Promoting Health Literacy through the Health Education Assessment Project

Science.gov (United States)

Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

2007-01-01

Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

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

International Nuclear Information System (INIS)

Ongel, Aybike; Sezgin, Fatih

2016-01-01

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.

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.

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.

Assessing communications effectiveness in meeting corporate goals of public health organizations.

Science.gov (United States)

Brown, Gordon D; Bopp, Kenneth D; Boren, Suzanne Austin

2005-01-01

Much evaluation of health communications in public health is considered from a program perspective of smoking cessation, weight reduction, education on sexually transmitted diseases, etc. These studies have advanced the knowledge base of communications theory and evaluation and have contributed to program effectiveness. In program-based evaluation the communications process is structured as part of the program itself. This article extends program-based communications evaluation to view communications from the perspective of the consumer and how effectively public health departments respond to consumer expectations. It develops a conceptual model for evaluating elements of communications such as its importance in defining mission and goals within the community, managing strategic constituencies, and enlisting individuals and groups as customers and co-producers of health. It gives a broader perspective on how communications in public heath organizations are managed and a basis for assessing whether they are being managed effectively.

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

A Unified Probabilistic Framework for Dose–Response Assessment of Human Health Effects

Science.gov (United States)

Slob, Wout

2015-01-01

Background When chemical health hazards have been identified, probabilistic dose–response assessment (“hazard characterization”) quantifies uncertainty and/or variability in toxicity as a function of human exposure. Existing probabilistic approaches differ for different types of endpoints or modes-of-action, lacking a unifying framework. Objectives We developed a unified framework for probabilistic dose–response assessment. Methods We established a framework based on four principles: a) individual and population dose responses are distinct; b) dose–response relationships for all (including quantal) endpoints can be recast as relating to an underlying continuous measure of response at the individual level; c) for effects relevant to humans, “effect metrics” can be specified to define “toxicologically equivalent” sizes for this underlying individual response; and d) dose–response assessment requires making adjustments and accounting for uncertainty and variability. We then derived a step-by-step probabilistic approach for dose–response assessment of animal toxicology data similar to how nonprobabilistic reference doses are derived, illustrating the approach with example non-cancer and cancer datasets. Results Probabilistically derived exposure limits are based on estimating a “target human dose” (HDMI), which requires risk management–informed choices for the magnitude (M) of individual effect being protected against, the remaining incidence (I) of individuals with effects ≥ M in the population, and the percent confidence. In the example datasets, probabilistically derived 90% confidence intervals for HDMI values span a 40- to 60-fold range, where I = 1% of the population experiences ≥ M = 1%–10% effect sizes. Conclusions Although some implementation challenges remain, this unified probabilistic framework can provide substantially more complete and transparent characterization of chemical hazards and support better-informed risk

Development of health effect assessment software using MACCS2 code

International Nuclear Information System (INIS)

Hwang, Seok-Won; Park, Jong-Woon; Kang, Kyung Min; Jae, Moosung

2008-01-01

The extended regulatory interests in severe accidents management and enhanced safety regulatory requirements raise a need of more accurate analysis of the effect to the public health by users with diverse disciplines. This facilitates this work to develop web-based radiation health effect assessment software, RASUM, by using the MACCS2 code and HTML language to provide diverse users (regulators, operators, and public) with easy understanding, modeling, calculating, analyzing, documenting and reporting of the radiation health effect under hypothetical severe accidents. The engine of the web-based RASUM uses the MACCS2 as a base code developed by NRC and is composed of five modules such as development module, PSA training module, output module, input data module (source term, population distribution, meteorological data, etc.), and MACCS2 run module. For verification and demonstration of the RASUM, the offsite consequence analysis using the RASUM frame is performed for such as early fatality risk, organ does, and whole body does for two selected scenarios. Moreover, CCDF results from the RASUM for KSNP and CANDU type reactors are presented and compared. (author)

Assessing catastrophic and impoverishing effects of health care payments in Uganda.

Science.gov (United States)

Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E

2015-01-22

Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day). A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively. The absence of financial protection in Uganda's health system calls for concerted action. Currently, out-of-pocket payments account for a large share of total health financing and there is no pooled prepayment system available. There is therefore a need to move towards mandatory prepayment. In this way, people could access the needed health services without any associated financial consequence.

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

DEFF Research Database (Denmark)

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

2011-01-01

contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... 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...... 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...

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.

Assessing income redistributive effect of health financing in Zambia.

Science.gov (United States)

Mulenga, Arnold; Ataguba, John Ele-Ojo

2017-09-01

Ensuring an equitable health financing system is a major concern particularly in many developing countries. Internationally, there is a strong debate to move away from excessive reliance on direct out-of-pocket (OOP) spending towards a system that incorporates a greater element of risk pooling and thus affords greater protection for the poor. This is a major focus of the move towards universal health coverage (UHC). Currently, Zambia with high levels of poverty and income inequality is implementing health sector reforms for UHC through a social health insurance scheme. However, the way to identify the health financing mechanisms that are best suited to achieving this goal is to conduct empirical analysis and consider international evidence on funding universal health systems. This study assesses, for the first time, the progressivity of health financing and how it impacts on income inequality in Zambia. Three broad health financing mechanisms (general tax, a health levy and OOP spending) were considered. Data come from the 2010 nationally representative Zambian Living Conditions and Monitoring Survey with a sample size of 19,397 households. Applying standard methodologies, the findings show that total health financing in Zambia is progressive. It also leads to a statistically significant reduction in income inequality (i.e. a pro-poor redistributive effect estimated at 0.0110 (p taxes (0.0101 (p taxes. This points to areas where government policy may focus in attempting to reduce the high level of income inequality and to improve equity in health financing towards UHC in Zambia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of nanoparticle release and associated health effect of polymer-silicon composites

International Nuclear Information System (INIS)

Zhu, H; Irfan, A; Sachse, S; Njuguna, J

2012-01-01

Little information is currently available on possible release of nanomaterials or/and nanoparticles (NP) from conventional and novel products and associated health effect. This study aimed to assess the possible release of NP during the application stage of conventional and nanoproducts. NP release was monitored during physical processing of polymer-silicon composites, and the toxicity of both the released NP and the raw silica nanomaterials that were used as fillers in the nanocomposites was assessed in vitro using human lung epithelial A549 cells. This study suggests that 1) NP can be released from the conventional and novel polymer-silicon composites under certain application scenario; 2) the level of NP release from polymer composites could be altered by different reinforcement materials; e.g. nanostructured MMT could reduce the release while SiO2 NP could increase the release; 3) working with polymer composites under certain conditions could risk inhalation of high level of polymer NP; 4) raw nanomaterials appeared to be toxic in the chosen in vitro system. Further study of the effect of novel filler materials on NP release from final polymer products and the effect of released NP on environment and human health will inform design of safe materials and minimization of negative impact on the environment and human health.

Health economic assessment: a methodological primer.

Science.gov (United States)

Simoens, Steven

2009-12-01

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

Health Economic Assessment: A Methodological Primer

Directory of Open Access Journals (Sweden)

Steven Simoens

2009-11-01

Full Text Available This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs, an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis, and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

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

OpenAIRE

Aunan, Kristin; Seip, Hans Martin

1995-01-01

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. It also gives results from some selected parts of a case-study in Hungary. This study is aimed at testing and improving the methodology for integrated assessment and focuses on energy productio...

Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

Science.gov (United States)

Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

2012-10-16

Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

Assessment of health risks of policies

International Nuclear Information System (INIS)

Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

2014-01-01

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

Assessment of health risks of policies

Energy Technology Data Exchange (ETDEWEB)

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

2014-09-15

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

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.

Assessment of Health Effects of Exogenous Urea: Summary and Key Findings.

Science.gov (United States)

Dickerson, Aisha S; Lee, Janice S; Keshava, Channa; Hotchkiss, Andrew; Persad, Amanda S

2018-05-01

Urea has been utilized as a reductant in diesel fuels to lower emission of nitrogen oxides, igniting interest in probable human health hazards associated with exposure to exogenous urea. Here, we summarize and update key findings on potential health effects of exogenous urea, including carcinogenicity. No definitive target organs for oral exposure were identified; however, results in animal studies suggest that the liver and kidney could be potential target organs of urea toxicity. The available human-subject literature suggests that the impact on lung function is minimal. Based on the literature on exogenous urea, we concluded that there was inadequate information to assess the carcinogenic potential of urea, or perform a quantitative assessment to derive reference values. Given the limited information on exogenous urea, additional research to address gaps for exogenous urea should include long-term cancer bioassays, two-generation reproductive toxicity studies, and mode-of-action investigations.

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

Directory of Open Access Journals (Sweden)

Evelyn Helena Corgosinho Ribeiro

Full Text Available ABSTRACT OBJECTIVE 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. METHODS 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. RESULTS 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 < 0.001. In the follow-up period, the exercise class group reduced its annual score (average: -0.3; 95%CI -0.5–-0.1, while the health education group increased this score (average: 0.2; 95%CI 0.1–0.4. There have been no differences in the levels of physical activity measured by accelerometry. CONCLUSIONS The interventions have been effective in increasing the practice of physical activity. However, we have observed that the health education intervention was more effective for maintaining the practice of physical activity in the period after intervention. We recommend the use of both interventions to promote physical activity in the Brazilian Unified Health System, according to the local reality of professionals, facilities, and team objectives.

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.

