no consensus regarding the proper method of indirect costs calculation. It is necessary to conduct further theoretical and empirical research in the area of indirect costs and enhance discussion among Polish pharmacoeconomists.

  18. Human Health Assessment of Alcohol To Jet (ATJ) Synthetic Kerosenes

    Science.gov (United States)

    2016-07-30

    AFRL-RH-WP-TR-2017-0007 HUMAN HEALTH ASSESSMENT OF ALCOHOL -TO-JET (ATJ) SYNTHETIC KEROSENES Teresa R. Sterner Brian A. Wong Henry M...the high dose in the FT study were correlated with body weight decreases and not considered to be a direct effect from the fuel (Mattie et al., 2011a...Air Force Research Laboratory, 711th Human Performance Wing, Human Effectiveness Directorate, Bioeffects Division, Molecular Bioeffects Branch. AFRL

  19. Health impact assessment of urban waterway decisions.

    Science.gov (United States)

    Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B J; Daniell, William; Erdmann, Jared; Garrison, Valerie

    2014-12-25

    Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a "health lens". This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond.

  20. 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.

  1. Internet-based cognitive behaviour therapy and physical exercise - Effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial.

    Science.gov (United States)

    Strid, Catharina; Andersson, Claes; Forsell, Yvonne; Öjehagen, Agneta; Lundh, Lars-Gunnar

    2016-11-01

    Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different

  2. Miniature Biosensor with Health Risk Assessment Feedback

    Science.gov (United States)

    Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

    2016-01-01

    Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

  3. Biochemical Assessment of Bone Health in Working Obese Egyptian Females with Metabolic Syndrome; the Effect of Weight Loss by Natural Dietary Therapies

    Directory of Open Access Journals (Sweden)

    Maha I.A. Moaty

    2015-12-01

    CONCLUSION: These results confirm the benefit of doum in improving bone health parameter [25 (OH D/PTH axis] in the MetS patients, beside the MetS criteria. So, we can conclude that natural effective supplements lead towards the optimization of biochemical parameters in favor of a healthy outcome.

  4. [Hospital-based Health Technology Assessment].

    Science.gov (United States)

    Zavadil, Martin; Rogalewicz, Vladimír; Kubátová, Ivana; Matloňová, Veronika; Salačová, Kristýna

    Hospital-based HTA (HB-HTA) consists in implementation of assessment activities "in" or "for" hospitals; hence, it covers processes and methods supporting organization and execution of health technology assessment (HTA) at the level of individual hospitals. This process is multidisciplinary, systematic and evidence-based.HB-HTA objectives and methods differ from the classic utilization of HTA at the national regulator level. Most experience and information concerning HB-HTA has originated in two large recent projects: activities of the HB-HTA Interest Group of the HTAi international association established in 2006, and the AdHopHTA European research project (20122015).This paper describes four basic organizational models of HB-HTA, their characteristics and utilization in various countries and hospital types. Results of the AdHopHTA project are analyzed, and recommendations for HB-HTA implementation in Czech hospitals are formulated.Key words: hospital-based HTA, medical device, implementation, hospital strategy.

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

    Science.gov (United States)

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

    2014-11-24

    attention to this finding can help to offer direction towards the development of comparable and reliable health literacy assessment tools that effectively respond to the informational needs of populations.

  6. Health Effects of Environmental Exposures, Occupational Hazards ...

    African Journals Online (AJOL)

    Health Effects of Environmental Exposures, Occupational Hazards and Climate Change in Ethiopia: Synthesis of Situational Analysis, Needs Assessment and the ... If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs.

  7. Health Effects of Environmental Exposures, Occupational Hazards ...

    African Journals Online (AJOL)

    Health Effects of Environmental Exposures, Occupational Hazards and Climate Change in Ethiopia: Synthesis of Situational Analysis, Needs Assessment and the Way ... Methods: The methods used in this work include a systematic review of secondary data from peer-reviewed literature, thesis reports from academia, ...

  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. Assessing Participation and Effectiveness of the Peer-Led Approach in Youth Sexual Health Education: Systematic Review and Meta-Analysis in More Developed Countries.

    Science.gov (United States)

    Sun, Wai Han; Miu, Heidi Yin Hai; Wong, Carlos King Ho; Tucker, Joseph D; Wong, William Chi Wai

    2016-11-29

    Sexual health education for young people is crucial not only for development of norms but also for protection against vulnerabilities during this stage in life. Although several systematic reviews have examined the effectiveness of peer-led sex education, none have focused on the extent of peer participation. The purpose of this review was to evaluate peer-led sexual health education interventions in more developed countries (MDCs). Electronic and manual searches across five social science, education, and medical databases were conducted. Fifteen articles were selected in total. Most (10 of 15) studies gave low or no responsibility to peers. The majority of articles found improvements in sexual health knowledge (13 of 14) and attitudes (11 of 15) at postintervention stages. Two studies showed improved self-efficacy, and three showed behavioral changes. A preliminary synthesis of effectiveness and level of participation was done. Meta-analysis revealed a large effect on knowledge change (Hedges' g = 0.84, 95% confidence interval [CI]: 0.43 to 1.25) and a medium effect on attitude change (Hedges' g = 0.49, 95% CI: 0.19 to 0.80). Peer-led interventions could be a powerful tool. This review shows that this approach is effective in changing knowledge and attitudes but not behaviors. Further research and action are needed to understand optimal implementation.

  10. 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.

  11. Positioning for partnerships. Assessing public health agency readiness.

    Science.gov (United States)

    Nelson, J C; Raskind-Hood, C; Galvin, V G; Essien, J D; Levine, L M

    1999-04-01

    Public health organizations are redefining their roles and aligning their structures with other components of the evolving American health system. Health departments must proactively and strategically plan how to position themselves for the coming years. Prior to implementing changes in functioning, structure, and/or future strategies, an organization should assess its internal readiness to commit to creating these substantial alterations. Using a diagnostic tool developed by study investigators, employees of the Cobb and Douglas Counties Boards of Health were surveyed in order to assess their organizational readiness to enter into a strategic partnership with Promina Northwest, a not-for-profit hospital network in the Atlanta, Georgia area. Frequency distributions were conducted for each categorical variable and data were analyzed in aggregate and by job category. The 122 analyzed questionnaires revealed some significant trends. Respondents ranked the six factors having the greatest impact on an organization's ability to change in the following order: leadership, planning, teamwork, mission, information and operations. Interestingly, this rank ordering parallels the perceived strengths and weaknesses of the health departments as determined by the frequency of the most positive responses. Cobb and Douglas Counties Boards of Health have taken many key steps to prepare the organizations for significant proactive changes. Survey results emphasized the need for open channels of communication within the organizations and with the external environment so that effective planning can guide the strategic alignment of the health departments with community partners.

  12. Using rangeland health assessment to inform successional management

    Science.gov (United States)

    Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...

  13. Managing Air Quality - Human Health, Environmental and Economic Assessments

    Science.gov (United States)

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  14. Developing public sociology through health impact assessment.

    Science.gov (United States)

    Elliott, Eva; Williams, Gareth

    2008-11-01

    The renewed interest in 'public sociology' has sparked debate and discussion about forms of sociological work and their relationship to the State and civil society. Medical sociologists are accustomed to engaging with a range of publics and audiences inside and outside universities and are in a position to make an informed contribution to this debate. This paper describes how some of the debates about sociological work are played out through a 'health impact assessment' of a proposed housing renewal in a former coal mining community. We explore the dynamics of the health impact assessment process and relate it to wider debates, current in the social sciences, on the 'new knowledge spaces' within which contentious public issues are now being discussed, and the nature of different forms of expertise. The role of the 'public sociologist' in mediating the relationships between the accounts and interpretations of lay participants and the published 'evidence' is described as a process of mutual learning between publics, professionals and social scientists. It is argued that the continued existence and development of any meaningful 'professional sociology' requires an openness to a 'public sociology' which recognises and responds to new spaces of knowledge production.

  15. Health Effects of Secondhand Smoke

    Science.gov (United States)

    ... still allows smoking in public areas, look for restaurants and other places that do not allow smoking. “ ... Facts Health Effects Secondhand Smoke Smokeless Tobacco Tobacco Marketing and Products Youth Tobacco Use Get Email Updates ...

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

    Science.gov (United States)

    McCallum, Lindsay C; Souweine, Kathleen; McDaniel, Mary; Koppe, Bart; McFarland, Christine; Butler, Katherine; Ollson, Christopher A

    2016-01-01

    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). 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). 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. 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. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  17. Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation?

    Science.gov (United States)

    Seong, Ki Moon; Seo, Songwon; Lee, Dalnim; Kim, Min-Jeong; Lee, Seung-Sook; Park, Sunhoo; Jin, Young Woo

    2016-02-01

    Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation.

  18. A critical review of population health literacy assessment.

    Science.gov (United States)

    Guzys, Diana; Kenny, Amanda; Dickson-Swift, Virginia; Threlkeld, Guinever

    2015-03-04

    Defining health literacy from a public health perspective places greater emphasis on the knowledge and skills required to prevent disease and for promoting health in everyday life. Addressing health literacy at the community level provides great potential for improving health knowledge, skills and behaviours resulting in better health outcomes. Yet there is a notable absence of discussion in the literature of what a health literate population looks like, or how this is best assessed. The emphasis in assessing health literacy has predominantly focused on the functional health literacy of individuals in clinical settings. This review examines currently available health literacy assessment tools to identify how well suited they are in addressing health literacy beyond clinical care settings and beyond the individual. Although public health literature appears to place greater emphasis on conceptualizing critical health literacy, the focus continues to remain on assessing individuals, rather than on health literacy within the context of families, communities and population groups. When a population approach is adopted, an aggregate of individual health literacy assessment is generally used. Aggregation of individual health literacy fails to capture the dynamic and often synergistic relationships within communities, and fails to reflect societal influences on health knowledge, beliefs and behaviours. We hypothesise that a different assessment framework is required to adequately address the complexities of community health literacy. We assert that a public health approach, founded on health promotion theories provides a useful scaffold to assess the critical health literacy of population groups. It is proposed that inclusion of community members in the research process is a necessary requirement to coproduce such an appropriate assessment framework. We contend that health literacy assessment and potential interventions need to shift to promoting the knowledge and skills

  19. Assessment of Mobile Health Nursing Intervention Knowledge among Community Health Nurses in Oyo State, Nigeria.

    Science.gov (United States)

    Titilayo, Odetola D; Okanlawon, F A

    2014-09-01

    Maternal mortality is high in Nigeria especially in rural areas due to knowledge deficit about expected care and labour process, socio-cultural belief, health care workers' attitude, physical and financial barriers to quality health care access. Mobile health (m-health) technology which is the use of mobile telecommunication devices in health care delivery reduces costs, improves care access, removes time and distance barriers and facilitates patient-provider communications needed to make appropriate health decisions. Previous studies empowering nurses with m-health knowledge resulted in improved uptake of health care services. There exists a literature dearth about knowledge and perception of nurses in Nigeria. This study became expedient to empower nurses working at the grassroots with the knowledge of m-health and assess the impact of educational training on their perception of its effectiveness. This quasi-experimental study carried out in four randomly selected LGAs across Oyo South Senatorial district involved participants at experimental (20 nurses) and control levels (27 nurses). A validated 25-item questionnaire explored nurses' perception, knowledge and perceived effectiveness of m-health in improving uptake of maternal health services in Nigeria among both groups before intervention. Intervention group nurses had a training equipping them with knowledge of m-health nursing intervention (MNHI) for a period of one week. Their perception, knowledge and perceived effectiveness were re-assessed at three-months and six-months after MHNI. Data were analyzed using Chi-square and repeated measures ANOVA at 5% significance level. In the EG, knowledge score significantly increased from 21.9±4.5 at baseline to 23.6±4.6 and 23.2±5.6 at three-month and six-month respectively while there was no significant difference in knowledge score among CG over the study period. A very significant difference was shown in the knowledge and perception of mobile health and its

  20. Assessing Psychological Health: The Contribution of Psychological Strengths

    Science.gov (United States)

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

    Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale…

  1. 75 FR 82382 - Beaches Environmental Assessment and Coastal Health Act

    Science.gov (United States)

    2010-12-30

    ... AGENCY Beaches Environmental Assessment and Coastal Health Act AGENCY: Environmental Protection Agency... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act... Environmental Assessment and Coastal Health (BEACH) Act of 2000 amends the Clean Water Act to better protect...

  2. 75 FR 70009 - Development of Health Risk Assessment Guidance

    Science.gov (United States)

    2010-11-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention Development of Health Risk Assessment Guidance... guidance concerning Health Risk Assessment (HRAs). Section 4103 of the Affordable Care Act (ACA) (Pub. L. 111-148) requires that a health risk assessment be included in the annual wellness visit benefit...

  3. 75 FR 1373 - Beaches Environmental Assessment and Coastal Health Act

    Science.gov (United States)

    2010-01-11

    ... AGENCY Beaches Environmental Assessment and Coastal Health Act AGENCY: Environmental Protection Agency... Water Act (CWA) as amended by the Beaches Environmental Assessment and Coastal Health (BEACH) Act... Environmental Assessment and Coastal Health (BEACH) Act of 2000 amends the Clean Water Act to better protect...

  4. Assessing organizational change in multisector community health alliances.

    Science.gov (United States)

    Alexander, Jeffrey A; Hearld, Larry R; Shi, Yunfeng

    2015-02-01

    The purpose of this article was to identify some common organizational features of multisector health care alliances (MHCAs) and the analytic challenges presented by those characteristics in assessing organizational change. Two rounds of an Internet-based survey of participants in 14 MHCAs. We highlight three analytic challenges that can arise when quantitatively studying the organizational characteristics of MHCAs-assessing change in MHCA organization, assessment of construct reliability, and aggregation of individual responses to reflect organizational characteristics. We illustrate these issues using a leadership effectiveness scale (12 items) validated in previous research and data from 14 MHCAs participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) program. High levels of instability and turnover in MHCA membership create challenges in using survey data to study changes in key organizational characteristics of MHCAs. We offer several recommendations to diagnose the source and extent of these problems. © Health Research and Educational Trust.

  5. Assessment of the effect of health education on mothers in Al Maki area, Gezira state, to improve homecare for children under five with diarrhea

    Directory of Open Access Journals (Sweden)

    Huda M Haroun

    2010-01-01

    Full Text Available Introduction: Home care of under-five children is one of the most important interventions in the control of diarrheal diseases. It has a significant impact in reducing childhood mortality and morbidity. Objective: This study was conducted to evaluate the effect of health education on home care of under- five children with diarrheal disease. Materials and Methods: This is a quasi- experimental study, held in Al Maki neighborhood, which is located in Greater Wad Medani locality, Gezira State, Central Sudan. The study targeted a random sample of 118 mothers who have at least one child under- five years of age with diarrhea needing home management. The study was conducted in three phases. Phase one was a base line survey for the mothers. Intervention phase including different health education approaches, home visits, group sessions and distribution of mother cards through community volunteers and researchers. Post intervention survey using the same pre-intervention questionnaire, and observation of mothers managing their children. Results: Results showed that knowledge of mothers about definition of diarrhea, its danger, when to seek medical help and the three rules of home management which was found to be 35,28,13 and 29% improved significantly after intervention to 91, 94,92 and 93% respectively with a very high significant level. Recommendations: We recommended that volunteers are effective health education provider especially on household based intervention. Health services should support the community based interventions to reinforce the knowledge and practices of mother towards the sick children.