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

42 CFR 90.4 - Contents of requests for health assessments.

Science.gov (United States)

2010-10-01

... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE... assessment. (c) Each request for a health assessment should include, where possible: (1) Any other... 42 Public Health 1 2010-10-01 2010-10-01 false Contents of requests for health assessments. 90.4...

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

Non-ionizing radiations : physical characteristics, biological effects and health hazard assessment

International Nuclear Information System (INIS)

Repacholi, M.H.

1988-01-01

The Workshop was a project of the International Non-Ionizing Radiation Committee of IRPA and comprised a series of educational lectures and demonstrations intended to give a comprehensive overview of non-ionizing electromagnetic radiation: physical characteristics, sources of concern, levels of exposure, mechanisms of interaction and reported effects of these fields and radiations with biological tissues, human studies, health risk assessment, national and international standards and guidelines, and protective measures

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.

Mining in the Alligator Rivers Region, northern Australia: Assessing potential and actual effects on ecosystem and human health

International Nuclear Information System (INIS)

Dam, R.A. van; Humphrey, C.L.; Martin, P.

2002-01-01

This paper presents an overview of issues related to surface water contamination arising from uranium mining activities in the Alligator Rivers Region (ARR) of northern Australia, and a program of research and monitoring that must assess the potential and actual effects on ecosystem and human health. The program of assessing effects on aquatic ecosystems involves a four-tiered approach including the derivation of local water quality guideline trigger values, direct toxicity assessment of mine waters prior to their release, creekside or in situ monitoring for early warning of adverse effects during mine water release, and longer-term monitoring of macroinvertebrate and fish communities. Bioaccumulation in aquatic biota is also assessed, and is an issue of importance not only to ecosystem health, but also to the health of local Aboriginal people. The aquatic animals they consume represent potential sources of radiological dose, and as a result, a major component of the program to assess potential effects on human health is the prediction of doses to Aboriginal people living downstream of mining activities. Acknowledging the assumptions and uncertainties, the calculation of concentration factors for local aquatic (and other) food sources allows the prediction of potential radiological exposure to people following hypothetical mine water releases. The approaches described form the basis of best-practice protocols that are relevant at both regional and national levels

Assessing effectiveness of a community based health insurance in rural Burkina Faso

Directory of Open Access Journals (Sweden)

Hounton Sennen

2012-10-01

Full Text Available Abstract Background Financial barriers are a recognized major bottleneck of access and use of health services. The aim of this study was to assess effectiveness of a community based health insurance (CBHI scheme on utilization of health services as well as on mortality and morbidity. Methods Data were collected from April to December 2007 from the Nouna’s Demographic Surveillance System on overall mortality, utilization of health services, household characteristics, distance to health facilities, membership in the Nouna CBHI. We analyzed differentials in overall mortality and selected maternal health process measures between members and non-members of the insurance scheme. Results After adjusting for covariates there was no significant difference in overall mortality between households who could not have been members (because their area was yet to be covered by the stepped-wedged scheme, non-members but whose households could have been members (areas covered but not enrolled, and members of the insurance scheme. The risk of overall mortality increased significantly with distance to health facility (35% more outside Nouna town and with education level (37% lower when at least primary school education achieved in households. Conclusion There was no statistically significant difference in overall mortality between members and non-members. The enrolment rates remain low, with selection bias. It is important that community based health insurances, exemptions fees policy and national health insurances be evaluated on prevention of deaths and severe morbidities instead of on drop-out rates, selection bias, adverse selection and catastrophic payments for health care only. Effective social protection will require national health insurance.

Health technology assessment and comparative effectiveness research: a pharmaceutical industry perspective.

Science.gov (United States)

Hao, Yanni; Thomas, Adrian

2013-08-01

We briefly review the characteristics of several established health technology assessment (HTA) programs in industrialized societies including Germany, the UK and France. Special attention is paid on two issues: the position of HTA in coverage decision making and the role of economic assessment in evaluation processes. Although law makers in the USA have barred the use of NICE's cost/quality-adjusted life year or similar health economics approaches by public payers for coverage decision making, there are suggestions of prioritizing relative efficacy evaluation over economic assessment under a comparative effectiveness research (CER) framework to inform payment rates of public payers (an approach similar to German and French HTA processes). However, such an approach is unlikely to prove viable. It should also be noted that, if cost considerations are made explicit in US CER policy decisions, CER may become an unsustainable approach undermined by a conflicting emphasis on both cost containment and a demand for costly comparative evidence. On the other hand, properly designed CER initiatives can serve as a facilitator of more efficient research activities and drug development models. With these points in mind, the likely pathway of US CER is explored and the plausible impact on industry innovation is discussed.

Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana.

Science.gov (United States)

Rokicki, Slawa; Fink, Günther

2017-12-20

While mobile health (mHealth) programs are increasingly used to provide health information and deliver interventions, little is known regarding the relative reach and effectiveness of these programs across sociodemographic characteristics. We use data from a recent trial of a text-messaging intervention on adolescent sexual and reproductive health (SRH) to assess the degree to which mHealth programs reach target adolescent subpopulations who may be at higher risk of poor SRH outcomes. The study was conducted among girls aged 14-24 in 22 secondary schools in Accra, Ghana. The mHealth intervention was an interactive mobile phone quiz in which participants could win phone credit for texting correct answers to SRH questions. We use detailed data on individuals' level of engagement with the program, SRH knowledge scores, and self-reported pregnancy collected as part of the original trial to assess the extent to which engagement and program impact vary across parental education, sexual experience, SRH knowledge deficit, and parental support. Eighty-one percent of participants engaged with the mHealth program, with no evidence that the program disproportionally reached better-off groups. The program was effective at increasing knowledge of SRH across all strata. Higher levels of engagement were associated with higher knowledge scores up to year later. There was no significant impact of the program on self-reported pregnancy within subgroups. mHealth programs for adolescents have the potential to engage and increase SRH knowledge of adolescent girls across sociodemographic strata, including those who may be at higher risk of poor SRH outcomes. ClinicalTrials.gov NCT02031575 . Registered 07 Jan 2014.

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.

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

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.

Comparative Assessment of Health Workers Performance and The ...

African Journals Online (AJOL)

Comparative Assessment of Health Workers Performance and The Performance ... had very high significant effect on performance of health workers which was independent of ... Keywords: Health Worker Performance Factors Hospitals Nigeria ...

The Difference-in-Difference Method: Assessing the Selection Bias in the Effects of Neighborhood Environment on Health

Science.gov (United States)

Grafova, Irina; Freedman, Vicki; Lurie, Nicole; Kumar, Rizie; Rogowski, Jeannette

2013-01-01

This paper uses the difference-in-difference estimation approach to explore the self-selection bias in estimating the effect of neighborhood economic environment on self-assessed health among older adults. The results indicate that there is evidence of downward bias in the conventional estimates of the effect of neighborhood economic disadvantage on self-reported health, representing a lower bound of the true effect. PMID:23623818

Statistical assessment of the learning curves of health technologies.

Science.gov (United States)

Ramsay, C R; Grant, A M; Wallace, S A; Garthwaite, P H; Monk, A F; Russell, I T

2001-01-01

(1) To describe systematically studies that directly assessed the learning curve effect of health technologies. (2) Systematically to identify 'novel' statistical techniques applied to learning curve data in other fields, such as psychology and manufacturing. (3) To test these statistical techniques in data sets from studies of varying designs to assess health technologies in which learning curve effects are known to exist. METHODS - STUDY SELECTION (HEALTH TECHNOLOGY ASSESSMENT LITERATURE REVIEW): For a study to be included, it had to include a formal analysis of the learning curve of a health technology using a graphical, tabular or statistical technique. METHODS - STUDY SELECTION (NON-HEALTH TECHNOLOGY ASSESSMENT LITERATURE SEARCH): For a study to be included, it had to include a formal assessment of a learning curve using a statistical technique that had not been identified in the previous search. METHODS - DATA SOURCES: Six clinical and 16 non-clinical biomedical databases were searched. A limited amount of handsearching and scanning of reference lists was also undertaken. METHODS - DATA EXTRACTION (HEALTH TECHNOLOGY ASSESSMENT LITERATURE REVIEW): A number of study characteristics were abstracted from the papers such as study design, study size, number of operators and the statistical method used. METHODS - DATA EXTRACTION (NON-HEALTH TECHNOLOGY ASSESSMENT LITERATURE SEARCH): The new statistical techniques identified were categorised into four subgroups of increasing complexity: exploratory data analysis; simple series data analysis; complex data structure analysis, generic techniques. METHODS - TESTING OF STATISTICAL METHODS: Some of the statistical methods identified in the systematic searches for single (simple) operator series data and for multiple (complex) operator series data were illustrated and explored using three data sets. The first was a case series of 190 consecutive laparoscopic fundoplication procedures performed by a single surgeon; the second

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.

Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

International Nuclear Information System (INIS)

Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

2007-01-01

Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

Assessment of zero gravity effects on space worker health and safety

Science.gov (United States)

1980-01-01

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 references Solar Power Satellites (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 efficiency 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.

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)

Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year.

Science.gov (United States)

Artac, Macide; Dalton, Andrew R H; Majeed, Azeem; Car, Josip; Millett, Christopher

2013-08-01

We aimed to assess whether the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program, was associated with reduction in CVD risk in attendees after one year. We extracted data from patients aged 40-74 years, with high estimated CVD risk, who were registered with general practices in a deprived, culturally diverse setting in England. We included 4748 patients at baseline (July 2008-November 2009), with 3712 at follow-up (December 2009-March 2011). We used a pre-post study design to assess changes in global CVD risk, individual CVD risk factors and statin prescription in patients with a complete and partial Health Check. There were significant reductions in mean CVD risk score (28.2%; 95% confidence interval (CI)=27.3-29.1 to 26.2%; 95% CI, 25.4-27.1), diastolic blood pressure, total cholesterol levels and lipid ratios after one year in patients with a complete Health Check. Statin prescription increased from 14.0% (95% CI=11.9-16.0) to 60.6% (95% CI=57.7-63.5). The introduction of NHS Health Check was associated with significant but modest reductions in CVD risk among screened high-risk individuals. Further cost-effectiveness analysis and work accounting for uptake is required to assess whether the program can make significant changes to population health. Copyright © 2013 Elsevier Inc. All rights reserved.

Statistical Models to Assess the Health Effects and to Forecast Ground Level Ozone

Czech Academy of Sciences Publication Activity Database

Schlink, U.; Herbath, O.; Richter, M.; Dorling, S.; Nunnari, G.; Cawley, G.; Pelikán, Emil

2006-01-01

Roč. 21, č. 4 (2006), s. 547-558 ISSN 1364-8152 R&D Projects: GA AV ČR 1ET400300414 Institutional research plan: CEZ:AV0Z10300504 Keywords : statistical models * ground level ozone * health effects * logistic model * forecasting * prediction performance * neural network * generalised additive model * integrated assessment Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.992, year: 2006

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.

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.

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.

Directory of Open Access Journals (Sweden)

Henny Rydberg

Full Text Available 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.

Expanding Health Technology Assessments to Include Effects on the Environment.

Science.gov (United States)

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

2016-01-01

There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Agroecosystem health assessment in Mashhad

Directory of Open Access Journals (Sweden)

kazem vafabakhsh

2009-06-01

Full Text Available Agroecosystem Health investigating requires a holistic approach based on its biophysical, socio-economic and human community dimensions. In order to assess Agroecosystem Health in Mahhad, this research was conducted for the period of 1982 to 2002. The assessment necessitates the selection of indicators which represent various aspects of the agroecosystem. The purpose of this study was to establish a conceptual framework that facilitates the assessment of Agroecosyetem Health. The first step was to develop a set of indicators. Data on structural, functional, and organizational indicators were collected from official documents and statistics and also questionnaires. Results showed that from 1982 to 1997 Health Index (HI decreased and the lowest HI was in 1997 and after that trend of HI was improved. Sensitivity analysis showed that functional criteria had the highest correlation with HI. To improve the HI in short term, the most effective parameters would be functional indices such as chemicals, water use efficiency, soil degradation, machinery costs, and education indices. The index of people’s concern on environmental issues showed that 69% are concerned about the environment. This could be a good reason for the governmental and non-governmental organizations to focus on environmental health and try to improve the level of HI. The index of government’s financial support to agricultural section has decreased from 1982 to 1997.

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

: Tools for the Assessment of Ecosystem Health, 2009-2011), which is part of the Baltic Sea BONUS+ Programme funded jointly by national funding agencies and FP7 ERA-NET+ of the European Commission. The BEAST project consists of three workpackages (WP) with the following main tasks: WP1- Field studies...... and experiments in selected sub-regions of the Baltic Sea, WP2 - Application and validation of methods in monitoring and assessment in the Baltic Sea, and WP3 - Developing tools for ecosystem health assessment in the Baltic Sea. BEAST research activities are focused in the sub-regions of Gulf of Bothnia, Gulf...... 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...

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

Directory of Open Access Journals (Sweden)

Ssengooba Freddie

2009-10-01

Full Text Available Background: 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. Methods: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. Results: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 174−360 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. Conclusion: Although donor aid is significant there is need to invest in the prerequisites that would guarantee its effective use.

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.

Assessing catastrophic and impoverishing effects of health care payments in Uganda

OpenAIRE

Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E

2015-01-01

Background Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Methods Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined ...

A Unified Probabilistic Framework for Dose-Response Assessment of Human Health Effects.

Science.gov (United States)

Chiu, Weihsueh A; Slob, Wout

2015-12-01

When chemical health hazards have been identified, probabilistic dose-response assessment ("hazard characterization") quantifies uncertainty and/or variability in toxicity as a function of human exposure. Existing probabilistic approaches differ for different types of endpoints or modes-of-action, lacking a unifying framework. We developed a unified framework for probabilistic dose-response assessment. We established a framework based on four principles: a) individual and population dose responses are distinct; b) dose-response relationships for all (including quantal) endpoints can be recast as relating to an underlying continuous measure of response at the individual level; c) for effects relevant to humans, "effect metrics" can be specified to define "toxicologically equivalent" sizes for this underlying individual response; and d) dose-response assessment requires making adjustments and accounting for uncertainty and variability. We then derived a step-by-step probabilistic approach for dose-response assessment of animal toxicology data similar to how nonprobabilistic reference doses are derived, illustrating the approach with example non-cancer and cancer datasets. Probabilistically derived exposure limits are based on estimating a "target human dose" (HDMI), which requires risk management-informed choices for the magnitude (M) of individual effect being protected against, the remaining incidence (I) of individuals with effects ≥ M in the population, and the percent confidence. In the example datasets, probabilistically derived 90% confidence intervals for HDMI values span a 40- to 60-fold range, where I = 1% of the population experiences ≥ M = 1%-10% effect sizes. Although some implementation challenges remain, this unified probabilistic framework can provide substantially more complete and transparent characterization of chemical hazards and support better-informed risk management decisions.

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.

Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

Science.gov (United States)

Appleton, Jane V; Cowley, Sarah

2008-02-01

Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

Children's health, the nation's wealth: assessing and improving child health

National Research Council Canada - National Science Library

Committee on Evaluation of Children's Health, National Research Council

2004-01-01

... in the effects of environmental contaminants such as lead. Yet major questions still remain about how to assess the status of children's health, what factors should be monitored, and the appropriate measurement tools that should be...

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...

Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage.

Science.gov (United States)

Phuong, Nguyen Khanh; Oanh, Tran Thi Mai; Phuong, Hoang Thi; Tien, Tran Van; Cashin, Cheryl

2015-01-01

Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.

The consideration of health in strategic environmental assessment (SEA)

International Nuclear Information System (INIS)

Fischer, Thomas B; Matuzzi, Marco; Nowacki, Julia

2010-01-01

Following the requirements of the European Directive 2001/42/EC on strategic environmental assessment (SEA) and the Protocol on Strategic Environmental Assessment (Kiev, 2003) to the Convention on Environmental Impact Assessment in a Transboundary Context (Espoo, 1991), health is one of the aspects to be considered in SEA. In this paper, results of an evaluation of eight SEAs from Austria, the Czech Republic, Germany, the Netherlands and the United Kingdom (England and Wales) regarding the consideration of health are presented. This includes SEAs for five spatial plans, as well as one SEA for each, a transport, a waste management and an economic development plan. It is found that while all SEAs cover important physical and natural aspects that are related to health, social and behavioural aspects are considered to a much smaller extent. Based on the results, facilitating factors and barriers for health inclusive SEA are identified. Overall, good baseline data can be seen as an important starting point for effective health inclusive SEA, while an effective monitoring system is crucial for effective implementation of the measures and recommendations brought forward in health inclusive SEA. Crucially, health authorities/health experts need to engage more with SEA, as this provides a key platform for cross sectoral dialogue on a range of issues. SEA presents the health sector with an opportunity to influence the policy and decision-making process to improve people's health and well-being.

Low-frequency fields - health risk assessment

International Nuclear Information System (INIS)

Bernhardt, J.

1993-01-01

The author briefly reviews the biological actions and effects of low-frequency fields, epidemiological studies and discusses health risks in detail. He describes the assessment principles of the International Commission on Non-ionizing Radiation Protection (ICNIRP), medical principles for risk assessment, determination of limits and thesholds, and aspects of prevention. This is supplemented to by several fables and literature list. (Uhe) [de

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

Directory of Open Access Journals (Sweden)

Shankar Prinja

2016-05-01

Full Text Available Background: 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. Methods/design: 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. Conclusions: The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child

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

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)

Air pollution epidemiology. Assessment of health effects and risks

Energy Technology Data Exchange (ETDEWEB)

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

1996-12-31

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)

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…

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).

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

International Nuclear Information System (INIS)

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

Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review.

Science.gov (United States)

Sondaal, Stephanie Felicie Victoria; Browne, Joyce Linda; Amoakoh-Coleman, Mary; Borgstein, Alexander; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Klipstein-Grobusch, Kerstin

2016-01-01

Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth and postnatal period in LMIC. The review was registered with Prospero (CRD42014010292). Six databases were searched from June 2014-April 2015, accompanied by grey literature search using pre-defined search terms linked to pregnant women in LMIC and mHealth. Quality of articles was assessed with an adapted Cochrane Risk of Bias Tool. Because of heterogeneity in outcomes, settings and study designs a narrative synthesis of quantitative results of intervention studies on maternal outcomes, neonatal outcomes, service utilization, and healthy pregnancy education was conducted. Qualitative and quantitative results were synthesized with a strengths, weaknesses, opportunities, and threats analysis. In total, 3777 articles were found, of which 27 studies were included: twelve intervention studies and fifteen descriptive studies. mHealth interventions targeted at pregnant women increased maternal and neonatal service utilization shown through increased antenatal care attendance, facility-service utilization, skilled attendance at birth, and vaccination rates. Few articles assessed the effect on maternal or neonatal health outcomes, with inconsistent results. mHealth interventions may be effective solutions to improve maternal and neonatal service utilization. Further studies assessing mHealth's impact on maternal and neonatal outcomes are recommended. The emerging trend of strong experimental research designs with randomized controlled trials, combined with feasibility research, government involvement

Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review.