  6. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

    management information system at the district level ... Despite Malawi's introduction of a health management information system (HMIS) in 1999, the country's health sector still lacks accurate, reliable .... CHIP = Committee for Health Information Policy; HIMTC = Health Information Management Technical Committee; DHO =.

  7. The Tennessee Department of Health WORKshops on Use of Secondary Data for Community Health Assessment, 2012

    OpenAIRE

    Behringer, Bruce A.; Omohundro, Ellen; Boswell, Derrick; Evans, Dwayne; Ferranti, Lori B.

    2014-01-01

    Community health assessment is a core function of public health departments, a standard for accreditation of public health departments, and a core competency for public health professionals. The Tennessee Department of Health developed a statewide initiative to improve the processes for engaging county health departments in assessing their community’s health status through the collection and analysis of secondary data. One aim of the Tennessee Department of Health was to position county publi...

  8. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    application for Tele-medicine (MAST). An introductory literature review identified stroke, heart failure (HF) and COPD as prototypes of IHC. Pre-existing evidence has been complemented by additional trials and surveys. Results: 1. Definition/organization of IHC: (1) Is carried out by a multidisciplinary team......-analysis of the effect on all-cause readmissions concludes OR=0.60 (CI95%: 0.40-0.92) COPD: 3 RCT (N=381) demonstrate each a significant reduction in readmissions. A meta-analysis of readmissions concludes (OR=0.5; CI: 0.25-0.80). 3. Health economic evaluation: For each selected condition the first year benefit...... satisfaction: Focus group interviews confirm literature findings of very good satisfaction by IHC both among patients/carers and health professionals. Discussion: The calculated net savings by IHC are not supposed to materialize in ‘cool’- cash but should enable local negotiation of adapted solutions...

  9. Health effects of indoor fungal bioaerosol exposure.

    Science.gov (United States)

    Fung, Frederick; Hughson, William G

    2003-07-01

    Occupational and environmental health professionals are confronted with issues concerning the health effects of indoor fungal bioaerosol exposure. This article reviews current data on the health effects of indoor mold exposure and provides practical suggestions for occupational and environmental health practitioners regarding how best to manage these exposures based on published human studies. We conducted MEDLINE searches and reviewed all English language studies on indoor mold exposure (visible survey or objective sampling) and human health effects published from 1966 to November 2002. The main findings of the studies are analyzed in conjunction with plausible association of health effects and fungal exposure. Five case control studies, 17 cross-sectional surveys, and 7 case reports met the selection criteria. Current evidence suggests that excessive moisture promotes mold growth and is associated with an increased prevalence of symptoms due to irritation, allergy, and infection. However, specific human toxicity due to inhaled fungal toxins has not been scientifically established. Methods for measuring indoor bioaerosol exposure and health assessment are not well standardized, making interpretation of existing data difficult. Additional studies are needed to document human exposure-disease and dose-response relationships.

  10. Comparative Human Health Impact Assessment of Engineered Nanomaterials in the Framework of Life Cycle Assessment.

    Science.gov (United States)

    Fransman, Wouter; Buist, Harrie; Kuijpers, Eelco; Walser, Tobias; Meyer, David; Zondervan-van den Beuken, Esther; Westerhout, Joost; Klein Entink, Rinke H; Brouwer, Derk H

    2017-07-01

    For safe innovation, knowledge on potential human health impacts is essential. Ideally, these impacts are considered within a larger life-cycle-based context to support sustainable development of new applications and products. A methodological framework that accounts for human health impacts caused by inhalation of engineered nanomaterials (ENMs) in an indoor air environment has been previously developed. The objectives of this study are as follows: (i) evaluate the feasibility of applying the CF framework for NP exposure in the workplace based on currently available data; and (ii) supplement any resulting knowledge gaps with methods and data from the life cycle approach and human risk assessment (LICARA) project to develop a modified case-specific version of the framework that will enable near-term inclusion of NP human health impacts in life cycle assessment (LCA) using a case study involving nanoscale titanium dioxide (nanoTiO 2 ). The intent is to enhance typical LCA with elements of regulatory risk assessment, including its more detailed measure of uncertainty. The proof-of-principle demonstration of the framework highlighted the lack of available data for both the workplace emissions and human health effects of ENMs that is needed to calculate generalizable characterization factors using common human health impact assessment practices in LCA. The alternative approach of using intake fractions derived from workplace air concentration measurements and effect factors based on best-available toxicity data supported the current case-by-case approach for assessing the human health life cycle impacts of ENMs. Ultimately, the proposed framework and calculations demonstrate the potential utility of integrating elements of risk assessment with LCA for ENMs once the data are available. © 2016 Society for Risk Analysis.

  11. Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

    Science.gov (United States)

    Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. not applicable

  12. Health effects of chronic arsenic exposure.

    Science.gov (United States)

    Hong, Young-Seoub; Song, Ki-Hoon; Chung, Jin-Yong

    2014-09-01

    Arsenic is a unique element with distinct physical characteristics and toxicity whose importance in public health is well recognized. The toxicity of arsenic varies across its different forms. While the carcinogenicity of arsenic has been confirmed, the mechanisms behind the diseases occurring after acute or chronic exposure to arsenic are not well understood. Inorganic arsenic has been confirmed as a human carcinogen that can induce skin, lung, and bladder cancer. There are also reports of its significant association to liver, prostate, and bladder cancer. Recent studies have also suggested a relationship with diabetes, neurological effects, cardiac disorders, and reproductive organs, but further studies are required to confirm these associations. The majority of research to date has examined cancer incidence after a high exposure to high concentrations of arsenic. However, numerous studies have reported various health effects caused by chronic exposure to low concentrations of arsenic. An assessment of the health effects to arsenic exposure has never been performed in the South Korean population; thus, objective estimates of exposure levels are needed. Data should be collected on the biological exposure level for the total arsenic concentration, and individual arsenic concentration by species. In South Korea, we believe that biological exposure assessment should be the first step, followed by regular health effect assessments.

  13. Integrated spatial health assessment of yellow perch (Perca flavescens) populations from the St. Lawrence River (QC, Canada), part B: cellular and transcriptomic effects.

    Science.gov (United States)

    Bruneau, Audrey; Landry, Catherine; Giraudo, Maeva; Douville, Mélanie; Brodeur, Philippe; Boily, Monique; Gagnon, Pierre; Houde, Magali

    2016-09-01

    Multi-biological level assessments have become great tools to evaluate the health of aquatic ecosystems. Using this approach, a complementary study was designed to evaluate the health of yellow perch (Perca flavescens) populations in the St. Lawrence River (Quebec, Canada). In the present study, stress responses were compared at the transcriptomic, cellular, and tissue levels in yellow perch collected at six sites along the river: Lake St. François, Lake St. Louis (north and south), Beauregard Island and Lake St. Pierre (north and south). These results complement the physiological and chemical parameters as well as pathogen infection investigated in a companion paper published in the present issue. Thiobarbituric acid reactive substance (TBARS) analyses indicated the presence of oxidative stress in fish collected in the southern part of Lake St. Louis and at the downstream sites of Lake St. Pierre. High lipid peroxidation levels were found in the muscle of yellow perch caught at Beauregard Island, located downstream of the Montreal's wastewater treatment plant, suggesting an impact of the municipal effluent on redox homeostasis. Transcriptomic results indicated the down-regulation of genes related to lipid, glucose, and retinoid in southern Lake St. Pierre as well as a decrease in retinoid storage. Overall, biochemical and molecular markers indicated that the health status of yellow perch followed a decreasing gradient from upstream to downstream of the St. Lawrence River. This gradient is representative of the cumulative negative impacts of human activities on water and habitat quality along the river.

  14. Health risk assessment of environmental selenium: Emerging evidence and challenges

    OpenAIRE

    Vinceti,Marco; Filippini, Tommaso; Cilloni, Silvia; Bargellini, Annalisa; Vergoni, Anna Valeria; Tsatsakis, Aristides; Ferrante, Margherita

    2017-01-01

    New data have been accumulated in the scientific literature in recent years which allow a more adequate risk assessment of selenium with reference to human health. This new evidence comes from environmental studies, carried out in populations characterized by abnormally high or low selenium intakes, and from high-quality and large randomized controlled trials with selenium recently carried out in the US and in other countries. These trials have consistently shown no beneficial effect on cance...

  15. COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

    2017-08-07

    Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

  16. 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.

  17. Environmental assessment in health care organizations.

    Science.gov (United States)

    Romero, Isabel; Carnero, María Carmen

    2017-12-22

    The aim of this research is to design a multi-criteria model for environmental assessment of health care organizations. This is a model which guarantees the objectivity of the results obtained, is easy to apply, and incorporates a series of criteria, and their corresponding descriptors, relevant to the internal environmental auditing processes of the hospital. Furthermore, judgments were given by three experts from the areas of health, the environment, and multi-criteria decision techniques. From the values assigned, geometric means were calculated, giving weightings for the criteria of the model. This innovative model is intended for application within a continuous improvement process. A practical case from a Spanish hospital is included at the end. Information contained in the sustainability report provided the data needed to apply the model. The example contains all the criteria previously defined in the model. The results obtained show that the best-satisfied criteria are those related to energy consumption, generation of hazardous waste, legal matters, environmental sensitivity of staff, patients and others, and the environmental management of suppliers. On the other hand, those areas returning poor results are control of atmospheric emissions, increase in consumption of renewable energies, and the logistics of waste produced. It is recommended that steps be taken to correct these deficiencies, thus leading to an acceptable increase in the sustainability of the hospital.

  18. District health information system assessment: a case study in iran.

    Science.gov (United States)

    Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab

    2013-03-01

    Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.

  19. IMPLEMENTING HEALTH TECHNOLOGY ASSESSMENT-BASED RECOMMENDATIONS IN FINLAND

    DEFF Research Database (Denmark)

    Sihvo, Sinikka; Ikonen, Tuija; Mäkelä, Marjukka

    2017-01-01

    Objectives: The Managed Uptake of Medical Methods Program (MUMM) started 10 years ago as a joint venture of the Finnish Office for Health Technology Assessment (Finohta) and the twenty hospital districts in Finland. The aim is to offer information on the effectiveness, safety, organizational......-form web-based surveys to hospitals. Results: The recommendations were noticed and considered relevant. In overall assessment they received a mean rating of 8.4 (range: 4 to 10). Two thirds of the respondents thought MUMM recommendations were useful for practice, but only a third had actually used them...

  20. Health Effects of Electromagnetic Fields

    Directory of Open Access Journals (Sweden)

    Peter Gajšek

    2011-02-01

    Full Text Available Abstract: Devices that emit electromagnetic fields (EMF have become a part of our daily life and can be found in telecommunications, industry, traffic, science, medicine and in every household. Due to the fact that general public is massively exposed to the EMF, even very small health effects could become a serious public health problem. Many studies show that the EMF above a certain threshold can have a negative health impact. The studies, which could explain the question of health risks as a result of chronic exposure to low intensities, are often contradictory and deficient. In this review the state of the art in the field of health risks associated with the EMF exposure in our environment is presented.

  1. Health impact assessment as an instrument to examine the health implications of education policies.

    Science.gov (United States)

    Pharr, J; Gakh, M; Coughenour, C; Clark, S

    2017-04-01

    Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. Case study. With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Assessment of Effective Coverage of HIV Prevention of Pregnant ...

    African Journals Online (AJOL)

    BACKGROUND: Coverage assessment of prevention of Pregnant Mother to Child Transmission (PMTCT) of HIV service is useful to measure the health system effort or performance of health service delivery function and to influence decisions. The objective of this study was to assess effective coverage level for prevention ...

  3. Assessing river health in Europe and Switzerland

    Science.gov (United States)

    Milano, Marianne; Chèvre, Nathalie; Reynard, Emmanuel

    2017-04-01

    River conditions and welfare of aquatic ecosystems are threatened by anthropogenic and climatic changes. The release of personal-care products, pharmaceuticals and crop protection products is increasing and climate change is likely to cause significant changes in hydrological regimes affecting water resources' capacity to dissolve pollutants. Assessing river health, i.e. the ability of a river to support and maintain a balanced ecosystem close to the natural habitat, is thus of major concern to ensure the development of ecosystems and to provide enough clean useable water to users. Such studies involve physical, chemical and biological processes and characteristics. In Europe and Switzerland, standardized procedures have been developed to assess the hydromorphological, ecological and toxicological status of rivers. The European Water Framework Directive sets ecological requirements and chemical guidelines while the Swiss Modular Stepwise Procedure suggests methods to apprehend ecological deficits and promote water management plans. In this study, both procedures were applied and compared in order (i) to address their capacity to follow-up the spatial and temporal variability of the river's water quality and (ii) to identify challenges that still need to be addressed to assess river's health. Applied on the Boiron River (canton of Vaud, Switzerland) for a 11-year period (2005-2015), both frameworks highlight that no section of the river currently meets a good environmental state. This river flows through a diversified agricultural area causing a progressive deterioration of its chemical and biological quality. The two methods also identify two periods of time with significant changes of the river's water quality. The 2009-2011 period is characterized by a significant deterioration of the river's ecological and toxicological state due to severe low flows and an increased use of pesticides. However, since 2013, an improvement in water quality is identified in

  4. Noise Pollution and Health Effects

    Directory of Open Access Journals (Sweden)

    Geravandi

    2015-01-01

    Full Text Available Background Noise pollution is of particular importance due to the physical and psychological effects on humans. Noise is a stressor that affects the autonomic nervous system and the endocrine system. Noise is also a threat to marine and terrestrial ecosystems. Health risks from noise are correlated with road traffic. In other words, noise health effects are the health consequences of elevated sound levels. Objectives This study aims to determine the effect of noise pollution (near roadways on health issues in Ahvaz, Iran. Materials and Methods In this cross-sectional study, equivalent sound pressure level were measured by sound level meters TES-1353 in 75 locations around 4 roadways, which had a high load of traffic in Ahvaz City during day time. During the study, 820 measurements were recorded at measuring stations, for 7 days per week with 1-hour interval between each measurement. Statistical analysis was carried out by SPSS software. Results According to the research findings, the equivalent sound pressure levels in all stations were 76.28 ± 3.12 dB (Mean ± SD. According to sound measurements and the survey questionnaire, noise pollution is higher than EPA (US Environmental Protection Agency and Iran standard level. Based on result of this study the worst noise health effects were the nervousness and sleep quality during 2012. Conclusions According to the results of this study, with increasing load of traffic, there is an increasing need for proper consideration plans to control noise pollution and prevent its effects.

  5. Contacts in the Office of Pesticide Programs, Health Effects Division

    Science.gov (United States)

    Contact the Health Effects Division about the review and validation of data on properties and effects of pesticides, as well as, characterizing and assessing exposure and risks to humans and domestic animals.

  6. Health Literacy Assessment: Feasibility in a Breast Surgical Oncology Clinic
.

    Science.gov (United States)

    Keim-Malpass, Jessica; Doede, Aubrey; Kennedy, Christine; Showalter, Shayna L

    2017-06-01

    Health literacy is recognized as an integral component of high-quality health care. However, health literacy has been understudied in the context of cancer care delivery and surgical decision making. The goal of this article is to outline a process for implementation of a health literacy screening assessment within the routine practices of an academic breast surgical oncology clinic. The self-reported health literacy assessment is feasible, particularly with integration of the health literacy screen in the electronic health record. The authors' estimated clinic prevalence of low health literacy was 22%, which has numerous implications for communication and shared decision-making processes.
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  7. Community Health Needs Assessments: Expanding the Boundaries of Nursing Education in Population Health.

    Science.gov (United States)

    Evans-Agnew, Robin; Reyes, David; Primomo, Janet; Meyer, Karen; Matlock-Hightower, Corrie

    2017-01-01

    Conducting federally mandated community health needs assessments through academic-practice partnerships provides new opportunities for developing population health nursing competencies. The purpose of this article was to describe how a baccalaureate practicum experience within such an assessment process, involving health care system partners, re-affirms the importance of community and population health assessment in the development of future nursing leaders. Student evaluations indicated an emerging appreciation for the social determinants of health, the power of partnerships, and the importance of diversity. Integrating health care and public health system perspectives on assessment meets both public health and nursing accreditation standards and extends student leadership experiences. Such integration also improves regional capacity for improving population health. Federal mandates for community health needs assessments provide opportunities to advance leadership roles for nursing graduates throughout the health care system, and for confirming the importance of community assessment as an essential nursing competency. © 2016 Wiley Periodicals, Inc.

  8. 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.

  9. A rural local health department-hospital collaborative for a countywide community health assessment.

    Science.gov (United States)

    Sampson, Gretchen; Miner Gearin, Kim J; Boe, Mary

    2015-01-01

    In mid-2012, the Polk County Health Department initiated a community health needs assessment process with the 3 medical centers serving this rural Wisconsin county of 45 000 residents. The collaborative process drew on primary and secondary data, including clinical data pooled from health care organizations, to assess population health. Community health assessment ultimately engaged more than 1800 county residents through coordinated surveys and community forums. Although the Polk County Health Department has a long history of collaboration with the local health care community, the Patient Protection and Affordable Care Act, coupled with meaningful use requirements for health care providers, sharply increased engagement, contributed to shared priorities, and brought this relationship to a new level. Partners have now convened community-based workgroups around the top 3 health focus areas selected from the assessment process. Community health assessment emphasized the social determinants of health as a step toward a more "upstream" orientation to population health goals.

  10. A Health Impact Assessment of California’s Proposed Cap-and-Trade Regulations

    Science.gov (United States)

    English, Paul; Rudolph, Linda

    2012-01-01

    Objectives. To identify unintended health effects of California’s controversial cap-and-trade regulations and establish health-promoting policy recommendations, we performed a health impact assessment. Methods. We used literature reviews, public data, and local health surveys to qualitatively assess potential health risks and benefits related to changes in employment and income, energy costs, effects of emission offset projects, and cobenefits from the allocation of program revenue. We examined case studies from various communities to find existing social, economic, and environmental health conditions. Results. We found that policy implementation will minimally impact job creation (strategies and cap-and-trade policy at the federal level. PMID:22742062

  11. Computer-assisted health impact assessment for intersectoral health policy

    NARCIS (Netherlands)

    Mooy, J. M.; Gunning-Schepers, L. J.

    2001-01-01

    Intersectoral health policy implies negotiations with politicians outside the health sector. Health politicians have a stronger position if they can quantify health impact. In this Dutch case-study we used a computer simulation approach to answer the following questions: Which anti-tobacco

  12. Health care technology assessment and adoption: a case study.

    Science.gov (United States)

    Veluchamy, S; Alder, H C

    1989-05-01

    Today's progressive hospital and health care system managers look to new ways to retain or augment their market share and to position themselves in their service areas. Since diffusion of new technologies into health care is market driven, informed decisions on the adoption of certain emerging patient care technologies can place a health care organization in a favorable financial position. There is a compelling need for hospital management and the governing board to collaborate with their medical staff on the development of an acceptable process to quickly identify and implement appropriate new technologies into the patient care environment. This joint effort is vital to ensure the integration of sound clinical values and objectives with planned institutional business strategies. Mount Carmel Health, a multifaceted health care corporation in central Ohio, has met the challenge of managing patient needs, physician interests, and limited hospital resources by forming a unique entity within the organization for the effective assessment and adoption of the latest medical technology. The division, which is called the Advanced Treatment and Bionics Institute (ATBI), is charged with assessing the latest clinical technologies and managing a hospital's adoption of the most appropriate ones. It serves to organize and streamline the identification, acquisition, adoption, and implementation of innovative treatment technologies at Mount Carmel hospitals.

  13. The Health Impact Assessment (HIA) Resource and Tool ...

    Science.gov (United States)

    Health Impact Assessment (HIA) is a relatively new and rapidly emerging field in the U.S. An inventory of available HIA resources and tools was conducted, with a primary focus on resources developed in the U.S. The resources and tools available to HIA practitioners in the conduct of their work were identified through multiple methods and compiled into a comprehensive list. The compilation includes tools and resources related to the HIA process itself and those that can be used to collect and analyze data, establish a baseline profile, assess potential health impacts, and establish benchmarks and indicators for monitoring and evaluation. These resources include literature and evidence bases, data and statistics, guidelines, benchmarks, decision and economic analysis tools, scientific models, methods, frameworks, indices, mapping, and various data collection tools. Understanding the data, tools, models, methods, and other resources available to perform HIAs will help to advance the HIA community of practice in the U.S., improve the quality and rigor of assessments upon which stakeholder and policy decisions are based, and potentially improve the overall effectiveness of HIA to promote healthy and sustainable communities. The Health Impact Assessment (HIA) Resource and Tool Compilation is a comprehensive list of resources and tools that can be utilized by HIA practitioners with all levels of HIA experience to guide them throughout the HIA process. The HIA Resource

  14. Assessment of levels and 'health-effects' of airborne particulate matter in mining, metal refining and metal working industries using nuclear and related analytical techniques

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-01-15

    The International Atomic Energy Agency (IAEA) has been supporting, over the years, several coordinated research programmes (CRPs) on various research topics related to environmental issues impacting human health. A variety of industrial environments such as: galvanisation, iron and steel production, steel construction, coal fired thermal power plants, mining and mineral beneficiation of monazite, zinc smelters, and phosphate fertilizer production plants were included in this CRP. Toxic elements specific for particular industries as potential pollutants were monitored within individual projects. The CRP focussed on the use of nuclear and related analytical techniques for studies of exposure to inorganic constituents and radionuclides from naturally occurring radioactive materials (NORMs), in the workplaces and their impacts on the health of the workers. The objectives were to: develop strategies and techniques for sampling of workplace airborne particulate matter (APM) and of bio-markers (e.g. hair, blood, nails, teeth, urine, breath) of exposed and non-exposed individuals; develop reliable analytical procedures for the analysis of such samples, using nuclear and related analytical techniques; carry out workplace and personal monitoring surveys, and assess workers' exposure to toxic elements on the basis of measurements results. This document provides an overview of the activities performed under the CRP by the participants. The overall achievements are summarized and those aspects that require a further deeper look are also pointed out. The individual country reports include details on the progress made by the respective participants during the CRP period.

  15. Effect of a 4-week Nordic walking training on the physical fitness and self-assessment of the quality of health of women of the perimenopausal age

    Directory of Open Access Journals (Sweden)

    Mariola Saulicz

    2015-06-01

    Full Text Available Aim of the study: To determine the effect of a 4-week Nordic walking training on the physical fitness of women of the perimenopausal age and self-assessment of the quality of their health. Material and methods: Eighty-four women between 48 and 58 years of age were included in the study. Half of the group (42 was assigned to the control group and the other half was assigned to the experimental group. In both groups studied, physical fitness was evaluated using a modified Fullerton’s test and a quality of life self-assessment SF-36 (Short Form of Health Status Questionnaire. Similar tests were repeated 4 weeks later. In the experimental group, a Nordic walking training was conducted between the two tests. During 4 weeks, 10 training sessions were performed, each session was 60 minutes long, and there was an interval of 2 days between the sessions. Results: A 4-week Nordic walking training resulted in a significant improvement (p < 0.001 of physical fitness as demonstrated by an increased strength and flexibility of the upper and lower part of the body and the ability to walk a longer distance during a 6-minute walking test. Women participating in the training also showed a significant improvement in health in terms of both physical health (p < 0.001 and mental health (p < 0.001. Conclusions: A 4-week Nordic walking training has a positive effect on the physical fitness of the women in the perimenopausal age. Participation in training contributes also to a clearly higher self-assessment of the quality of health.

  16. Integrated monitoring for environmental health impact assessment related to the genotoxic effects of vehicular pollution in Uberlândia, Brazil.

    Science.gov (United States)

    Pereira, Boscolli Barbosa; da Cunha, Paolla Brandão; Silva, Guilherme Gomes; de Campos Júnior, Edimar Olegário; Morelli, Sandra; Filho, Cláudio Alves Vieira; de Lima, Euclides Antônio Pereira; Barrozo, Marcos Antônio Souza

    2017-01-01

    The development of parameters to explore the link between air-related diseases and their significant driving forces is an important aim in terms of national economics and public health. In this study, we did an integrated analysis involving multiple environmental health indicators from Uberlândia, Brazil, registered before and during a period when the Brazilian government reduced taxes on new cars in a bid to bolster local manufacturing. In addition, the present study utilized Driving Force-Pressure-State-Exposure-Effect-Action (DPSEEA) frameworks to evaluate correlations in environmental health indicators over 10 years (2004-2013), in which the Brazilian government reduced vehicle production taxes beginning in 2008. Significant correlations in all indicators selected were found from 2008 to 2013, corresponding to the tax reduction on new vehicles. The frequency of micronuclei (MN) was significantly higher in the city center compared to the reference site, with the highest MN levels observed during the period of reduced taxes. Results reinforced the need to adopt air quality monitoring programs in major cities.

  17. Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

    Science.gov (United States)

    Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

    2015-05-01

    Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.

  18. The development of methodological tools to assess the health sector with the resulting standardized index

    Directory of Open Access Journals (Sweden)

    Hansuvarova Evgenia Adolfovna

    2016-10-01

    The proposed assessment methodology resulting standardized health index in the various countries of the world allows you to define the country implementing an effective management strategy in the health sector. The leading positions belong to the countries where the state health policy has shown its greatest efficiency. This technique can be used not only for point scoring result of a standardized health index in the world, but also to assess in a particular country.

  19. 78 FR 20523 - Community Health Needs Assessments for Charitable Hospitals

    Science.gov (United States)

    2013-04-05

    ... Internal Revenue Service 26 CFR Parts 1 and 53 RIN 1545-BL30 Community Health Needs Assessments for... organizations on the community health needs assessment (CHNA) requirements, and related excise tax and reporting... hospital organization to conduct a CHNA and adopt an implementation strategy to meet the community health...

  20. Watershed health assessment to monitor land degradation

    Science.gov (United States)

    Hamidreza Sadeghi, Seyed; Hazbavi, Zeinab; Cerdà, Artemi

    2017-04-01

    Land degradation is a worldwide issue that affects the Planet and the fate of the humankind (Cerdà et al., 2009; Choudhury et al., 2016; Fernández et al., 2016; Ferreira et al., 2016). Several processes affect the sustainability of the ecosystems, from soil erosion to soil compation, deforestation, Climate Change or water, soil and air pollution (Sadeghi et al., 2015a; 2015b; Gómez-Acanta et al., 2016; Mengistu et al., 2016; Mukai, 2016). Several ecosystem theories have been presented in the scientific literatures to monitor land degradation (Cerdà et al., 2016; Davudirad et al., 2016; Fava et al., 2016; Mahyou et al., 2016; Soulard et al., 2016). Besides the scientific tasks of improving the indication, the conviction of the potential users to change their concepts toward a higher consideration of ecosystem attributes, and toward a fruitful application of the health or integrity concepts, will be a main task of future activities. Reliability, resilience and vulnerability (R-R-V) indicators are often used in combination for quantifying risk and decision making in many systems. However, the use of hydrological series data for R-R-V computations has been rather limited. Toward this, the overall objective of this paper is to conduct a risk assessment analysis on stream flow discharge from Shazand Watershed located in the south western of Markazi Province in Iran for the period of 1972-2014 using R-R-V indicators. Based on the R-R-V analysis conducted in this study, the stream flow discharge of the study region followed a cyclic pattern with a decreasing trend. The results further showed a decreasing trend in reliability and resilience and an increasing trend in vulnerability in the Shazand Watershed. It may be concluded that the Shazand Watershed was in overall in unhealthy condition from view of stream flow discharge. Acknowledgements This research was funded by the European Union Seventh Framework Programme (FP7/2007-2013) under grant no. 603498 (RECARE Project

  1. E-health readiness assessment framework in iran.

    Science.gov (United States)

    Rezai-Rad, M; Vaezi, R; Nattagh, F

    2012-01-01

    Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well.

  2. E-Health Readiness Assessment Framework in Iran

    Science.gov (United States)

    Rezai-Rad, M; Vaezi, R; Nattagh, F

    2012-01-01

    Background: Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. Methods: The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. Results: The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). Conclusion: The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well. PMID:23304661

  3. 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...... of the structure over its life-cycle as well as the costs associated with monitoring and possible remedial actions. The suggested approach is illustrated through two case studies concerning the monitoring of welded details in steel structures subjected to fatigue loading. The case studies address the effect...... of the uncertainty associated with the performance of SHM on the value of SHM. Moreover, in order to illustrate the potential of the application of approach for monitoring of structural systems an optimal strategy for SHM is determined for a system comprised of three welded details. © 2013 Taylor & Francis Group...