Directory of Open Access Journals (Sweden)

Stephanie Felicie Victoria Sondaal

Full Text Available Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC. Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth and postnatal period in LMIC.The review was registered with Prospero (CRD42014010292. Six databases were searched from June 2014-April 2015, accompanied by grey literature search using pre-defined search terms linked to pregnant women in LMIC and mHealth. Quality of articles was assessed with an adapted Cochrane Risk of Bias Tool. Because of heterogeneity in outcomes, settings and study designs a narrative synthesis of quantitative results of intervention studies on maternal outcomes, neonatal outcomes, service utilization, and healthy pregnancy education was conducted. Qualitative and quantitative results were synthesized with a strengths, weaknesses, opportunities, and threats analysis.In total, 3777 articles were found, of which 27 studies were included: twelve intervention studies and fifteen descriptive studies. mHealth interventions targeted at pregnant women increased maternal and neonatal service utilization shown through increased antenatal care attendance, facility-service utilization, skilled attendance at birth, and vaccination rates. Few articles assessed the effect on maternal or neonatal health outcomes, with inconsistent results.mHealth interventions may be effective solutions to improve maternal and neonatal service utilization. Further studies assessing mHealth's impact on maternal and neonatal outcomes are recommended. The emerging trend of strong experimental research designs with randomized controlled trials, combined with feasibility research

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

NARCIS (Netherlands)

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

2014-01-01

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

What is Health Impact Assessment?

Directory of Open Access Journals (Sweden)

Ahmet Soysal

2010-12-01

Full Text Available Health Impact Assessment (HIA was disseminated by World Health Organization (WHO European Region in Gothenburg consensus paper in 1999. In this consensus, HIA is defined as ‘a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of population and the distribution of those effects within the population’. HIA was accepted as a goal for 4th phase of healthy city projects between 2003- 2008. HIA is a new process for our country and especially municipal boroughs, local authorities interest with it. There is no legal base for HIA in our country. EIA practices conducted since 1993 showed us that, environmental and public health was postponed. Functional and decisive implementation of HAI depends on legal basis and national acceptance. If legal basis is supplied, society must take care about it, work for strict application and have to put a crimp in going back. [TAF Prev Med Bull 2010; 9(6.000: 689-694

Assessing the Health Effects of Blast Injuries and Embedded Metal Fragments

Science.gov (United States)

2017-10-01

dissolution tests. Health Physics , 1999, 77: 638-645, PMID 10568542. 618 619 23. Issacson, L.C. Urinary ionic strength, osmolality, and specific... physical health , in the last 4 weeks, have you…. Study ID: ________________ For use in HRPO Log No. A-19735.2 (McDiarmid- "Assessing the...of the time None of the time 52. During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with

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.

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

International Nuclear Information System (INIS)

Popescu, I.A.; Lacob, O.; Roman, I.; Havarneanu, D.

2006-01-01

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

The impact and effectiveness of health impact assessment: A conceptual framework

International Nuclear Information System (INIS)

Harris-Roxas, Ben; Harris, Elizabeth

2013-01-01

The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project and (iii) an in-depth study of seven completed HIAs. The framework emphasises context, process and impacts as key domains in understanding and evaluating the effectiveness of an HIA. This new framework builds upon the existing approaches to evaluating HIA and extends them to reflect the broad range of factors that comprise and influence the effectiveness of HIAs. It may be of use in evaluating completed HIAs and in planning HIAs that are yet to be undertaken. -- Highlights: ► The first empirically-derived conceptual framework for evaluating HIA ► It may also be useful for planning and reporting on HIAs. ► The framework emphasises context, process and impacts as key domains. ► A broad range of factors influence the effectiveness of HIAs

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

Assessment of National Health Insurance Scheme's (NHIS) Effectiveness in a Tertiary Teaching Hospital in Southeast Nigeria

OpenAIRE

N. Ele Grace; O. Ogbonna Brian; M. Ochei Uche; U. Odili Valentine

2017-01-01

Background: The fundamental concept of health insurance is risk sharing and burden bearing. The scheme is undermined by limitations ranging from very frequent use of the services more than necessary by enrollees, to cost escalation, poor management, and skimming. Assessment of services is a quality control measure in patients’ care and service delivery. It helps to identify gaps for improvement of care and services. Objective: This study assessed the effectiveness of NHIS from the perspec...

Stochastic health effects assessment due to short-term external exposure

International Nuclear Information System (INIS)

Raicevic, J.J.; Raskob, W.; Merkle, M.; Ninkovic, M.M.

2001-01-01

The new model for calculation of stochastic health effects is presented in this paper. The exposure pathways which are briefly considered are the short-term external exposure due to passage of the radioactive cloud (cloudshine) and the short-term external exposure due to radioactive material deposited on skin and clothes (skin contamination). The quantitative assessment of stochastic effects is expressed in numbers of deaths, which are given as a functions of the time at the accident, and age at death, what on the other side enables estimation of the number of deaths within the specified range of the time/age parameters. That means the model calculates the number of deaths within one particular year, summed up over all ages at deaths, or vice versa, it finds the number of deaths within the specified range of ages at death, summed up over all observation times. Results presented in this paper are implemented in the module LATEHEAL, which is incorporated in RODOS, a new European system for decision support for nuclear emergencies. (author)

Assessment of the effects of the zero gravity environment on the health and safety of space workers

Science.gov (United States)

1980-01-01

A review was conducted of currently available information relating to adverse effects to the health and safety that space power system (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 were 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 physiological health of space workers so long as proper preventive or ameliorating action were taken.

Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

Science.gov (United States)

Bhatia, Rajiv; Wernham, Aaron

2008-08-01

The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

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

Directory of Open Access Journals (Sweden)

Ryall T

2016-02-01

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

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

Science.gov (United States)

Ryall, Tayne; Judd, Belinda K; Gordon, Christopher J

2016-01-01

The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education. A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (Medline), and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included. A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the research papers included small participant numbers, poor methodological quality, and predominance of studies from medicine, which preclude any definite conclusions. Simulation has now been embedded across a range of health professional education and it appears that simulation

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.

Future of health technology assessment studies in gene and cell ...

African Journals Online (AJOL)

However, as should be noted, health care decisions need to be based on Health Technology Assessments (HTA) that should be based on objective criteria as efficacy, effectiveness, quality, safety, psychological, social, ethical, organisational and professional implications as well as cost effectiveness and further macro ...

Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth.

Science.gov (United States)

Jalaluddin, Md; Goyal, Vinod; Naqvi, Zuber A; Gupta, Bhaskar; Asnani, Mohil M; Sonigra, Hitesh M

2017-07-01

Intorduction: Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodonti-cally restored tooth. The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Orthodontic treatment can be safely carried in patients with endodontically restored teeth.

Assessing Your Weight and Health Risk

Science.gov (United States)

... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

Preventive effectiveness of pre-employment medical assessments

NARCIS (Netherlands)

de Kort, W.; van Dijk, F.

1997-01-01

Health gain, prevention of health loss, and avoidance of financial risk all seem to be driving forces for the use of pre-employment medical assessment. An attempt is made to measure the effect of implementing the pre-employment medical assessment on these end points. The anticipated maximum

Physiological Basis for Prompt Health Effects

International Nuclear Information System (INIS)

VINCENT, Andrew

2006-01-01

As input to design considerations precluding worker radiological exposure that could lead to an acute health effect from a postulated accident condition, an assessment of the short term health effects was performed. To assure that the impact of the accident scenario on the individual is appropriately considered, both external and internal exposures are included in the evaluation. The focus of this evaluation was to develop a quantitative basis from which to consider the level of exposure postulated in an accident that could lead to a defined physiological impact for short term health effects. This paper does not assess latent health effects of radiological exposure associated with normal operations or emergency response guidelines as these are clearly articulated in existing regulations and ICRP documents. The intent of this paper is to facilitate a dialogue on the appropriate meaning of currently undefined terms such as ''significant'' exposure and ''high-hazard material'' in DSA development

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.

Effects of Yoga on Measures of Health-related Quality of Life from SF-36 and SF-12 Assessments: A Systematic Review and Meta-analysis

Directory of Open Access Journals (Sweden)

Gabriel Benavidez

2017-12-01

Full Text Available Objectives Yoga is commonly being adopted and prescribed with the intent to increase a participant’s health-related quality of life. In practice, the current gold-standard health-related quality of life measurement tool is the SF-36 and SF-12 assessments. Therefore, it is important for yoga scientists and practitioners to understand yoga’s effects on health-related quality of life when in fact a gold-standard assessment is implemented. The purpose of this study was to employ systematic review and meta-analytic techniques to examine the effect of yoga on measures of health-related quality of life measured using only the SF-36/12 assessments. Methods A current (January 2007 to December 2016 systematic review of the Pubmed database was conducted and included studies that used yoga as an intervention with outcomes measures of health-related quality of life measured by the SF-36/12. Ten different measures were extracted from studies including eight dimension scores (physical functioning, bodily pain, physical role function, general health, mental health, emotional role function, social function, and vitality and two summary scores (physical component and mental component. Ten different meta-analyses were performed using calculated standardized mean effect sizes and random effects models. Both moderator and sensitivity analyses were conducted. Results A total of 34 studies were included is the analyses with 185 independent effect sizes. Yoga intervention showed a significant positive effect on all ten measures of the SF-36/12. Effects ranged from 0.56 (0.39-0.73 to 0.28 (0.17-0.40. Yoga type (Hatha, Iyengar, Other moderated the effects of yoga intervention on the mental component (p=.021, with Hatha yielding the greatest effects (ES=1.63, 0.61-2.65. The sensitivity analysis showed little to no bias in mean effect size estimates. Conclusions The meta-analytic evidence clearly supports the small-to-medium positive effects of yoga on health

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

OpenAIRE

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

2016-01-01

Background: 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.Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for as...

Health effects

International Nuclear Information System (INIS)

Mahieu, L.

1998-01-01

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

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.

Health Effects of Chronic Arsenic Exposure

Directory of Open Access Journals (Sweden)

Young-Seoub Hong

2014-09-01

Full Text Available 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.

Assessment of Chronic Sublethal Effects of Imidacloprid on Honey Bee Colony Health

Science.gov (United States)

Dively, Galen P.; Embrey, Michael S.; Kamel, Alaa; Hawthorne, David J.; Pettis, Jeffery S.

2015-01-01

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. PMID:25786127

Statistical health-effects study

International Nuclear Information System (INIS)

Gilbert, E.S.

1982-01-01

The main purpose of this program is to analyze the mortality of Hanford workers and to determine the effects of radiation exposure in this population. A secondary purpose is to improve methodology for assessing health effects of chronic low-level exposure to harmful agents or substances, particularly in an occupational setting. In the past year we have updated our analyses, submitted papers for publication in the two areas of methodological research, and have interacted with Hanford Environmental Health Foundation staff to improve data collection procedures

Health risk assessment of exposure to ionizing radiation

International Nuclear Information System (INIS)

Ogata, Hiromitsu

2011-01-01

Risk assessment is an essential process for evaluating the human health effects of exposure to ionizing radiation and for determining acceptable levels of exposure. There are two major components of radiation risk assessment: a measure of exposure level and a measure of disease occurrence. For quantitative estimation of health risks, it is important to evaluate the association between exposure and disease occurrence using epidemiological or experimental data. In these approaches, statistical risk models are used particularly for estimating cancer risks related to exposure to low levels of radiation. This paper presents a summary of basic models and methods of risk assessment for studying exposure-risk relationships. Moreover, quantitative risk estimates are subject to several sources of uncertainty due to inherent limitations in risk assessment studies. This paper also discusses the limitations of radiation risk assessment. (author)

Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review

OpenAIRE

Sondaal, Stephanie Felicie Victoria; Browne, Joyce Linda; Amoakoh-Coleman, Mary; Borgstein, Alexander; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Klipstein-Grobusch, Kerstin

2016-01-01

INTRODUCTION: Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth a...

Assessment on health and energy sources

International Nuclear Information System (INIS)

Acket, C.; Yvon, M.

2013-01-01

After having recalled some issues related to the prevention of environmental health risks and mentioned in the preparation of the debate on energy transition in France, this document gathers actual objective elements for an assessment of health impact of the different energy sources. It discusses the impacts on health (mortality, sicknesses and diseases) of fossil fuels (coal and its wastes, gas), of renewable energies, of nuclear energy. For this last one, the document outlines the lack of documentation for various topics, discusses some results published on the dose impact of nuclear operation, and comment the issue of waste storage. It also recalls the main accidents (Three Mile Island, Chernobyl, and Fukushima) and some of the known and assessed impacts. The third part proposes comparisons between the different energy sources in terms of deadly accidents, of pollution and greenhouse effect (current and late mortality), of released radioactivity (release sources and collective dose). In conclusion, the authors outline that the impact on health of environmental risks must be one of the essential issues for the definition of energy policy, and discuss the resulting implications. Various data are provided in appendix: energy in France and in the world, origins of radioactivity

Assessing elders using the functional health pattern assessment model.

Science.gov (United States)

Beyea, S; Matzo, M

1989-01-01

The impact of older Americans on the health care system requires we increase our students' awareness of their unique needs. The authors discuss strategies to develop skills using Gordon's Functional Health Patterns Assessment for assessing older clients.

Expanding Health Technology Assessments to Include Effects on the Environment

DEFF Research Database (Denmark)

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

2016-01-01

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......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...... and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some...

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…

Assessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review

Science.gov (United States)

Kokabisaghi, Fatemeh

2018-01-01

Background: Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community’s uncertainty about peaceful purpose of Iran’s nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. Methods: To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran’s government and UN’ health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians’ right to health were extracted. Results: The sanctions on Iran caused a fall of country�

Practical consequences of the assessment of different energy health risks

International Nuclear Information System (INIS)

Hamilton, L.D.

1984-01-01

Public authorities must make decisions about energy, and the risks of alternative strategies need to be calculated including health and environmental costs. Information from various sources must be organized into a logical framework for comparing impacts. This must include the widest practicable range of health and environmental damage - public health impact of pollution, role of accidents, disease and hazardous materials in the workplace, and odds for catastrophes. It must put each part of the energy cycle into perspective - giving particular attention to uncertainties in knowledge - to convey what is known, what is uncertain, and the importance of each factor in the overall picture. This paper gives examples of the use of health-impact assessment by decision-makers: (1) comparative risk assessment of the health effects of coal and nuclear fuel cycles used in nuclear power plant siting and licensing hearings, and (2) health risks of acid deposition and other air-transported pollutants, carried out as part of an assessment for the U.S. Congress Office of Technology Assessment. (author)

Medical assessment of the health effects of short leisure trips.

Science.gov (United States)

Toda, Masahiro; Makino, Hiroaki; Kobayashi, Hidetoshi; Nagasawa, Shingo; Kitamura, Kazuyuki; Morimoto, Kanehisa

2004-12-01

Using responses to questionnaires and results of saliva samples from 40 women, the authors assessed the effects on health of participation in a short leisure trip (2 nights, 3 d) to Kyushu Island in Japan. They addressed transportation, sightseeing, and group activities during the tour, which might differ from participants' usual activities. Levels of the salivary endocrinological stress markers cortisol and chromogranin A (CgA) were determined by enzyme-linked immunosorbent assay (ELISA). In each of the groups with characteristics considered healthy and related to lifestyle, patterns of behavior, perceived stressors, and stress reactions, a decrease in the cortisol levels and an increase in the CgA levels were apparent during the tour. The baseline for stress hormone changes was the levels on awakening on Day 1 (i.e., immediately before the tour). These findings suggest that even short periods of travel can bring about a reduction in di-stress and acquisition of eu-stress, experienced as feeling uplifted or fulfilled.

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.

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.

Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India.

Science.gov (United States)

Downey, Laura E; Mehndiratta, Abha; Grover, Ashoo; Gauba, Vijay; Sheikh, Kabir; Prinja, Shankar; Singh, Ravinder; Cluzeau, Francoise A; Dabak, Saudamini; Teerawattananon, Yot; Kumar, Sanjiv; Swaminathan, Soumya

2017-01-01

India is at crossroads with a commitment by the government to universal health coverage (UHC), driving efficiency and tackling waste across the public healthcare sector. Health technology assessment (HTA) is an important policy reform that can assist policy-makers to tackle inequities and inefficiencies by improving the way in which health resources are allocated towards cost-effective, appropriate and feasible interventions. The equitable and efficient distribution of health budget resources, as well as timely uptake of good value technologies, are critical to strengthen the Indian healthcare system. The government of India is set to establish a Medical Technology Assessment Board to evaluate existing and new health technologies in India, assist choices between comparable technologies for adoption by the healthcare system and improve the way in which priorities for health are set. This initiative aims to introduce a more transparent, inclusive, fair and evidence-based process by which decisions regarding the allocation of health resources are made in India towards the ultimate goal of UHC. In this analysis article, we report on plans and progress of the government of India for the institutionalisation of HTA in the country. Where India is home to one-sixth of the global population, improving the health services that the population receives will have a resounding impact not only for India but also for global health.

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...

Health impact assessment of the Atlanta BeltLine.

Science.gov (United States)

Ross, Catherine L; Leone de Nie, Karen; Dannenberg, Andrew L; Beck, Laurie F; Marcus, Michelle J; Barringer, Jason

2012-03-01

Although a health impact assessment (HIA) is a tool that can provide decision makers with recommendations to promote positive health impacts and mitigate adverse health impacts of proposed projects and policies, it is not routinely conducted on most major projects or policies. To make health a decision criterion for the Atlanta BeltLine, a multibillion-dollar transit, trails, parks, and redevelopment project. An HIA was conducted in 2005-2007 to anticipate and influence the BeltLine's effect on health determinants. Changes in access and equity, environmental quality, safety, social capital, and physical activity were forecast, and steps to maximize health benefits and reduce negative effects were recommended. Key recommendations included giving priority to the construction of trails and greenspace rather than residential and retail construction, making health an explicit goal in project priority setting, adding a public health professional to decision-making boards, increasing the connectivity between the BeltLine and civic spaces, and ensuring that affordable housing is built. BeltLine project decision makers have incorporated most of the HIA recommendations into the planning process. The HIA was cited in the awarding of additional funds of $7,000,000 for brownfield clean-up and greenspace development. The project is expected to promote the health of local residents more than in the absence of the HIA. This report is one of the first HIAs to tie specific assessment findings to specific recommendations and to identifiable impacts from those recommendations. The lessons learned from this project may help others engaged in similar efforts. Copyright © 2012. Published by Elsevier Inc.

Assessment of Effective Coverage of Voluntary Counseling and ...