  4. EOS imaging versus current radiography: A health technology assessment study.

    Science.gov (United States)

    Mahboub-Ahari, Alireza; Hajebrahimi, Sakineh; Yusefi, Mahmoud; Velayati, Ashraf

    2016-01-01

    EOS is a 2D/3D muscle skeletal diagnostic imaging system. The device has been developed to produce a high quality 2D, full body radiographs in standing, sitting and squatting positions. Three dimensional images can be reconstructed via sterEOS software. This Health Technology Assessment study aimed to investigate efficacy, effectiveness and cost-effectiveness of new emerged EOS imaging system in comparison with conventional x-ray radiographic techniques. All cost and outcome data were assessed from Iran's Ministry of Health Perspective. Data for clinical effectiveness was extracted using a rigorous systematic review. As clinical outcomes the rate of x-ray emission and related quality of life were compared with Computed Radiography (CR) and Digital Radiography (DR). Standard costing method was conducted to find related direct medical costs. In order to examine robustness of the calculated Incremental Cost Effectiveness Ratios (ICERs) we used two-way sensitivity analysis. GDP Per capita of Islamic Republic of Iran (2012) adopted as cost-effectiveness threshold. Review of related literature highlighted the lack of rigorous evidence for clinical outcomes. Ultra low dose EOS imaging device is known as a safe intervention because of FDA, CE and CSA certificates. The rate of emitted X-ray was 2 to 18 fold lower for EOS compared to the conventional techniques (p<0.001). The Incremental Cost Effectiveness Ratio for EOS relative to CR calculated $50706 in baseline analysis (the first scenario) and $50714, $9446 respectively for the second and third scenarios. Considering the value of neither $42146 as upper limit, nor the first neither the second scenario could pass the cost-effectiveness threshold for Iran. EOS imaging technique might not be considered as a cost-effective intervention in routine practice of health system, especially within in-patient wards. Scenario analysis shows that, only in an optimum condition such as lower assembling costs and higher utilization rates

  5. Geriatric Assessment Units and Rural Health System Viability.

    Science.gov (United States)

    Lassey, William R.; Lassey, Marie L.

    The Geriatric Assessment Unit (GAU), which has proven successful in urban areas, may be a viable system for providing health care to the elderly in rural areas. GAUs engage in assessment, follow-up response to findings, education, and research. The assessment component includes, at minimum, physical health, functional ability in activities of…

  6. Environmental, health, and safety assessment of photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Rose, E.C.

    1983-10-15

    Potential enviornmental, health, and safety (E,H and S) concerns associated with all phases of the photovoltaic (PV) energy system life cycle are identified and assessed. E,H and S concerns affecting the achievement of National PV Program goals or the viability of specific PV technologies are emphasized. The report is limited to near-term manufacturing process alternatives for crystalline silicon PV materials, addresses flat-plate and concentrator collector designs, and reviews system deployment in grid-connected, roof-mounted, residential and ground-mounted central-station applications. The PV life-cycle phases examined include silicon refinement and manufacture of PV collectors, system deployment, and decommissioning. 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.

  7. 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.

  8. Evaluation of Home Health Care Devices: Remote Usability Assessment.

    Science.gov (United States)

    Kortum, Philip; Peres, S Camille

    2015-06-05

    An increasing amount of health care is now performed in a home setting, away from the hospital. While there is growing anecdotal evidence about the difficulty patients and caregivers have using increasingly complex health care devices in the home, there has been little systematic scientific study to quantify the global nature of home health care device usability in the field. Research has tended to focus on a handful of devices, making it difficult to gain a broad view of the usability of home-care devices in general. The objective of this paper is to describe a remote usability assessment method using the System Usability Scale (SUS), and to report on the usability of a broad range of health care devices using this metric. A total of 271 participants selected and rated up to 10 home health care devices of their choice using the SUS, which scores usability from 0 (unusable) to 100 (highly usable). Participants rated a total of 455 devices in their own home without an experimenter present. Usability scores ranged from 98 (oxygen masks) to 59 (home hormone test kits). An analysis conducted on devices that had at least 10 ratings showed that the effect of device on SUS scores was significant (Pusability of these devices was on the low end when compared with other commonly used items in the home, such as microwave ovens and telephones. A large database of usability scores for home health care devices collected using this remote methodology would be beneficial for physicians, patients, and their caregivers.

  9. Health Effects of Air Pollution.

    Science.gov (United States)

    Environmental Education Report and Newsletter, 1985

    1985-01-01

    Summarizes health hazards associated with air pollution, highlighting the difficulty in establishing acceptable thresholds of exposure. Respiratory disease, asthma, cancer, cardiovascular disease, and other problems are addressed. Indicates that a wide range of effects from any one chemical exists and that there are differences in sensitivity to…

  10. A Model of the Pre-Assessment Learning Effects of Summative Assessment in Medical Education

    Science.gov (United States)

    Cilliers, Francois J.; Schuwirth, Lambert W. T.; Herman, Nicoline; Adendorff, Hanelie J.; van der Vleuten, Cees P. M.

    2012-01-01

    It has become axiomatic that assessment impacts powerfully on student learning. However, surprisingly little research has been published emanating from authentic higher education settings about the nature and mechanism of the pre-assessment learning effects of summative assessment. Less still emanates from health sciences education settings. This…

  11. Rangeland health assessment - The key to understanding and assessing rangeland soil health in the Northern Great Plains

    Science.gov (United States)

    As the science related to soil and rangeland health evolves, so do their protocols and assessment methodologies. Rangeland health assessments consist of evaluating how well ecological processes such as the water cycle, energy flow and nutrient cycling are functioning at a site. Soil health is the ca...

  12. Health risk assessment in the occupational health nurse’s practice

    OpenAIRE

    2012-01-01

    M.Cur. Occupational health nurses are qualified registered nurses with a post-graduate qualification in occupational health nursing as a specialised discipline, and provide the basic healthcare aspect of the occupational health programme. Their most important activity is to identify and assess the health hazard risks in the workplace. Health risk assessments are conducted by occupational health nurses to determine all the stresses, e.g. hazardous chemicals, vibration, insufficient lighting...

  13. Imaginary Worlds: The European Network for Health Technology Assessment (EUnetHTA Recommendations for Health Economic Evaluations

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2016-08-01

    Full Text Available The European Network for Health Technology Assessment (EUnetHTA guidelines for health economic evaluations represent a consolidated view of non-binding recommendations for assessments of the relative effectiveness of pharmaceuticals or other health technologies. EUnetHTA views itself as the scientific and technological backbone of the development of health technology assessment in the European Union and among its member states and other partners. Unfortunately, the standards for health technology assessment proposed by EUnetHTA do not meet the standards of normal science. They do not support credible claims for the clinical and comparative cost-effectiveness of pharmaceuticals. In rejecting the standards of normal science the guidelines put to one side the opportunity not only to re-assess and replicate clinical and cost-effectiveness claims but to provide meaningful feedback on claims assessment to health care decision makers. The purpose of this review is to make the case that, in failing to support standards for experimentation, EUnetHTA is advocating its partners support the creation of modeled or simulated imaginary or false worlds. While EUnetHTA is not alone in recommending the construction of imaginary worlds to support formulary decisions, there is still the opportunity to revisit these recommendations and decide whether or not to encourage a scientifically rigorous approach to health technology assessments - to abandon a commitment to intelligent design in favor of natural selection.  Conflict of Interest None   Type: Commentary  

  14. Policy processes and health technology assessment

    NARCIS (Netherlands)

    Palmhøj Nielsen, Camilla; Sarriá Santamera, Antonio; Vondeling, Hindrik

    2008-01-01

    Decision-makers throughout Europe have a common goal of raising health standards in order to improve the health status of the European population. Health service delivery is carried out under conditions of growing political and economic complexity – rapid technological change puts pressure on

  15. Effectiveness assessment of otosclerosis surgery.

    Science.gov (United States)

    Pérez-Lázaro, J J; Urquiza, R; Cabrera, A; Guerrero, C; Navarro, E

    2005-09-01

    The epidemiological characteristics of otosclerosis and its treatment in Andalusia resemble those of other populations with similar socioeconomic levels. Two complementary approaches, such as questionnaires and pure-tone audiometry, are required to assess the effectiveness of otosclerosis surgery (OS) reliably and precisely. We describe a new method to assess effectiveness in OS. It is based on the results of pure-tone audiometry and a specially designed quality of hearing questionnaire (QHQ). The objectives of the study are: (i) to report the general epidemiologic profile of otosclerosis in Andalusia; (ii) to study the effectiveness of OS in our community using conventional methods; and (iii) to study the outcomes of OS using the QHQ and to compare them to those obtained using conventional methods. All 31 hospitals in the public healthcare system of Andalusia were studied. They were graded into four groups using a specially designed grouping system. The data were obtained from the minimum basic dataset. The prevalence of otosclerosis in Andalusia was calculated from the incidence data, the duration of the disease and life expectancy. To assess the effectiveness of OS, 475 clinical records from 15 hospitals representing all 4 groups were analysed. Effectiveness was assessed by conventional methods, using data obtained from pure-tone audiometry, and by using version 1.02 p of the QHQ. The incidence of clinical otosclerosis was 5.67 patients/100,000 inhabitants/year. The calculated prevalence was 0.287%. The number of cases increased progressively during the study period (p 65 years age group showed the best gap improvement but the largest variability. The quality of hearing measured by the QHQ showed that, in general, a better gap improvement was associated with a higher quality of hearing (Pearson correlation r=0.183; p<0.05). The 15-45-year age group had the worst gap improvement but, in contrast, the better quality of hearing.

  16. Health effects associated with waterpipe smoking.

    Science.gov (United States)

    El-Zaatari, Ziad M; Chami, Hassan A; Zaatari, Ghazi S

    2015-03-01

    It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms 'waterpipe' and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings. We included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria. Data were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors. WPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems. Contrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. mHealth Assessment: Conceptualization of a Global Framework

    OpenAIRE

    Bradway, Meghan; Carrión Ribas, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

    2017-01-01

    Background The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. Objective We aim to offer a collective description of a uni...

  18. Assessing the Potential Effectiveness of Food and Beverage Taxes and Subsidies for Improving Public Health: A Systematic Review of Prices, Demand and Body Weight Outcomes

    Science.gov (United States)

    Powell, Lisa M.; Chriqui, Jamie F.; Khan, Tamkeen; Wada, Roy; Chaloupka, Frank J.

    2012-01-01

    Taxes and subsidies are increasingly being considered as potential policy instruments to incentivize consumers to improve their food and beverage consumption patterns and related health outcomes. This study provided a systematic review of recent U.S. studies on the price elasticity of demand for sugar-sweetened beverages (SSBs), fast food and fruits and vegetables as well as the direct associations of prices/taxes with body weight outcomes. Based on the recent literature, the price elasticity of demand for SSBs, fast food, fruits and vegetables was estimated to be −1.21, −0.52, −0.49 and −0.48, respectively. The studies that linked soda taxes to weight outcomes showed minimal impacts on weight; however, they were based on existing state-level sales taxes that were relatively low. Higher fast-food prices were associated with lower weight outcomes particularly among adolescents suggesting that raising prices would potentially impact weight outcomes. Lower fruit and vegetable prices were generally found to be associated with lower body weight outcomes among both low-income children and adults suggesting that subsidies that would reduce the cost of fruits and vegetables for lower-socioeconomic populations may be effective in reducing obesity. Pricing instruments should continue to be considered and evaluated as potential policy instruments to address public health risks. PMID:23174017

  19. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes.

    Science.gov (United States)

    Powell, L M; Chriqui, J F; Khan, T; Wada, R; Chaloupka, F J

    2013-02-01

    Taxes and subsidies are increasingly being considered as potential policy instruments to incentivize consumers to improve their food and beverage consumption patterns and related health outcomes. This study provided a systematic review of recent U.S. studies on the price elasticity of demand for sugar-sweetened beverages (SSBs), fast food, and fruits and vegetables, as well as the direct associations of prices/taxes with body weight outcomes. Based on the recent literature, the price elasticity of demand for SSBs, fast food, fruits and vegetables was estimated to be -1.21, -0.52, -0.49 and -0.48, respectively. The studies that linked soda taxes to weight outcomes showed minimal impacts on weight; however, they were based on existing state-level sales taxes that were relatively low. Higher fast-food prices were associated with lower weight outcomes particularly among adolescents, suggesting that raising prices would potentially impact weight outcomes. Lower fruit and vegetable prices were generally found to be associated with lower body weight outcomes among both low-income children and adults, suggesting that subsidies that would reduce the cost of fruits and vegetables for lower-socioeconomic populations may be effective in reducing obesity. Pricing instruments should continue to be considered and evaluated as potential policy instruments to address public health risks. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  20. 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.

  1. Policy health impact assessment of the EU Health Strategy (2008-2013). Fostering good health in an aging Europe – tackling tobacco consumption

    DEFF Research Database (Denmark)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza

    2012-01-01

    smoking by incorporating the issue into its 1st objective “Fostering good health in an aging Europe”. The aim of the study was to assess the health impact of the most effective tobacco control policy, taxation, on the EU level. Methods: The assessment was based on the mapping of the whole impact scheme......Background: The public health importance of smoking necessitates effective actions to tackle tobacco epidemic and minimize its health consequences. The white paper of the European Commission “Together for Health: A Strategic Approach for the EU 2008-2013” acknowledged the significance of tobacco...... from which one priority causal pathway was selected for detailed quantitative evaluation. The analysis was carried out on each impact level using the top-down risk assessment tool developed in the Risk Assessment from Policy to Impact Dimension EU project. Health outcome was quantified as the change...

  2. [Health effects of living habits].

    Science.gov (United States)

    Vuori, Ilkka

    2015-01-01

    Single healthy living habits such as non-smoking and regular physical activity decrease the risk of common non-communicable diseases, unsuccessful aging and premature death to a small to moderate degree. Their cumulative effects are, however, large. Only a small minority of people adhere well to all healthy living habits or even the healthiest ones. Consequently, the population attributable fractions of major public health problems due to unhealthy lifestyles are large. Substantial improvement of public health calls for policies and programs to influence the root causes of the lifestyles in the multiple environments and systems where they are developed, maintained, and changed.

  3. The Effects of Head Start Health Services: Report of the Head Start Health Evaluation. Volume I and II.

    Science.gov (United States)

    Fosburg, Linda B.; And Others

    In 1977, a longitudinal study was initiated to assess the effectiveness of health services provided by Head Start. The study provided for 10 domains: pediatric health examinations, health history recordings, dental evaluation, anthropometric assessment, diet and nutrition assessment, and hematology evaluations, as well as for developmental,…

  4. Health literacy assessment in adults with neurofibromatosis: electronic and short-form measurement using FCCHL and Health LiTT.