African Journals Online (AJOL)

Assessment of Effective Coverage of Voluntary Counseling and Testing ... The objective of this study was to assess effective coverage level for Voluntary Counseling and testing services in major health facilities ... AJOL African Journals Online.

Health technology assessment in Saudi Arabia.

Science.gov (United States)

Al-Aqeel, Sinaa

2018-05-16

The Saudi government, similar to any other government, is committed to making public spending more efficient, using resources more effectively, and limiting waste. Health technology assessment (HTA) is a tool that informs policy and decision makers regarding the formulation of safe and effective policies that are patient-focused and help to achieve efficiency when allocating limited health-care resources. Areas covered: After a brief description of HTA in the international context, this review provides a brief introduction to Saudi Arabia's health-care system, followed by a delineation of the decision maker(s) and influencers and the decision-making process for pricing and reimbursement. The article then discusses the current status of HTA in Saudi Arabia and proposes four strategic objectives that can form the first step in the development of a formal HTA process. Expert commentary: In Saudi Arabia, facilitators for incorporating HTA into the decision-making process exist. Future local research is needed to guide the implementation of full HTA.

Health workforce in India: assessment of availability, production and distribution.

Science.gov (United States)

Hazarika, Indrajit

2013-01-01

India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, this shortfall impedes progress towards achievement of the Millennium Development Goals. The aim of this study was to assess health-workforce distribution, identify inequalities in health-worker provision and estimate the impact of this maldistribution on key health outcomes in India. Health-workforce availability and production were assessed by use of year-end data for 2009 obtained from the Indian Ministry of Statistics and Programme Implementation. Inequalities in the distribution of doctors, dentists, nurses and midwives were estimated by use of the Gini coefficient and the relation between health-worker density and selected health outcomes was assessed by linear regression. Inequalities in the availability of health workers exist in India. Certain states are experiencing an acute shortage of health personnel. Inequalities in the distribution of health workers are highest for doctors and dentists and have a significant effect on health outcomes. Although the production of health workers has expanded greatly in recent years, the problems of imbalances in their distribution persist. As India seeks to achieve universal health coverage by 2020, the realization of this goal remains challenged by the current lack of availability and inequitable distribution of appropriately trained, motivated and supported health workers.

Relocation: Its Effect on Health, Functioning and Mortality.

Science.gov (United States)

Borup, Jerry H.; And Others

1980-01-01

Relocation of older patients had a positive effect on hypochondria, stamina, hygiene, and daily functioning but no effect on health status. Self-health assessments, stamina, hypochondria, and hygiene had no effect on the mortality rate of relocated patients, but daily functioning did effect the mortality rate. (Author)

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.

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

The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications

Directory of Open Access Journals (Sweden)

Fries James F

2003-06-01

Full Text Available Abstract The ability to effectively measure health-related quality-of-life longitudinally is central to describing the impacts of disease, treatment, or other insults, including normal aging, upon the patient. Over the last two decades, assessment of patient health status has undergone a dramatic paradigm shift, evolving from a predominant reliance on biochemical and physical measurements, such as erythrocyte sedimentation rate, lipid profiles, or radiographs, to an emphasis upon health outcomes based on the patient's personal appreciation of their illness. The Health Assessment Questionnaire (HAQ, published in 1980, was among the first instruments based on generic, patient-centered dimensions. The HAQ was designed to represent a model of patient-oriented outcome assessment and has played a major role in many diverse areas such as prediction of successful aging, inversion of the therapeutic pyramid in rheumatoid arthritis (RA, quantification of NSAID gastropathy, development of risk factor models for osteoarthrosis, and examination of mortality risks in RA. Evidenced by its use over the past two decades in diverse settings, the HAQ has established itself as a valuable, effective, and sensitive tool for measurement of health status. It is available in more than 60 languages and is supported by a bibliography of more than 500 references. It has increased the credibility and use of validated self-report measurement techniques as a quantifiable set of hard data endpoints and has contributed to a new appreciation of outcome assessment. In this article, information regarding the HAQ's development, content, dissemination and reference sources for its uses, translations, and validations are provided.

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. ©Leming Zhou, Jie Bao, Bambang Parmanto. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.08.2017.

Health Impact Assessment Practice and Potential for Integration within Environmental Impact and Strategic Environmental Assessments in Italy

Science.gov (United States)

Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

2014-01-01

Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest. PMID:25493391

Assessment of time management attitudes among health managers.

Science.gov (United States)

Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

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.

The assessment of health effect of Yonggwang site using the MACCS code

International Nuclear Information System (INIS)

Jeong, Dognhan Yu; Kim, Seiung Hwan; Han, Byoung Sub; Song, Jong Soon

1996-12-01

The health effect assessment near the Yonggwang site by using IPE results and its site data was performed. The health effect assessment is an important part of consequence analysis of a nuclear power plant site. The MACCS code developed by SNL was used in the assessment. The necessary input data are source term data, meteorological data, population data, and detailed information about the release of radionuclides. The core inventory data for end-of-cycle are calculated by ORIGEN2 code for conservatism because fission product buildup is greatest at end-of-cycle conditions. Meteorological and population data was derived from the FSAR and environmental impact statement report, and source term release data was derived from the IPE report. by using the MACCS code, the CCDF is obtained as a result and economic impact analysis is also possible. First of all, the average value of early fatality was estimated by changing the initial value of random numbers. The average value obtained from 10 trials is in the rage between 10 -4 and 10 -3 and have a log-uniform distribution. More than 10 data are necessary in order to have a meaningful value statistically. And the calculations about early fatality, early injury, risks of early fatality, population dose within 16.0km, population risk for early fatality within 8.0km are performed. In all cases, STC-3 is the dominant contributor (about 70%), and STC-14 is the next important contributor. Therefore, in case of consequence analysis resulting from internal events, the analysis based on STC-3 which is the failure of early containment isolation is very important. Based on the calculation of CCDF for each risk measure, it is shown that CCDF has a slow slope and thus wide probability distribution in cases of early fatality, early injury, total early fatality risk, and total weighted early fatality risk, And in cases of cancer fatality and population dose within 48 km and 80km, the CCDF curve have a steep slope and thus narrow

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).

Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China.

Science.gov (United States)

Tai, Bao-Jun; Jiang, Han; Du, Min-Quan; Peng, Bin

2009-10-01

To assess the outcome of oral health promotion in schoolchildren over a 3-year period in Yichang City, Hubei, China. In a cluster randomized controlled trial, the concept of the World Health Organization Health Promoting Schools Project was applied to primary schoolchildren. Seven intervention schools and eight control schools were randomly selected from one district by stratified cluster sampling. The study was conducted as a 3-year follow-up study. After 3 years, 661 children remained in the intervention group and 697 children in the control group. Data on dental caries, plaque accumulation, and sulcus bleeding were collected by clinical examination, while behavioural data were gathered by self-administered questionnaires. The 3-year net mean DMFS increment score was 0.22 in the intervention schools and 0.35 in the control schools (P schools adopted regular oral health behavioural practices such as brushing their teeth at least twice a day, visiting the dentist within the past calendar year, and using fluoride toothpaste. The study suggests that the school-based oral health promotion was an effective way to reduce new caries incidence, improve oral hygiene and establish positive oral health behavioural practices in the targeted schoolchildren.

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.

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

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).

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…

Health impact assessment in Korea

International Nuclear Information System (INIS)

Kang, Eunjeong; Lee, Youngsoo; Harris, Patrick; Koh, Kwangwook; Kim, Keonyeop

2011-01-01

Recently, Health Impact Assessment has gained great attention in Korea. First, the Ministry of Environment introduced HIA within existing Environment Impact Assessment. Second, the Korea Institute for Health and Social Affairs began an HIA program in 2008 in alliance with Healthy Cities. In this short report, these two different efforts are introduced and their opportunities and challenges discussed. We believe these two approaches complement each other and both need to be strengthened. We also believe that both can contribute to the development of health in policy and project development and ultimately to improvements in the Korean population's health.

Assessment of the Effects of Economic Sanctions on Iranians' Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review.

Science.gov (United States)

Kokabisaghi, Fatemeh

2018-01-20

Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community's uncertainty about peaceful purpose of Iran's nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran's government and UN' health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians' right to health were extracted. The sanctions on Iran caused a fall of country's revenues, devaluation of national currency, and

History of health technology assessment in Belgium.

Science.gov (United States)

Cleemput, Irina; Van Wilder, Philippe

2009-07-01

This paper gives an overview of health technology assessment (HTA) in Belgium. The information included in the overview is based on legal documents and publicly available year reports of the Belgian Health Care Knowledge Centre (KCE). Belgium has a relatively young history in HTA. The principle of evidence-based medicine (EBM) was introduced in the drug reimbursement procedure in 2001, with the establishment of the Drug Reimbursement Committee (DRC). The DRC assesses the efficacy, safety, convenience, applicability, and effectiveness of a drug relative to existing treatment alternatives. For some drugs, relative cost-effectiveness is also evaluated. The activities of the DRC can, therefore, be considered to be the first official HTA activities in Belgium. Later, in 2003, KCE was established. Its mission was to perform policy preparing research in the healthcare and health insurance sector and to give advice to policy makers about how they can obtain an efficient allocation of limited healthcare resources that optimizes the quality and accessibility of health care. This broad mission has been operationalized by activities in three domains of research: HTA, health services research, and good clinical practice. KCE is independent from the policy maker. Its HTAs contain policy recommendations that may inform policy decisions but are not binding. Although the Belgian history of HTA is relatively short, its foundations are strong and the impact of HTA increasing. Nevertheless KCE has many challenges for the future, including continued quality assurance, further development of international collaboration, and further development of methodological guidance for HTA.