    Science.gov (United States)

    Merker, Vanessa L; McDannold, Sarah; Riklin, Eric; Talaei-Khoei, Mojtaba; Sheridan, Monica R; Jordan, Justin T; Plotkin, Scott R; Vranceanu, Ana-Maria

    2017-11-08

    Determining health literacy level is an important prerequisite for effective patient education. We assessed multiple dimensions of health literacy and sociodemographic predictors of health literacy in patients with neurofibromatosis. In 86 individuals with a confirmed diagnosis of neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), or schwannomatosis, we assessed health literacy status using two HL tools-the adapted functional, communicative, and critical health literacy scale (adapted FCCHL) and health literacy assessment using talking touchscreen technology (Health LiTT). Factor analyses of the adapted FCCHL in NF patients showed factor structure and psychometric properties similar to pilot work in other patient populations. As a group, patients with NF had moderate scores on the Health LiTT and moderate to high scores on the adapted FCCHL, with the highest score on the functional health literacy subscale. Patients with NF1, those with lower education and those with learning disabilities had lower scores on Health LiTT; in multivariate analysis, learning disability and education remained significant predictors of HealthLiTT scores. Only lower education was associated with lower adapted FCCHL scores. Results suggest utilizing health literacy tools in NF patients is feasible and could provide physicians with valuable information to tailor health communication to subpopulations with lower health literacy levels.

  5. Integrated Science Assessment (ISA) for Nitrogen Dioxide (Health Criteria)

    Science.gov (United States)

    Information, history and background on the development and maintenance of nitrogen dioxide (health criteria) assessments. There is a separate site that has combined NOx/SOx ecological criteria assessment.

  6. Human Health Toxicity Values in Superfund Risk Assessments

    Science.gov (United States)

    This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.

  7. Health effects of unemployment benefit program generosity.

    Science.gov (United States)

    Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

    2015-02-01

    We assessed the impact of unemployment benefit programs on the health of the unemployed. We linked US state law data on maximum allowable unemployment benefit levels between 1985 and 2008 to individual self-rated health for heads of households in the Panel Study of Income Dynamics and implemented state and year fixed-effect models. Unemployment was associated with increased risk of reporting poor health among men in both linear probability (b=0.0794; 95% confidence interval [CI]=0.0623, 0.0965) and logistic models (odds ratio=2.777; 95% CI=2.294, 3.362), but this effect is lower when the generosity of state unemployment benefits is high (b for interaction between unemployment and benefits=-0.124; 95% CI=-0.197, -0.0523). A 63% increase in benefits completely offsets the impact of unemployment on self-reported health. Results suggest that unemployment benefits may significantly alleviate the adverse health effects of unemployment among men.

  8. Assessment of university student health literacy toward Influenza

    Directory of Open Access Journals (Sweden)

    Marzieh Meraji

    2016-12-01

    Full Text Available Background and objective: Outbreak of influenza A/H1N1 become serious concern. Student in academic institutions can play effective role in prevention and control of influenza. Here paramedical faculty student health literacy toward Influenza was assessed. Methods: A cross sectional-descriptive study was conducted among 139 students in Medical Records, Physiotherapy, Radiology, Health Information Technology, Speech Therapy and Optometry discipline at paramedical faculty of Mashhad medical university in 2016. A pandemic influenza questionnaire was translated and edited. Demographic characteristics of student, level of knowledge and perception toward influenza and perception toward government and media were collected. Results: More than half of student correctly identified influenza symptoms as fever 95/1%, body ache 51/2%, cough 46/3% and headaches 43/9%.person to person transmission and contact with infected objects were recognized by 87/8% and 68/3% of student as a mode of transmission. Students Covering identified nose and mouth 87/8%, hand washing with soap and water 80/5% and throwing tissues in rubbish bin as precutions.48/6% of student believed that influenza is not fatal; despite 88/9% of student perceived influenza as serious disease. In Government and media assessment, 39% of student agreed health department and other health authorities had a good control plan, 51/4% of student agreed with transparency of necessary intervention during flu outbreak. Conclusion: This study shows that paramedical faculty student has appropriate influenza health literacy. Delivering more information about mode of transmission, high risk group and precaution intervention and playing more effective role by media is recommended. Paper Type: Research Article.

  9. 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, the disproportionate use of hazard information has overshadowed the important role of exposure science in determinations of human safety. In addition, major risk assessments lack the clarity and transparency that hinder an understanding of the analysis and communication of key safety messages. To help answer these challenges, the HESI-managed RISK21 project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment. RISK21 involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. RISK21 developed a tiered approach that is problem formulation-based, makes maximum use of prior knowledge, and is led by exposure science to produce a highly transparent and flexible visualization of and approach to assessing human safety and risk. The general principles underlying the RISK21 approach as well as an overview of the RISK21 Roadmap are presented here. This paper will be followed by a series of publications that will articulate the details that comprise this systematic approach. The purpose of this manuscript is to provide an overview

  10. METHODOLOGICAL APPROACHES TO ASSESSMENTS OF HEALTH RISKS IN HYGIENIC RESEARCH

    Directory of Open Access Journals (Sweden)

    A. M. Biblin

    2013-01-01

    Full Text Available This review of publications presents the analysis of national scientific publications and methodological documents on health risks assessments under unfavorable external impacts. In available research publications, the hygienic risks assessment is most often considered in situations of chemicals impact, and such assessment has sufficient methodological providing. Comparison of publications and methodological documents allows determination of the possibility of methodological unity for health risk assessment in conditions of chemical and radiation impacts.

  11. Health effects of biofuel exhaust

    OpenAIRE

    Vugt, M.A.T.M. van; Mulderij, M.; Usta, M; Kadijk, G.; Kooter, I.M.; Krul, C.A.M.

    2009-01-01

    Alternatives to fossil fuels receive a lot of attention. In particular, oil derived of specific crops forms a promising fuel. In order to warrant global expectance of such novel fuels, safety issues associated with combustion of these fuels needs to be assessed. Although only a few public reports exist, recently potential toxic effects associated with biofuels has been published. Here, we report the analysis of a comprehensive study, comparing the toxic effects of conventional diesel, biodies...

  12. Using Community Health Assessment to Teach and Explore Health Status Disparities

    Science.gov (United States)

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  13. Electronic cigarettes: human health effects.

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-05-01

    With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Literature searches were conducted through September 2013 using multiple electronic databases. Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data.

  14. Electronic cigarettes: human health effects

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-01-01

    Objective With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Methods Literature searches were conducted through September 2013 using multiple electronic databases. Results Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Conclusions Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data. PMID:24732161

  15. Self-assessed approach to improving school health in Niger.

    Science.gov (United States)

    Takeuchi, R; Boureima, D; Mizuguchi, D; Awazawa, T; Kato, Y; Akiyama, T; Nonaka, D; Kobayashi, J

    2013-01-01

    Award schemes and self-evaluation systems have been developed to implement the 'Health-Promoting School (HPS)' concept in European and Asian countries. While there have been many successes in these regions, the implementation of HPS in African countries has been minimal. This study evaluated the impact of a self-evaluation system on school health in Niger. A school health activity guide was developed and distributed to 1999 primary schools in the Niger Tahoua region to raise awareness and solve problems related to school health and hygiene. The number of schools that planned or implemented health-related activities, and the budget and implementation status of their activities was compared over 3 years (before, soon after, and 1 year after distribution). Focus group discussions (FGDs) were also conducted targeting Conseillers Pédagogiques (CPs), who supervise primary schools and teachers, primary school principals and members of Comité de Gestion des Etablissement Scolaire (COGES), which is a type of school steering committee. The number of schools planning at least one health-related activity increased from 47% to 79% soon after distribution of the guide (p <0.001).The number of schools implementing activities increased from 44% to 65% one year after distribution (p <0.001). Health-related budget per school also increased after distribution (p <0.0001) and increases were maintained 1 year after the intervention (p=0.8414). Fulfilment or partial fulfilment rates for health-related activities were lower compared with other (non-health) activities in all three years (80%, 77% & 84% in health-related activities vs 88%, 90% & 91% in others; p <0.001, p <0.001, & p=0.004, respectively). Most FGD participants expressed a positive impression of the program and noted the usefulness of the guide. However, some respondents reported difficulties, especially in relation to budget. The introduction of a health activity guide for self-assessment was effective in increasing

  16. 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…

  17. Assessment of the English literacy level of patients in primary health ...

    African Journals Online (AJOL)

    Low literacy can be described as the inability to read, write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the English literacy levels of primary health care patients using the Learning Ability ...

  18. 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.

  19. Questioning reliability assessments of health information on social media

    OpenAIRE

    Nicole K. Dalmer, BSc, MLIS, PhD Candidate

    2017-01-01

    This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media?s increasing role in health i...

  20. Health Impact Assessment Impact Characterization Table

    Science.gov (United States)

    The potential health impacts of the proposed decision should be characterized based on the following criteria: Direction, Likelihood, Magnitude, Distribution, Severity, Permanence, Strength of Evidence.

  1. Health Technology Assessment and vaccine: new needs and opportunities?

    Directory of Open Access Journals (Sweden)

    Giuseppe La Torre

    2007-03-01

    Full Text Available Health Technology Assessment (HTA can represent an innovative and effective approach to supply decisionmakers with a valid instrument to improve the allocation of resources in the field of vaccines. We proposed a HTA approach for considering the introduction of a new vaccine that could potentially have a great impact on the population’s health, using as an example the vaccine against Human Papilloma Virus (HPV. This approach could be of great interest when the decision making process involves choices regarding new vaccines. We developed a HTA approach for assessing all of the aspects involved in the introduction of vaccines against HPV in Italy, considering the following issues: - epidemiological evaluation of HPV infection and related pathologies through the consultation of data banks and the scientific literature; - evaluation of health care resources utilisation by people suffering from the infection/ related diseases, through the consultation of hospital archives; - systematic review and meta-analysis of randomised clinical trials on HPV vaccination effectiveness and safety; - mathematical modelling and economic evaluation of the vaccination using a cost-effectiveness analysis; - evaluation of the impact of vaccination on the Health System [organisational aspects, vaccine surveillance, relationship between different decisional levels (national, regional]; - analysis of the ethical, social (acceptability, availability, accessibility, information and legislative aspects of vaccination. A HTA report on the new vaccine could represent an new important tool to support the choice of decision makers in order to better inform the allocation of economic resources and maximize healthcare services, since it takes into account not only the burden and the epidemiology of the disease, and the economic evaluation of different scenarios, but also the social, legal and bioethical aspects. For HTA to support the introduction of new technologies, and new

  2. Health financing reform in Kenya- assessing the social health ...

    African Journals Online (AJOL)

    For economic, social, political and organisational reasons a transition period will be necessary, which is likely to last more than a decade. However, important objectives such as access to health care and avoiding impoverishment due to direct health care payments should be recognised from the start so that steady progress ...

  3. A health impact assessment framework for assessing vulnerability and adaptation planning for climate change.

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-12-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  4. A Health Impact Assessment Framework for Assessing Vulnerability and Adaptation Planning for Climate Change

    Directory of Open Access Journals (Sweden)

    Helen Brown

    2014-12-01

    Full Text Available This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  5. A Health Impact Assessment Framework for Assessing Vulnerability and Adaptation Planning for Climate Change

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-01-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru. PMID:25514146

  6. 78 FR 26026 - Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Science.gov (United States)

    2013-05-03

    ... AGENCY Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides--Health... Science Assessment for Nitrogen Oxides--Health Criteria.'' The draft document was prepared by the National... Integrated Science Assessment (ISA) for the health effects of nitrogen oxides (NO X ), which will provide a...

  7. Revisiting Health System Performance Assessment in Africa

    NARCIS (Netherlands)

    Achoki, Tom

    2016-01-01

    Health systems in Africa have long faced a huge burden of disease, amidst pressing resource constraints. However, despite the constraints, the last three decades have seen the region make progress in tackling some of the most critical health challenges. Notably, many countries have registered

  8. Comprehensively measuring health-related subjective well-being : Dimensionality analysis for improved outcome assessment in health economics

    NARCIS (Netherlands)

    de Vries, Marieke; Emons, W.H.M.; Plantinga, A.; Pietersma, Suzanne; van den Hout, W.B.; Stiggelbout, Anne M.; van den Akker-van Marle, M. Elske

    2016-01-01

    Background Allocation of inevitably limited financial resources for health care requires assessment of an intervention’s effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World

  9. Comprehensively measuring health-related subjective well-being: Dimensionality analysis for improved outcome assessment in health economics

    NARCIS (Netherlands)

    Vries, M. de; Emons, W.H.M.; Plantinga, A.; Pietersma, S.; Hout, W.B. van den; Stiggelbout, A.M.; Akker-van Marle, M.E. van den

    2016-01-01

    Background: Allocation of inevitably limited financial resources for health care requires assessment of an intervention’s effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World

  10. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth) technology.

    Science.gov (United States)

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-12-01

    Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents' use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 and R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention are necessary to include when evaluating mHealth

  11. Personal Electronic Health Record for Patients with Diabetes; Health Technology Assessment Protocol

    Directory of Open Access Journals (Sweden)

    MasoomehRahimi Alami

    2017-10-01

    Full Text Available Introduction: In recent decades, diabetes has contributed significantly to the burden of disease in developed and developing countries, due to the considerable prevalence and involvement of various age groups in the communities.Today, a variety of ways to manage and control the disease are used, one of which is the use of personal electronic health records. Recently there has been a remarkable upsurge in activity surrounding the adoption of personal electronic health records systems for patients and consumers. personal electronic health records systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care.The present study was conducted with the goal of Health Technology Assessment the impact of personal electronic health records in Patients with Diabetes. Methods: Writing is based on PRISMA standards.  This was a Health Technology Assessment  study. It aimed to evaluate the technology of personal electronic health record . The scoping review was conducted to evaluate 8 dimensions (Health Problem and Current Use of the Technology, Description and technical characteristics of technology, Safety, Costs and economic evaluation, Ethical analysis, Organisational aspects, Patients and Social aspects, Legal aspects of  Personal electronic health record . This study was based on answering questions which were developed based on Health Diagnostics Technology Assessment Documents Framework and HTA Core Model 3.0 . A systematic review was conducted to evaluate the Clinical Effectiveness dimension of personal electronic health record  in controlling diabetes. In order to gather evidences, Ovid databases, Cochrane Library, PubMed, CRD, Trip database and EMBASE, and Randomized Controlled Trial Registries, such as the Clinical Trial and Trial Registry, were searched using specific keywords and strategies. .Articles are evaluated on the

  12. 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. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Health Assessment and the Right to Health in Sweden: Asylum Seekers' Perspectives.

    Science.gov (United States)

    Lobo Pacheco, Lubin; Jonzon, Robert; Hurtig, Anna-Karin

    2016-01-01

    Swedish law entitles asylum seekers to a voluntary health assessment and to "health care that cannot be postponed". The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective. The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health. Forty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such. Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the information

  14. Health Assessment and the Right to Health in Sweden: Asylum Seekers' Perspectives.

    Directory of Open Access Journals (Sweden)

    Lubin Lobo Pacheco

    Full Text Available Swedish law entitles asylum seekers to a voluntary health assessment and to "health care that cannot be postponed". The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective.The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health.Forty-eight (12.4% respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such.Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the

  15. The Development of a Secondary School Health Assessment Model

    Science.gov (United States)

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

    The objective of this research was to: 1) involved a survey of information relating to secondary school health, 2) involved the construction of a model of health assessment and a handbook for using the model in secondary school, 3) develop an assessment model for secondary school. The research included 3 phases. (1) involved a survey of…

  16. Urban ecosystem health assessment: perspectives and Chinese practice.

    Science.gov (United States)

    Su, Meirong; Zhang, Yan; Liu, Gengyuan; Xu, Linyu; Zhang, Lixiao; Yang, Zhifeng

    2013-11-06

    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.