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.

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

42 CFR 90.7 - Decision to conduct health effects study.

Science.gov (United States)

2010-10-01

... occurred, and any possible health effects resulting from such exposure. (b) Should ATSDR decide, in its... 42 Public Health 1 2010-10-01 2010-10-01 false Decision to conduct health effects study. 90.7... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE...

Effect of feeding biotin on milk production and hoof health in lactating dairy cows: a quantitative assessment.

Science.gov (United States)

Lean, I J; Rabiee, A R

2011-03-01

Objectives of this study were to critically review randomized controlled trials, evaluate the effectiveness of supplementation with biotin on milk yield and composition and hoof health in lactating dairy cows, explore sources of heterogeneity among studies, and evaluate publication bias. Quantitative assessments can increase the statistical power with which we study the effect of treatments, such as biotin, on outcomes. A total of 9 papers, with 6 production and 3 hoof health studies, met the eligibility criteria for meta-analysis. Eight studies evaluated various hoof lesions in biotin-supplemented cows that did not meet the inclusion criteria. Eleven comparisons were made of milk production responses to biotin treatment. Data extracted included the number of cows in control and treatment groups, measures of variance of responses (standard error or standard deviation) and P-values. Other data obtained included the duration of treatment before and after calving, parity, breed of cow, type and dose of biotin, delivery method of supplementation, and types of diets. Biotin increased milk production by 1.29 kg per head per day (95% confidence interval=0.35 to 2.18 kg) with no evidence of heterogeneity (I(2)=0.0%). Treatment did not affect milk fat or protein percentages, and a trend to increase fat and protein yields was observed. Milk production and composition results were not influenced by duration of treatment before calving, parity, or diet type. Assessment of biotin supplementation on hoof health indicated that more studies had improved rather than negative or neutral outcomes. The effect of biotin treatment on milk production was relatively large and the effects on fat and protein yields, although not significant, were consistent in direction and magnitude with the milk response. The hoof health responses to biotin should encourage further studies to more effectively define the nature of these responses using consistent criteria for examination of hoof conditions

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.

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.

Conceptualisation and development of the Conversational Health Literacy Assessment Tool (CHAT).

Science.gov (United States)

O'Hara, Jonathan; Hawkins, Melanie; Batterham, Roy; Dodson, Sarity; Osborne, Richard H; Beauchamp, Alison

2018-03-22

The aim of this study was to develop a tool to support health workers' ability to identify patients' multidimensional health literacy strengths and challenges. The tool was intended to be suitable for administration in healthcare settings where health workers must identify health literacy priorities as the basis for person-centred care. Development was based on a qualitative co-design process that used the Health Literacy Questionnaire (HLQ) as a framework to generate questions. Health workers were recruited to participate in an online consultation, a workshop, and two rounds of pilot testing. Participating health workers identified and refined ten questions that target five areas of assessment: supportive professional relationships, supportive personal relationships, health information access and comprehension, current health behaviours, and health promotion barriers and support. Preliminary evidence suggests that application of the Conversational Health Literacy Assessment Tool (CHAT) can support health workers to better understand the health literacy challenges and supportive resources of their patients. As an integrated clinical process, the CHAT can supplement existing intake and assessment procedures across healthcare settings to give insight into patients' circumstances so that decisions about care can be tailored to be more appropriate and effective.

Randomised studies of income supplementation: a lost opportunity to assess health outcomes.

Science.gov (United States)

Connor, J; Rodgers, A; Priest, P

1999-11-01

Despite the wealth of evidence linking low income to ill health, there is little information from randomised studies on how much and how quickly these risks can be reversed by improvements in income. To conduct a systematic review of randomised studies of income supplementation, with particular reference to health outcomes. Extensive searches of electronic databases and contact with previous authors. As well as searching for trials that were specifically designed to assess the effects of increased income, studies of winners and losers of lotteries were also sought: if winning is purely chance, such studies are, in effect, randomised trials of increased income. Ten relevant studies were identified, all conducted in North America, mostly in the late 1960s and 1970s. Five trials were designed to assess the effects of income supplementation on workforce participation and randomised a total of 10,000 families to 3-5 years of various combinations of minimum income guarantees and reduced tax rates. Two trials were designed to assess re-offending rates in recently released prisoners and randomised a total of 2400 people to 3-6 months of benefits. One trial was designed to assess housing allowances and randomised 3500 families to three years of income supplements. One trial assessed the health effects of 12 months of income supplementation in 54 people with severe mental illness. Finally, one study compared three groups of people who won different amounts of money in a state lottery. In all these studies the interventions resulted in increases in income of at least one fifth. However, no reliable analyses of health outcome data are available. Extensive opportunities to reliably assess the effects of increases in income on health outcomes have been missed. Such evidence might have increased the consideration of potential health effects during deliberations about policies that have major implications for income, such as taxation rates, benefit policies, and minimum wage

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

NARCIS (Netherlands)

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

2014-01-01

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

[Health assessment of river ecosystem in Haihe River Basin, China].

Science.gov (United States)

Hao, Li-Xia; Sun, Ran-Hao; Chen, Li-Ding

2014-10-01

With the development of economy, the health of river ecosystem is severely threatened because of the increasing effects of human activities on river ecosystem. In this paper, the authors assessed the river ecosystem health in aspects of chemical integrity and biological integrity, using the criterion in water quality, nutrient, and benthic macroinvertebrates of 73 samples in Haihe River Basin. The research showed that the health condition of river ecosystem in Haihe River Basin was bad overall since the health situation of 72. 6% of the samples was "extremely bad". At the same time, the health situation in Haihe River Basin exhibited obvious regional gathering effect. We also found that the river water quality was closely related to human activities, and the eutrophication trend of water body was evident in Haihe River Basin. The biodiversity of the benthic animal was low and lack of clean species in the basin. The indicators such as ammonia nitrogen, total nitrogen and total phosphorus were the key factors that affected the river ecosystem health in Haihe River Basin, so the government should start to curb the deterioration of river ecosystem health by controlling these nutrients indicators. For river ecosystem health assessment, the multi-factors comprehensive evaluation method was superior to single-factor method.

Conceptualising the effectiveness of impact assessment processes

International Nuclear Information System (INIS)

Chanchitpricha, Chaunjit; Bond, Alan

2013-01-01

This paper aims at conceptualising the effectiveness of impact assessment processes through the development of a literature-based framework of criteria to measure impact assessment effectiveness. Four categories of effectiveness were established: procedural, substantive, transactive and normative, each containing a number of criteria; no studies have previously brought together all four of these categories into such a comprehensive, criteria-based framework and undertaken systematic evaluation of practice. The criteria can be mapped within a cycle/or cycles of evaluation, based on the ‘logic model’, at the stages of input, process, output and outcome to enable the identification of connections between the criteria across the categories of effectiveness. This framework is considered to have potential application in measuring the effectiveness of many impact assessment processes, including strategic environmental assessment (SEA), environmental impact assessment (EIA), social impact assessment (SIA) and health impact assessment (HIA). -- Highlights: • Conceptualising effectiveness of impact assessment processes. • Identification of factors influencing effectiveness of impact assessment processes. • Development of criteria within a framework for evaluating IA effectiveness. • Applying the logic model to examine connections between effectiveness criteria

Conceptualising the effectiveness of impact assessment processes

Energy Technology Data Exchange (ETDEWEB)

Chanchitpricha, Chaunjit, E-mail: chaunjit@g.sut.ac.th [School of Environmental Health, Suranaree University of Technology, 111 University Avenue, Maung District, Nakhon Ratchasima 30000 (Thailand); Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Unit for Environmental Sciences and Management School of Geo and Spatial Sciences, Internal Box 375, North West University (Potchefstroom campus) (South Africa)

2013-11-15

This paper aims at conceptualising the effectiveness of impact assessment processes through the development of a literature-based framework of criteria to measure impact assessment effectiveness. Four categories of effectiveness were established: procedural, substantive, transactive and normative, each containing a number of criteria; no studies have previously brought together all four of these categories into such a comprehensive, criteria-based framework and undertaken systematic evaluation of practice. The criteria can be mapped within a cycle/or cycles of evaluation, based on the ‘logic model’, at the stages of input, process, output and outcome to enable the identification of connections between the criteria across the categories of effectiveness. This framework is considered to have potential application in measuring the effectiveness of many impact assessment processes, including strategic environmental assessment (SEA), environmental impact assessment (EIA), social impact assessment (SIA) and health impact assessment (HIA). -- Highlights: • Conceptualising effectiveness of impact assessment processes. • Identification of factors influencing effectiveness of impact assessment processes. • Development of criteria within a framework for evaluating IA effectiveness. • Applying the logic model to examine connections between effectiveness criteria.

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.

The need to include Health Impact Assessment at the International Monetary Fund.

Science.gov (United States)

Cave, Ben; Birley, Martin

2010-01-01

The lending and technical support provided by the International Monetary Fund affect the determinants of health and healthy equity. Most health determinants lie outside the control of the health sector, and thus non-health-sector policies have profound positive and negative effects on population health. Health Impact Assessment (HIA) is an instrument for identifying the effect of policies, plans, programs, and projects on population health and health equity. It is a feasible, cost-effective, and transparent process that has been adopted by several financial institutions, including members of the World Bank Group. Adopting HIA would assist the IMF in ensuring that the potential health consequences of its policies are identified and addressed.