  17. Using evaluability assessment to assess local community development health programmes: a Scottish case-study

    Directory of Open Access Journals (Sweden)

    Melissa Belford

    2017-04-01

    Full Text Available Abstract Background Evaluation of the potential effectiveness of a programme’s objectives (health or otherwise is important in demonstrating how programmes work. However, evaluations are expensive and can focus on unrealistic outcomes not grounded in strong theory, especially where there is pressure to show effectiveness. The aim of this research was to demonstrate that the evaluability assessment (a cost-effective pre-evaluation tool that primarily gives quick, constructive feedback can be used to help develop programme and outcome objectives to improve programmes while they run and to assist in producing more effective evaluations. This was done using the example of a community development programme aiming to improve health and reduce health inequalities in its target population. Methods The setting was Glasgow, Scotland, UK and focused on the Health Issues in the Community programme. Data were collected from documents and nine individual stakeholder interviews. Thematic analysis and a realist approach were used to analyse both datasets and, in conjunction with a workshop with stakeholders, produce a logic model of the programme theory and related evaluation options to explore further. Results Five main themes emerged from the analysis: History; Framework; Structure and Delivery of the Course; Theory of Action; and Barriers to Delivery and Successful Outcomes. These themes aided in drafting the logic model which revealed they key programme activities (e.g. facilitating group learning and 23 potential outcomes. The majority of these outcomes (16 were deemed to be short-term outcomes (more easily measured within the timeframe of an individual being involved in the programme e.g. increased self-esteem or awareness of individual/community health. The remaining 6 outcomes were deemed longer-term and included outcomes such as increased social capital and individual mental health and wellbeing. Conclusions We have shown that the evaluability

  18. Quantitative health impact assessment: taking stock and moving forward.

    Science.gov (United States)

    Fehr, Rainer; Hurley, Fintan; Mekel, Odile Cecile; Mackenbach, Johan P

    2012-12-01

    Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents.

  19. [Health effects of electromagnetic fields].

    Science.gov (United States)

    Röösli, Martin

    2013-12-01

    Use of electricity causes extremely low frequency magnetic fields (ELF-MF) and wireless communication devices emit radiofrequency electromagnetic fields (RF-EMF). Average ELF-MF exposure is mainly determined by high voltage power lines and transformers at home or at the workplace, whereas RF-EMF exposure is mainly caused by devices operating close to the body (mainly mobile and cordless phones). Health effects of EMF are controversially discussed. The IARC classified ELF-MF and RF-EMF as possible carcinogenic. Most consistent epidemiological evidence was found for an association between ELF-MF and childhood leukaemia. If causal, 1 - 4 percent of all childhood leukaemia cases could be attributed to ELF-MF. Epidemiological research provided some indications for an association between ELF-MF and Alzheimer's diseases as well as amyotrophic lateral sclerosis, although not entirely consistent. Regarding mobile phones and brain tumours, some studies observed an increased risk after heavy or long term use on the one hand. On the other hand, brain tumour incidence was not found to have increased in the last decade in Sweden, England or the US. Acute effects of RF-EMF on non-specific symptoms of ill health seem unlikely according to randomized and double blind provocation studies. However, epidemiological research on long term effects is still limited. Although from the current state of the scientific knowledge a large individual health risk from RF-EMF exposure is unlikely, even a small risk would have substantial public health relevance because of the widespread use of wireless communication technologies.

  20. Hygienic environmental assessment and health of children in Penza

    Directory of Open Access Journals (Sweden)

    Yu.V. Korochkina

    2015-09-01

    Full Text Available Assessment of the carcinogenic risk from air pollution, the chemical composition of the drinking water and the content of contaminants in food showed that the total cancer risk for both inhalation and oral routes of administering priority pollutants and contaminants into the body of Penza children and adolescents complies with the maximum permissible level. The greatest risk of non-carcinogenic impact associated with air pollution is generated in respect of the respiratory system, eyes and immune system. The maximum hazard indices associated with the consumption of drinking water, are set for blood, hormone system and kidneys. The risk of negative impacts associated with the receipt of food contaminants is observed in respect of the hematopoietic and cardiovascular systems. Application of risk assessment methodology to study the effects of chemicals polluting the environment on health has allowed to justify preventive measures aimed at reducing the risk to the health of children and adolescents, as well as increased monitoring researches of environmental objects to isolate areas of high risk to children's health.

  1. Assessing the health effects of potential exposure to PCBs, dioxins, and furans from electrical transformer fires: the Binghamton State Office Building medical surveillance program.

    Science.gov (United States)

    Fitzgerald, E F; Standfast, S J; Youngblood, L G; Melius, J M; Janerich, D T

    1986-01-01

    A medical surveillance program has been established for 482 persons who were potentially exposed to polychlorinated biphenyls (PCBs), dibenzo-p-dioxins, and dibenzofurans from an electrical transformer fire in a Binghamton, NY office building in 1981. Blood samples were analyzed for serum concentrations of PCBs and for biochemical and hematologic parameters at the time of the fire and 9 to 12 mo later. Firefighters and individuals who were in the building for 25 hr or more were also asked about post-fire symptomatology and examined after 1 yr for disorders of the skin, eyes, liver, and neurologic system. The results indicated that reported exposure was positively related to mean serum PCB levels (p = .004). The means and individual values, however, were within the range reported by other studies of persons with no unusual exposures. Significant correlations were observed between serum PCB concentrations and levels of liver enzymes and lipids, but mean levels of these biochemical parameters were not associated with reported exposure after adjustment for relevant covariables. Approximately one-half of those examined had skin lesions, but no cases of chloracne were detected, and there was no clinical evidence of any other exposure-related systemic disorder. The data suggest that exposure to contaminants from the building did not result in substantial absorption or cause any major short-term health effects.

  2. Health literacy and its importance for effective communication. Part 2.

    Science.gov (United States)

    Lambert, Veronica; Keogh, Deborah

    2014-05-01

    This is the second of two articles exploring the concept of health literacy, an often hidden barrier to effective healthcare communication. Part 1 was published in April ( Lambert and Keogh 2014 ). This article explains how to detect low levels of health literacy among parents and children, and outlines the challenges to assessing health literacy levels, including the stigma and discrimination some people experience. Some basic healthcare communication strategies for supporting health literacy in practice are suggested.

  3. Mental Snapshots: Creating an Organized Plan for Health Assessment.

    Science.gov (United States)

    Fosbrook, Susan Curro

    2015-01-01

    Beginning nursing students enter a rapidly moving and changing health care climate. Multiple stimulations can frighten and overwhelm the student's ability to find order of essential patient information. Students need to know how to collect, process, and manage important health data accurately and efficiently in the clinical setting. An integrative method for teaching nursing students to walk into the patient's room and construct a patterned sequence of focused assessments assists students in creating an organized plan for health assessment. The Mental Snapshots Method includes three components for health assessment: (a) sequential assessment steps of the patient; (b) color-coded visual images of the patient representing a bodily condition; and (c) focused assessment questions of primary health complaint(s) with a plan for nursing care. This mental snapshots strategy employs an information processing model of sensory, memory, and motor functioning, which enable students to maintain patient quality and safety. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. 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 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 causes mortality, but >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

  5. Development of health impact assessment in the Netherlands

    NARCIS (Netherlands)

    den Broeder, Lea; Staatsen, Brigit; Kemm, John

    2012-01-01

    This chapter discusses the development of health impact assessment (HIA) in The Netherlands. HIA in The Netherlands began in the early 1990s and developed along two different lines: one shaped by the public health approach and the other stemming from the environmental field. Public health-based HIA

  6. Performance Needs Assessment of Maternal and Newborn Health ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Esan & Fatusi. Performance of maternal health services. African Journal of Reproductive Health June 2014; 18(2): 105. ORIGINAL RESEARCH ARTICLE. Performance Needs Assessment of Maternal and Newborn Health. Service Delivery in Urban and Rural areas of Osun State, South-. West, Nigeria. Oluwaseun T. Esan*.

  7. The empirical limits of forensic mental health assessment.

    Science.gov (United States)

    Grisso, Thomas; Vincent, Gina M

    2005-02-01

    This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.

  8. [Health impact assessment: one way to introduce health in all policies. SESPAS Report 2010].

    Science.gov (United States)

    Esnaola, Santiago; Bacigalupe, Amaia; Sanz, Elvira; Aldasoro, Elena; Calderón, Carlos; Zuazagoitia, Juan; Cambra, Koldo

    2010-12-01

    Health impact assessment is a predictive tool to support decisions in policy-making. Current experience shows that health impact assessment could play an important role in the development of the Health in All Policies strategy. This strategy has been extensively used in other European countries and in a wide range of policy and administrative sectors. Health impact assessment is hardly ever mandatory and is frequently carried out separately from other impact assessments. The use of this process in Spain is relatively new, limited and fundamentally based on local level experiences and the screening of regional interventions. The current normative and organizational reform of public health in Spain provides an excellent opportunity to promote the development of health impact assessment. Some of the barriers to the development of this process are related to the biomedical model of health prevailing among health professionals, politicians, and the general population, political disaffection, lack of assessment culture, underdevelopment of community participation processes, and insufficient intersectoral work. Health impact assessment provides an opportunity to move toward improving the population's health and reducing inequalities in health. Consequently, political commitment, as well as investment in education and research, is needed to introduce and develop health impact assessment in all administrative settings and policy sectors. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  9. Soil microbiology and soil health assessment

    Science.gov (United States)

    Soil scientists have long recognized the importance of soil biology in ecological health. In particular, soil microbes are crucial for many soil functions including decomposition, nutrient cycling, synthesis of plant growth regulators, and degradation of synthetic chemicals. Currently, soil biologis...

  10. Assessing health professional education: workshop summary

    National Research Council Canada - National Science Library

    Cuff, Patricia A

    2014-01-01

    ... professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and practicing health care and prevention professionals about the role each could play...

  11. Measuring the health effects of gender.

    Science.gov (United States)

    Phillips, S P

    2008-04-01

    The health effects of gender are mediated via group-level constraints of sex roles and norms, discrimination and marginalisation of individuals, and internalisation of the stresses of role discordance. Although gender is frequently a lens through which data are interpreted there are few composite measures that insert gender as an independent variable into research design. Instead, sex disaggregation of data is often conflated with gender, identifying statistically significant but sometimes clinically insignificant sex differences. To directly assess the impact of gender on wellbeing requires development of group and individual-level derived variables. At the ecological level such a summative variable could be composed of a selection of group-level measures of equality between sexes. This gender index could be used in ecological and individual-level studies of health outcomes. A quantitative indicator of gender role acceptance and of the personal effects of gender inequities could insert the often hidden variable of gender into individual-level clinical research.

  12. The health technology assessment adaptation toolkit: description and use.

    Science.gov (United States)

    Turner, Sheila; Chase, Deborah L; Milne, Ruairidh; Cook, Andrew; Hicks, Nicholas J; Rosten, Claire; Payne, Liz; Coles, Suzanne; Bell, Eleanor

    2009-12-01

    Adapting health technology assessment (HTA) reports for different contexts could reduce the need for multiple reports on the same health technology with resultant saving of time and resources. This article describes an instrument, the adaptation toolkit, which has been developed to aid in the process of adaptation of HTA reports. The toolkit was developed by a partnership of HTA agencies and networks from across Europe. The role of the toolkit is to guide the user through the process of selecting possible relevant material from these report(s), assessing the relevance, reliability, and transferability of the material, and adapting it for the desired context. The adaptation toolkit has been developed, it comprises a collection of resources that help the user assess whether data and information in existing HTA reports should and could be adapted for their own setting. The toolkit contains two sections: a preliminary speedy sifting section and the main toolkit. The main toolkit includes five domains: (i) technology use and development, (ii) safety, (iii) effectiveness (including efficacy), (iv) economic evaluation, and (v) organizational aspects. Legal, ethical, and social aspects are beyond the scope of the toolkit. The toolkit is designed for the adaptation of evidence synthesis rather than primary research. The completed current version of the toolkit contains checklists and resources to aid in the adaptation of HTA reports. This collection of resources is available for use by all HTA agencies and can be accessed at: http://www.eunethta.net/upload/WP5/EUnetHTA_HTA_Adaptation_Toolkit_October08.pdf..

  13. Systematic Review on Evaluation of Health Impact Assessments in Iran: Evolution, Studies and Areas for Improvement

    Directory of Open Access Journals (Sweden)

    Edris Hoseinzadeh

    2017-06-01

    Conclusion: Health Impact Assessment (HIA has been required for large development projects by the fifth development plan, however, there is a need to HIA by another fields such as air pollution and urban subjects as they have effects on human health. Presenting such assessment before presentation national health standards requirement of Iran indicates this fact. Thus, we expect from politicians and decision makers to address these issues and apply HIA by other fields alongside assessment of national development projects and plans. By doing so, we can bridge the gap between knowledge and action which may result in health promotion in the society.

  14. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  15. A global human health risk assessment for octamethylcyclotetrasiloxane (D4).

    Science.gov (United States)

    Gentry, Robinan; Franzen, Allison; Van Landingham, C; Greene, Tracy; Plotzke, Kathy

    2017-10-20

    Octamethylcyclotetrasiloxane (D4) is a low-molecular-weight volatile cyclic siloxane, primarily used as an intermediate in the production of some widely-used industrial and consumer silicone based polymers and may be present as a component in a variety of consumer products. 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's Chemical Management Program (CMP) and various independent scientific committees of the European Commission (e.g. the Scientific Committee on Consumer Safety (SCCS), the Scientific Committee on Health and Environmental Risks (SCHER)), as well as to provide guidance for chemical safety assessments under REACH in Europe. 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 was included to estimate internal dose metrics, benchmark modeling was used to determine a point of departure (POD), and a margin of safety (MOS) evaluation was used to compare the estimates of intake with the POD. Because of the specific pharmacokinetic behaviors of D4 including high lipophilicity, high volatility with low blood-to-air partition coefficients and an extensive metabolic clearance that regulates 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 D4 using a MOS approach based on an internal dose metric removes the subjective application of varying uncertainty factors from various regulatory agencies and allows examination of the differences between internal dose metrics associated with exposure and those associated with adverse effects. Copyright

  16. Potent health effects of pomegranate

    Directory of Open Access Journals (Sweden)

    Aida Zarfeshany

    2014-01-01

    Full Text Available Accumulating data clearly claimed that Punica granatum L. (pomegranate has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions.

  17. Potent health effects of pomegranate

    Science.gov (United States)

    Zarfeshany, Aida; Asgary, Sedigheh; Javanmard, Shaghayegh Haghjoo

    2014-01-01

    Accumulating data clearly claimed that Punica granatum L. (pomegranate) has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions. PMID:24800189

  18. How well do strategic environmental assessments in Scotland consider human health?

    Science.gov (United States)

    Douglas, M J; Carver, H; Katikireddi, S V

    2011-09-01

    Strategic environmental assessment (SEA) is a systematic approach to identifying, describing, evaluating and reporting on the environmental - and health - effects of policies, plans and strategies. SEAs have potential to improve population health because they assess 'upstream' health determinants and recommend measures to improve these. The authors studied the range of health issues considered in SEAs in Scotland, and the evidence used in their assessment. Documentary review of 62 consecutive SEA reports. Environmental reports were categorized by sector, and the health-related environmental problems, SEA objectives/criteria, differential impacts, evidence, recommended mitigation and monitoring were identified for each report. Environmental reports identified many health-related issues, and set a wide range of health-related objectives/criteria, but these were inconsistent for SEAs assessing similar plans. Few identified differential impacts or mental health impacts. Mitigation focused on mitigating adverse impacts rather than enhancing positive impacts. It was unclear what health evidence was used to inform the judgements made in scoring the plans against SEA objectives. Many SEAs in Scotland adopt a wide perspective on health, but most fail to identify differential impacts. Health involvement in scoping of health issues and better use of health evidence may enhance their quality. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. [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

  20. Assessment of Learning and Program Evaluation in Health Professions Education Programs

    Science.gov (United States)

    Moore, Donald E., Jr.

    2018-01-01

    This chapter proposes approaches for assessing learners and evaluating courses and curriculum that could be used by directors of health professions education (HPE) programs to determine the effectiveness and impact of their programs.

  1. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  2. Health assessment instruments for people with intellectual disabilities-A systematic review.

    Science.gov (United States)

    Bakker-van Gijssel, E J; Lucassen, P L B J; Olde Hartman, T C; van Son, L; Assendelft, W J J; van Schrojenstein Lantman-de Valk, H M J

    2017-05-01

    People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems. The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality. We conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments. We distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments. Two instruments, "Stay well and healthy -Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Health effects of dietary fiber.

    Science.gov (United States)

    Otles, Semih; Ozgoz, Selin

    2014-01-01

    Dietary fibre is a group of food components which is resistant to digestive enzymes and found mainly in cereals, fruits and vegetables. Dietary fi ber and whole grains contain a unique blend of bioactive components including resistant starches, vitamins, minerals, phytochemicals and antioxidants. Dietary fi ber which indigestible in human small intestinal, on the other hand digested completely or partially fermented in the large intestine, is examined in two groups: water-soluble and water insoluble organic compounds. Dietary fi ber can be separated into many different fractions. These fractions include arabinoxylan, inulin, pectin, bran, cellulose, β-glucan and resistant starch. Dietary fibres compose the major component of products with low energy value that have had an increasing importance in recent years. Dietary fibres also have technological and functional properties that can be used in the formulation of foods, as well as numerous beneficial effects on human health. Dietary fibre components organise functions of large intestine and have important physiological effects on glucose, lipid metabolism and mineral bioavailability. Today, dietary fibers are known to be protective effect against certain gastrointestinal diseases, constipation, hemorrhoids, colon cancer, gastroesophageal reflux disease, duodenal ulcer, diverticulitis, obesity, diabetes, stroke, hypertension and cardiovascular diseases. In this review the physicochemical and biological properties of dietary fibers and their important implications on human health will be investigated.

  4. Effectiveness of oral health education among primary health care workers at the primary health center in Nellore district, Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    Muthyala Pavana Sandhya

    2014-01-01

    Full Text Available Background: Primary dental care can be a way of achieving good oral health for the community. This can be achieved by integration of oral health care with the existing primary health care activities through training of primary health care workers on aspects of oral health. Objective: To assess the effectiveness of oral health education among primary health care workers at the primary health center (PHC in Nellore district, Andhra Pradesh. Materials and Methods: Descriptive longitudinal study was conducted from June 2010 to August 2010 at a PHC. Knowledge about oral health among primary health care workers was pretested using a self-administered questionnaire prepared in local language (Telugu. Later after a month health education was provided to the health workers, and pamphlets with information on oral health were distributed. Posttest assessment was done 1-month after providing health education using the same questionnaire. Statistical analysis was performed using the SPSS 12.0 software, Student′s t-test was used to compare knowledge scores between pre and posttests. Results: A total of 118 Primary Health Care Workers with the majority in the 20-30 years age group participated in the study. Posttest assessment showed a change in knowledge level with an overall increase in knowledge level of primary health care workers with a mean difference of 12.56 ± 3.23, which was highly significant (P < 0.001. Conclusion: The knowledge about oral health was poor, and it improved after providing health education to primary health care workers. Change in knowledge was appreciable and may play a key role in oral health promotion of the vast majority of the rural population.

  5. Cost-Effectiveness of Health Coaching: An Integrative Review.

    Science.gov (United States)

    Hale, Rachel; Giese, Jeannie

    The purpose of this review was to evaluate published literature to distinguish how health coaching influences the cost of chronic disease management in insured adults with chronic conditions. An integrated literature review was conducted. MEDLINE, Business Source Complete, and OneSearch were searched for the years 2001-2016 utilizing the following key words: health coaching, health coaching AND insurance companies, health coaching AND cost, health coaching AND health insurance, and health coaching AND insurance cost. A total of 67 articles met inclusion criteria and were assessed for applicability. Of those, 27 articles were found to be relevant to the research question. The practice settings of these articles are mostly primary care and wellness programs. Throughout the literature, health coaching has been found effective in chronic disease management such as hypertension, diabetes, and hyperlipidemia. Studies evaluating the cost-effectiveness of health coaching are limited. The current literature does not clearly demonstrate that health coaching lowers expenditures and patient copayments in the short term but projects future savings. Health coaching has the potential to improve chronic disease management and lower health care expenditures. Further long-term research is needed to evaluate the cost-effectiveness of health coaching. It has been projected that the cost-effectiveness of health coaching will be long-term or over 12 months after initiating the health coaching program.

  6. Assessment of Public Health Infrastructure to Determine Public Health Preparedness

    Science.gov (United States)

    2006-03-01

    eight-year-old James Phipps with Cow Pox. When the boy later proved to be immune to Small Pox humanity was on its way to taming the microbe. Between...33 Anjum Hajat, Carol K. Brown and Michael R. Frazer , Local Public Health Agency Infrastructure : A Chartbook., 2001 ed...Care, Housing & Human Services and 42 George W. Bush, Homeland Security Presidential Directive

  7. Health Security Intelligence: Assessing the Nascent Public Health Capability

    Science.gov (United States)

    2012-03-01

    however, that “Declining federal support for preparedness activities is translating to shuttering of 60 programs and staff layoffs at state/local health...a more humanistic management. Journal of Buisness Ethics , 445–462. Rollins, J., & Connors, T. (2007). State fusion center processes and procedures

  8. Computer-assisted client assessment survey for mental health: patient and health provider perspectives.

    Science.gov (United States)

    Ferrari, Manuela; Ahmad, Farah; Shakya, Yogendra; Ledwos, Cliff; McKenzie, Kwame

    2016-09-23

    The worldwide rise in common mental disorders (CMDs) is posing challenges in the provision of and access to care, particularly for immigrant, refugee and racialized groups from low-income backgrounds. eHealth tools, such as the Interactive Computer-Assisted Client Assessment Survey (iCCAS) may reduce some barriers to access. iCCAS is a tablet-based, touch-screen self-assessment completed by clients while waiting to see their family physician (FP) or nurse practitioner (NP). In an academic-community initiative, iCCAS was made available in English and Spanish at a Community Health Centre in Toronto through a mixed-method trial. This paper reports the perspectives of clients in the iCCAS group (n = 74) collected through an exit survey, and the perspectives of 9 providers (four FP and five NP) gathered through qualitative interviews. Client acceptance of the tool was assessed for cognitive and technical dimensions of their experience. They rated twelve items for perceived Benefits and Barriers and four questions for the technical quality. Most clients reported that the iCCAS completion time was acceptable (94.5 %), the touch-screen was easy to use (97.3 %), and the instructions (93.2 %) and questions (94.6 %) were clear. Clients endorsed the tool's Benefits, but were unsure about Barriers to information privacy and provider interaction (mean 4.1, 2.6 and 2.8, respectively on a five-point scale). Qualitative analysis of the provider interviews identified five themes: challenges in Assessing Mental Health Services, such as case complexity, time, language and stigma; the Tool's Benefits, including non-intrusive prompting of clients to discuss mental health, and facilitation of providers' assessment and care plans; the Tool's Integration into everyday practice; Challenges for Use (e.g. time); and Promoting Integration Effectively, centered on the timing of screening, setting readiness, language diversity, and technological advances. Participant clients and

  9. Evidence-Based Medicine and State Health Care Coverage: The Washington Health Technology Assessment Program.

    Science.gov (United States)

    Rothman, David J; Blackwood, Kristy L; Adair, Whitney; Rothman, Sheila M

    2017-12-03

    To evaluate the Washington State Health Technology Assessment Program (WHTAP). Washington State Health Technology Assessment Program proceedings in Seattle, Washington. We assessed the program through observation of its proceedings over a 5-year period, 2009-2014. We conducted detailed analyses of the documents it produced and reviewed relevant literature. Washington State Health Technology Assessment Program is unique compared to other state and federal programs. It has successfully applied evidence-based medicine to health care decision making, limited by the strength of available data. It claims cost savings, but they are not substantiated. Washington State Health Technology Assessment Program is a useful model for other states considering implementation of technology assessment programs. We provide key lessons for improving WHTAP's process. © Health Research and Educational Trust.

  10. 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. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Assessing Effectiveness of Ceiling-Ventilated Mock Airborne Infection Isolation Room in Preventing Hospital-Acquired Influenza Transmission to Health Care Workers

    OpenAIRE

    THATIPARTI, DEEPTHI SHARAN; Ghia, Urmila; Mead, Kenneth R.

    2016-01-01

    Exposure to airborne influenza (or flu) from a patient's cough and exhaled air causes potential flu virus transmission to the persons located nearby. Hospital-acquired influenza is a major airborne disease that occurs to health care workers (HCW).

  12. Health technology assessment demonstrates efficient health promotion bu Transcendental Meditation (TM)

    DEFF Research Database (Denmark)

    Larsen, Torben

    2002-01-01

    of negative side-effects is considered to be minimal for a general relaxation procedure disseminated within democratic societies. In conclusion universities are recommended to introduce alternative stressmanagement programs including TM as long-term health promotion options for students.......BACKGROUND/OBJECTIVES: Health Technology Assessment of mantrameditation implemented as Transcendental Meditation (TM) METHODS: MEDLINE contains October 2001 335 titles on 'Transcendental Meditation' including various metaanalyses and a series of randomised, controlled trials: In summary...... mantrameditation (TM) is evidenced to produce a wakeful, hypometabolic state (in-depth-relaxation) independent of personality or individual mantras. A general metaanalysis summarizes the long-termed meditation effects as (1) a low baseline function; (2) release of stress and anxiety empowering self...

  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, Hindrik; 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

  14. Molecular assessment of muscle health and function

    NARCIS (Netherlands)

    Hangelbroek, Roland W.J.

    2017-01-01

    Prolonged lifespan and decreased fertility will lead to an increased proportion of older adults in the world population (population aging). An important strategy to deal with population aging has been to promote healthy aging; not only to prevent mounting health care costs, but also to maintain

  15. The effects of performance-based assessment criteria on student performance and self-assessment skills

    NARCIS (Netherlands)

    Fastré, Greet; Van der Klink, Marcel; Van Merriënboer, Jeroen

    2010-01-01

    Fastré, G. M. J., Van der Klink, M. R., & Van Merriënboer, J. J. G. (2010). The effects of performance-based assessment criteria on student performance and self-assessment skills. Advances in Health Science Education, 15(4), 517-532.

  16. Learning about health: The pupils' and the school health nurses assessment of the health dialogue

    DEFF Research Database (Denmark)

    Borup, Ina K.

    Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse......Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse...

  17. Learning about health: The pupils' and the school health nurses assessment of the health dialogue

    DEFF Research Database (Denmark)

    Borup, Ina K.

    Public health, health promotion, empowerment, experiential learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialouge, school health nurse......Public health, health promotion, empowerment, experiential learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialouge, school health nurse...

  18. Assessing Effectiveness of Ceiling-Ventilated Mock Airborne Infection Isolation Room in Preventing Hospital-Acquired Influenza Transmission to Health Care Workers.

    Science.gov (United States)

    Thatiparti, Deepthi Sharan; Ghia, Urmila; Mead, Kenneth R

    2016-01-01

    Exposure to airborne influenza (or flu) from a patient's cough and exhaled air causes potential flu virus transmission to the persons located nearby. Hospital-acquired influenza is a major airborne disease that occurs to health care workers (HCW). This paper examines the airflow patterns and influenza-infected cough aerosol transport behavior in a ceiling-ventilated mock airborne infection isolation room (AIIR) and its effectiveness in mitigating HCW's exposure to airborne infection. The computational fluid dynamics (CFD) analysis of the airflow patterns and the flu virus dispersal behavior in a mock AIIR is conducted using the room geometries and layout (room dimensions, bathroom dimensions and details, placement of vents and furniture), ventilation parameters (flow rates at the inlet and outlet vents, diffuser design, thermal sources, etc.), and pressurization corresponding to that of a traditional ceiling-mounted ventilation arrangement observed in existing hospitals. The measured data shows that ventilation rates for the AIIR are about 12 air changes per hour(ach). However, the numerical results reveals incomplete air mixing and that not all of the room air is changed 12 times per hour. Two life-sized breathing human models are used to simulate a source patient and a receiving HCW. A patient cough cycle is introduced into the simulation and the airborne infection dispersal is tracked in time using a multiphase flow simulation approach. The results reveal air recirculation regions that diminished the effect of air filtration and prolong the presence of flu-contaminated air at the HCW's zone. Immediately after the patient coughs (0.51 s), the cough velocity from the patient's mouth drives the cough aerosols toward the HCW standing next to patient's bed. Within 0.7 s, the HCW is at risk of acquiring the infectious influenza disease, as a portion of these aerosols are inhaled by the HCW. As time progresses (5 s), the aerosols eventually spread throughout the entire

  19. Effects of Health Status and Health Behaviors on Depression Among Married Female Immigrants in South Korea.

    Science.gov (United States)

    Kim, Jung A; Yang, Sook Ja; Chee, Yeon Kyung; Kwon, Kyoung Ja; An, Jisook

    2015-06-01

    This study examined the effects of health status and health behaviors on depression in married female immigrants in South Korea. Sampling 316 immigrant women from the Philippines, Vietnam, China, and other Asian countries, a cross-sectional research design was used with self-report questionnaires that assessed sociodemographic characteristics, health status, health behaviors, and depression. There were significant differences in stillbirth experience, induced abortion, morbidity, perceived health status, meal skipping, and physical activity between depressed and nondepressed immigrant women. After adjusting for sociodemographic variables, stillbirth experience, poorer perceived health status, more meal skipping, and less physical activity were associated with greater depressive symptoms. Both health status and health behaviors had significant impacts on depression, suggesting that development of nursing interventions and educational programs should be targeted towards improving maternal health, healthy lifestyle, and subjective health perception to promote married female immigrants' psychological well-being. Copyright © 2015. Published by Elsevier B.V.

  20. Health effects of dietary phospholipids

    Directory of Open Access Journals (Sweden)

    Küllenberg Daniela

    2012-01-01

    Full Text Available Abstract Beneficial effects of dietary phospholipids (PLs have been mentioned since the early 1900's in relation to different illnesses and symptoms, e.g. coronary heart disease, inflammation or cancer. This article gives a summary of the most common therapeutic uses of dietary PLs to provide an overview of their approved and proposed benefits; and to identify further investigational needs. From the majority of the studies it became evident that dietary PLs have a positive impact in several diseases, apparently without severe side effects. Furthermore, they were shown to reduce side effects of some drugs. Both effects can partially be explained by the fact that PL are highly effective in delivering their fatty acid (FA residues for incorporation into the membranes of cells involved in different diseases, e.g. immune or cancer cells. The altered membrane composition is assumed to have effects on the activity of membrane proteins (e.g. receptors by affecting the microstructure of membranes and, therefore, the characteristics of the cellular membrane, e.g. of lipid rafts, or by influencing the biosynthesis of FA derived lipid second messengers. However, since the FAs originally bound to the applied PLs are increased in the cellular membrane after their consumption or supplementation, the FA composition of the PL and thus the type of PL is crucial for its effect. Here, we have reviewed the effects of PL from soy, egg yolk, milk and marine sources. Most studies have been performed in vitro or in animals and only limited evidence is available for the benefit of PL supplementation in humans. More research is needed to understand the impact of PL supplementation and confirm its health benefits.

  1. 3. Assessing the Delivery and Effectiveness of a New Immunisation ...

    African Journals Online (AJOL)

    Esem

    management, cold chain management, and immunisation monitoring. Based on these assessments, 12 areas were identified as of particular relevance, and the World Health. Organisation MLM course manual was adapted to reflect them. Two groups of 25 participants were. Assessing the Delivery and Effectiveness of a ...

  2. The Treatment Effectiveness Assessment (TEA

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-09-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers.  View original paper by Ling W, Farabee D, Liepa D, Wu LT. 

  3. HEALTH ASSESSMENT OF 1,3-BUTADIENE | Science ...

    Science.gov (United States)

    This assessment was conducted to review the new information that has become available since EPA's 1985 health assessment of 1,3-butadiene.1,3-Butadiene is a gas used commercially in the production of styrene-butadiene rubber, plastics, and thermoplastic resins. The major environmental source of 1,3-butadiene is the incomplete combustion of fuels from mobile sources (e.g., automobile exhaust). Tobacco smoke can be a significant source of 1,3-butadiene in indoor air.This assessment concludes that 1,3-butadiene is carcinogenic to humans by inhalation, based on the total weight of evidence. The specific mechanisms of 1,3-butadiene-induced carcinogenesis are unknown; however, it is virtually certain that the carcinogenic effects are mediated by genotoxic metabolites of 1,3-butadiene.Animal data suggest that females may be more sensitive than males for cancer effects; nevertheless, there are insufficient data from which to draw any conclusions on potentially sensitive subpopulations.The human incremental lifetime unit cancer (incidence) risk estimate is based on extrapolation from leukemias observed in an occupational epidemiologic study. A twofold adjustment to the epidemiologic-based unit cancer risk is then applied to reflect evidence from the rodent bioassays suggesting that the epidemiologic-based estimate may underestimate total cancer risk from 1,3-butadiene exposure in the general population. 1,3-Butadiene also causes a variety of reproductive and develop

  4. 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.

  5. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume III. SPAHR interactive package guide

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projectons. The model extends several health risk projection models by making realistic assumptions about the population at risk, adn thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This manual outlines the use of the interactive capabilities of SPAHR. SPAHR is an integrated system of computer programs designed for simulating numerous health risk scenarios using the techniques of demographic modeling. This system of computer programs has been designed to be very flexible so as to allow the user to simulate a large variety of scenarios. It provides the user with an integrated package for projecting the impacts on human health of exposure to various hazards, particularly those resulting from the effluents related to energy production.

  6. Questioning reliability assessments of health information on social media.

    Science.gov (United States)

    Dalmer, Nicole K

    2017-01-01

    This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media's increasing role in health information consumption is recognized, studies are dominated by investigations of traditional (i.e., non-social media) sites. To more richly assess constructions of reliability when using social media for health information, future research must focus on health consumers' unique contexts, virtual relationships, and degrees of trust within their social networks.

  7. Questioning reliability assessments of health information on social media

    Directory of Open Access Journals (Sweden)

    Nicole K. Dalmer, BSc, MLIS, PhD Candidate

    2017-01-01

    Full Text Available This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media’s increasing role in health information consumption is recognized, studies are dominated by investigations of traditional (i.e., non-social media sites. To more richly assess constructions of reliability when using social media for health information, future research must focus on health consumers’ unique contexts, virtual relationships, and degrees of trust within their social networks.

  8. The effect of Ghana's National Health Insurance Scheme on health ...

    African Journals Online (AJOL)

    Objectives: The study investigates the effect of Ghana's National Health Insurance Scheme (NHIS) on health care utilisation. Methods: We provide a short history of health insurance in Ghana, and briefly discuss general patterns of enrolment in Ghana as well as in Accra in a first step. In a second step, we use data from the ...

  9. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume V. SPAHR programmer's guide

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.; Lundy, R.T.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, numbers of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume contains a programmer's guide to SPAHR.

  10. History of the international societies in health technology assessment: International Society for Technology Assessment in Health Care and Health Technology Assessment International.

    Science.gov (United States)

    Banta, David; Jonsson, Egon; Childs, Paul

    2009-07-01

    The International Society for Technology Assessment in Health Care (ISTAHC) was formed in 1985. It grew out of the increasing awareness of the international dimensions of health technology assessment (HTA) and the need for new communication methods at the international level. The main function of ISTAHC was to present an annual conference, which gradually grew in size, and also to generally improve in quality from to year. ISTAHC overextended itself financially early in the first decade of the 2000s and had to cease its existence. A new society, Health Technology Assessment international (HTAi), based on many of the same ideas and people, grew up beginning in the year 2003. The two societies have played a large role in making the field of HTA visible to people around the world and providing a forum for discussion on the methods and role of HTA.

  11. Ethical issues of obesity surgery--a health technology assessment.

    Science.gov (United States)

    Saarni, Samuli I; Anttila, Heidi; Saarni, Suoma E; Mustajoki, Pertti; Koivukangas, Vesa; Ikonen, Tuija S; Malmivaara, Antti

    2011-09-01

    New surgical technologies may challenge societal values, and their adoption may lead to ethical challenges. Despite proven cost-effectiveness, obesity (bariatric) surgery and its public funding have been questioned on ethical arguments relating to, for example, the self-inflicted or non-disease nature of obesity. Our aim was to analyze the ethical issues relevant to bariatric surgery. A comprehensive health technology assessment was conducted on bariatric surgery for morbid obesity using the EUnetHTA method, including a fully integrated ethical analysis. The ethical arguments suggesting that obesity should not be surgically treated because it is self-inflicted were rejected. Medicalization of obesity may have both positive and negative effects that impact the various stakeholders differently, thus being difficult to balance. Informing bariatric surgery patients and actively supporting their autonomy is exceptionally important, as the benefits and harms of both obesity and bariatric surgery are complex, and the outcome depends on how well the patient understands and adheres to the life-long changes in eating habits required. Justice considerations are important in organizing surgical treatment of obesity, as the obese are discriminated against in many ways and obesity is more common in socioeconomically disadvantaged populations who might have problems of access to treatments. Obesity should be treated like other diseases in health care, and obesity surgery rationed like other cost-effective treatments. Positive actions to ensure patient autonomy and just access to surgical treatments may be warranted.

  12. Health impact assessment of traffic noise in Madrid (Spain).

    Science.gov (United States)

    Tobías, Aurelio; Recio, Alberto; Díaz, Julio; Linares, Cristina

    2015-02-01

    The relationship between environmental noise and health has been examined in depth. In view of the sheer number of persons exposed, attention should be focused on road traffic noise. The city of Madrid (Spain) is a densely populated metropolitan area in which 80% of all environmental noise exposure is attributed to traffic. The aim of this study was to quantify avoidable deaths resulting from reducing the impact of equivalent diurnal noise levels (LeqD) on daily cardiovascular and respiratory mortality among people aged ≥65 years in Madrid. A health impact assessment of (average 24h) LeqD and PM2.5 levels was conducted by using previously reported risk estimates of mortality rates for the period 2003-2005: For cardiovascular causes: LeqD 1.048 (1.005, 1.092) and PM2.5 1.041(1.020, 1.062) and for respiratory causes: LeqD 1.060 (1.000, 1.123) and PM2.5 1.030 (1.000, 1.062). The association found between LeqD exposure and mortality for both causes suggests an important health effect. A reduction of 1dB(A) in LeqD implies an avoidable annual mortality of 284 (31, 523) cardiovascular- and 184 (0, 190) respiratory-related deaths in the study population. The magnitude of the health impact is similar to reducing average PM2.5 levels by 10µg/m(3). Regardless of air pollution, exposure to traffic noise should be considered an important environmental factor having a significant impact on health. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Vibrations on board and health effects

    DEFF Research Database (Denmark)

    Jensen, Anker; Jepsen, Jørgen Riis

    2014-01-01

    for such relation among seafarers except for fishermen, who, however, are also exposed to additional recognised physical risk factors at work. The assessment and reduction of vibrations by naval architects relates to technical implications of this impact for the ships’ construction, but has limited value......There is only limited knowledge of the exposure to vibrations of ships’ crews and their risk of vibration-induced health effects. Exposure to hand-arm vibrations from the use of vibrating tools at sea does not differ from that in the land-based trades. However, in contrast to most other work places...... of the health consequences of whole body vibrations in land-transportation, such exposure at sea may affect ships’ passengers and crews. While the relation of back disorders to high levels of whole body vibration has been demonstrated among e.g. tractor drivers, there are no reported epidemiological evidence...

  14. Health effects of exhaust particles

    Energy Technology Data Exchange (ETDEWEB)

    Pihlava, T.; Uuppo, M.; Niemi, S.

    2013-11-01

    This report introduces general information about diesel particles and their health effects. The purpose of this report is to introduce particulate matter pollution and present some recent studies made regarding the health effects of particulate matter. The aim is not to go very deeply into the science, but instead to keep the text understandable for the average layman. Particulate matter is a complex mixture of extremely small particles and liquid droplets. These small particles are made up of a number of components that include for example acids, such as nitrates and sulphates, as well as organic chemicals, metals and dust particles from the soil. Particulate matter comes from several sources, such as transportation emissions, industrial emissions, forest fires, cigarette smoke, volcanic ash and climate variations. Particles are divided into coarse particles with diameters less than 10 ..m, fine particles with diameters smaller than 2.5 ..m and ultra-fine particles with diameters less than 0.1 ..m. The particulate matter in diesel exhaust gas is a highly complex mixture of organic, inorganic, solid, volatile and partly volatile compounds. Many of these particles do not form until they reach the air. Many carcinogenic compounds have been found in diesel exhaust gas and it is considered carcinogenic to humans. Particulate matter can cause several health effects, such as premature death in persons with heart or lung disease, cancer, nonfatal heart attacks, irregular heartbeat, aggravated asthma, decreased lung function and an increase in respiratory symptoms, such as irritation of the airways, coughing or difficulty breathing. It is estimated that in Finland about 1300 people die prematurely due to particles and the economic loss in the EU due to the health effects of particles can be calculated in the billions. Ultra-fine particles are considered to be the most harmful to human health. Ultrafine particles usually make the most of their quantity and surface area

  15. The value of mainstreaming human rights into health impact assessment.

    Science.gov (United States)

    MacNaughton, Gillian; Forman, Lisa

    2014-09-26

    Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well.

  16. The Value of Mainstreaming Human Rights into Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Gillian MacNaughton

    2014-09-01

    Full Text Available Health impact assessment (HIA is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well.

  17. Health technology assessment of asthma disease management programs.

    Science.gov (United States)

    Steuten, Lotte; Lemmens, Karin; Vrijhoef, Bert

    2007-06-01

    To provide a critical opinion on the extent to which asthma disease management programs currently improve the effectiveness and efficiency of care and directions for future policy and research. The methodological quality of health technology assessment of asthma disease management programs remains moderate. Asthma disease management programs are predominantly educational and organizational in nature and focus either on children or on adults. Paediatric disease management programs make more effort to outreach into patients' living environments and show higher participation rates than those targeting adults. Reductions in asthma-related hospitalization, emergency department, and unplanned clinic visits range from 0 to 85%, 87% and 71%, respectively. Aspects of self-management and organization of care improved after the implementation of disease management programs. Almost no impact on asthma symptoms, lung function or the use of long-term control medication was found. There is accumulating 'circumstantial' evidence that disease management programs reduce resource utilization. The analytical rigor and uniformity of health technology assessment of asthma disease management programs has improved, but the generalizability of results remains uncertain. Practical, multicentre, clinical trials including broad representative study samples should be performed in different settings to increase methodological quality and substantiate current findings.

  18. The Value of Mainstreaming Human Rights into Health Impact Assessment

    Science.gov (United States)

    MacNaughton, Gillian; Forman, Lisa

    2014-01-01

    Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well. PMID:25264683

  19. Urgency to Assess the Health Impact of Ambient Air Pollution in China.

    Science.gov (United States)

    Yang, Bo-Yi; Liu, Yimin; Hu, Li-Wen; Zeng, Xiao-Wen; Dong, Guang-Hui

    2017-01-01

    As the world's second-largest economy, China is going on suffering from environmental pollution, especially for ambient air pollution, which has become a major threat to public health; public awareness of the detrimental effects of air pollution on health is increasing-particularly in relation to haze days. Considering the nonlinear relationship of ambient air pollution exposure and health impacts, and the differences in specific sources of air pollution with those in North America and Europe, conducting health impact assessments of ambient air pollution in China has thus become an urgent task for public health practitioners. Systematic review of the health effects of exposure to ambient air pollution from quantitative studies conducted in Chinese could provide vital information for epidemiology-based health impact assessments and the implementation of a national environmental protection policy.

  20. Effect of health education on knowledge and attitude of tertiary ...

    African Journals Online (AJOL)