Human health and wellbeing in environmental impact assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects

International Nuclear Information System (INIS)

Harris, Patrick J.; Harris, Elizabeth; Thompson, Susan; Harris-Roxas, Ben; Kemp, Lynn

2009-01-01

Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs in New South Wales, Australia. Results showed that health and wellbeing impacts were not considered explicitly. They were, however, included indirectly in the identification of traditional public health exposures associated with the physical environment and to a lesser extent the inclusion of social and economic impacts. However, no health data was used to inform any of the assessments, there was no reference to causal pathways between exposures or determinants and physical or mental health effects, and there was no inclusion of the differential distribution of exposures or health impacts on different populations. The results add conceptually and practically to the long standing integration debate, showing that health is in a position to add value to the EIA process as an explicit part of standard environmental, social and economic considerations. However, to overcome the consistently documented barriers to integrating health in EIA, capacity must be developed amongst EIA professionals, led by the health sector, to progress health related knowledge and tools.

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification

Science.gov (United States)

Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-01-01

Background Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. Objective The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. Methods We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. Results For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self

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 ...

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

Science.gov (United States)

Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

2018-05-01

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

Directory of Open Access Journals (Sweden)

Minjin Lee

2018-04-01

Full Text Available The inhalation of a water aerosol from a humidifier containing disinfectants has led to serious lung injuries in Korea. To promote the safe use of products, the Korean government enacted regulations on the chemicals in various consumer products that could have adverse health effects. Given the concern over the potential health risks associated with the hazardous ingredients in deodorizing consumer products, 17 ingredients were analyzed and assessed according to their health risk on 3 groups by the application type in 47 deodorizing products. The risk assessment study followed a stepwise procedure (e.g., collecting toxicological information, hazard identification/exposure assessment, and screening and detailed assessment for inhalation and dermal routes. The worst-case scenario and maximum concentration determined by the product purpose and application type were used as the screening assessment. In a detailed assessment, the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. The exposed concentrations of seven ingredients were calculated. Due to limitation of toxicity information, butylated hydroxyl toluene for a consumer’s exposure via the dermal route only was conducted for a detailed assessment. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorizing products. This approach can be used to establish guidelines for ingredients that may pose inhalation and dermal hazards.

Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

Science.gov (United States)

Lee, Minjin; Kim, Joo-Hyon; Lee, Daeyeop; Kim, Jaewoo; Lim, Hyunwoo; Seo, Jungkwan; Park, Young-Kwon

2018-01-01

The inhalation of a water aerosol from a humidifier containing disinfectants has led to serious lung injuries in Korea. To promote the safe use of products, the Korean government enacted regulations on the chemicals in various consumer products that could have adverse health effects. Given the concern over the potential health risks associated with the hazardous ingredients in deodorizing consumer products, 17 ingredients were analyzed and assessed according to their health risk on 3 groups by the application type in 47 deodorizing products. The risk assessment study followed a stepwise procedure (e.g., collecting toxicological information, hazard identification/exposure assessment, and screening and detailed assessment for inhalation and dermal routes). The worst-case scenario and maximum concentration determined by the product purpose and application type were used as the screening assessment. In a detailed assessment, the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. The exposed concentrations of seven ingredients were calculated. Due to limitation of toxicity information, butylated hydroxyl toluene for a consumer’s exposure via the dermal route only was conducted for a detailed assessment. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorizing products. This approach can be used to establish guidelines for ingredients that may pose inhalation and dermal hazards. PMID:29652814

Air Pollution and Climate Change Health Impact Assessment. The ACHIA Project

International Nuclear Information System (INIS)

Kinney, P.L.

2013-01-01

Climate change may affect human health via interactions with air pollutants such as ozone and PM 2.5 . These air pollutants are linked to climate because they can be both affected by and have effects on climate. In coming decades, substantial, cost-effective improvements in public health may be achieved with well-planned strategies to mitigate climate impacts while also reducing health effects of ozone and PM 2.5 . Climate mitigation actions affect greenhouse pollutant emissions, including methane and black carbon, but also may affect other key air pollution precursors such as NOx, CO, and SOx. To better understand the potential of such strategies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. The overall objective of this project is to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of ozone and PM 2.5 under different IPCCs scenario of climate change, focusing specifically on pollution-related health co-benefits which could be achieved under alternative climate mitigation pathways in the period 2030-2050. This question will be explored at three spatial scales: global, regional (Europe), and urban (Paris). ACHIA is comprised of an integrated set of four work packages: WP1. Global Climate and Air Pollution Impacts of Alternative Emissions Pathways; WP2. Climate and Air Quality at Regional and Urban Scales: Results for Europe and Paris; WP3. Health Impact Assessment; WP4. Dissemination, Evaluation, Management. ACHIA is designed to create an interdisciplinary approach to the impacts of climate change on health through air quality changes, and to start longer-term collaborations between communities. We expect the project to advance state of art across all WPs, with important implications for research groups around the world. A particular innovation of the project is the multi-scale aspect, i.e., the

Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

OpenAIRE

Wright, John; Parry, Jayne; Scully, Edward

2005-01-01

European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into o...

Reliability assessments in qualitative health promotion research.

Science.gov (United States)

Cook, Kay E

2012-03-01

This article contributes to the debate about the use of reliability assessments in qualitative research in general, and health promotion research in particular. In this article, I examine the use of reliability assessments in qualitative health promotion research in response to health promotion researchers' commonly held misconception that reliability assessments improve the rigor of qualitative research. All qualitative articles published in the journal Health Promotion International from 2003 to 2009 employing reliability assessments were examined. In total, 31.3% (20/64) articles employed some form of reliability assessment. The use of reliability assessments increased over the study period, ranging from qualitative articles decreased. The articles were then classified into four types of reliability assessments, including the verification of thematic codes, the use of inter-rater reliability statistics, congruence in team coding and congruence in coding across sites. The merits of each type were discussed, with the subsequent discussion focusing on the deductive nature of reliable thematic coding, the limited depth of immediately verifiable data and the usefulness of such studies to health promotion and the advancement of the qualitative paradigm.

Characteristics of effective health care managers.

Science.gov (United States)

Johnson, Sherryl W

2005-01-01

This article provides an overview of traditional and contemporary management theories. Concerns, characteristics, and skills of effective managers are also presented. Further, a self-assessment (survey) of 7 highly effective health care managers in a South Georgia community was conducted to determine their ratings on 6 management indices. The assessment or Scale of Transformational Leadership uses a Likert-type scale to allow for the evaluation of managers. The scale contains 6 management elements for assessment: attention, meaning, trust, self, vision, and feeling. Individual ratings and group summary skills rating are presented. Findings revealed the order of managerial importance of the elements as follows (from highest to lowest): Management of Trust, Management of Attention, Management of Self, Management of Feeling, Management of Meaning, and Management of Risk. As a second tier, the final ratings are corroborated by health care management interns.

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.

Implementation of stress assessments by occupational health nurses working in occupational health agencies and their confidence in conducting such assessments.

Science.gov (United States)

Ikeda, Chiseko; Saeki, Kazuko; Hirano, Michiyo

2016-06-21

Stress assessments are due to be conducted in December 2015. It is expected that there will be an increase in the number of private health agencies that provide stress assessment services and mental health care. This study aimed to clarify the current situation of and the factors related to stress assessments conducted by nurses in occupational health agencies. Nurses working full time were randomly selected from 60 organizations that were members of the National Federation of Industrial Health Organization. Self-administered questionnaires were sent out between November 2013 and January 2014. The questionnaire included the personal attributes of the participants, training programs, job contents, and how practical mental health care, including stress assessment, is. The study was approved by the ethics committees in the respective organizations. Out of the 162 questionnaires that were distributed, 89 (54.9%) were returned and 85 (53.1%) were valid for analysis. Stress assessments were conducted by 38.8% of the participants. With reference to their confidence in conducting stress assessments, "confidence and" 70.6%, respectively. The groups that conducted and did not conduct the stress assessments did not show any differences in the findings or other attributes. Further, the implementation of stress assessment was not associated with occupational health nurse (OHN) training, education, position, age, years of experience, attendance of lectures on mental health, etc. However, the confidence in conducting the assessment was related to age when dealing with cases on confidence stress assessment consultation in follow-up to the implementation of screening, such as stress, persons at high risk, and so on. Approximately 40% of the nurses were already conducting stress assessments, but most of them conducted such assessments about once a year and were not deeply involved in them. Approximately 70% of the nurses were confident in implementing stress assessments. Further

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

Climate change and health effects in Northwest Alaska

Directory of Open Access Journals (Sweden)

Michael Brubaker

2011-10-01

Full Text Available This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities.In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weather-related injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects.The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses.The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska.Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate.The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures.

Methodology and parameters for assessing human health effects for waste sites at the Savannah River Plant: Environmental information document

International Nuclear Information System (INIS)

King, C.M.; Marter, W.L.; Looney, B.B.; Pickett, J.B.

1987-03-01

This report provides a summary of the components of risk assessment and presents the technical basis for application of the risk evaluation process to the principal pollutants at SRP: radionuclides, toxic chemicals, and carcinogenic compounds. An extensive technical data base from the fields of radiation health physics, toxicology, and environmental sciences is required to accomplish this task. The origin and meaning of this data base is summarized for each class of contaminant and parameter values provided for use in numerical analysis of risk. The process of risk assessment is associated with uncertainties, a fact which is frequently stated in the technical literature addressing this subject. A review of risk assessment uncertainties and the limitations of predictive risk assessment are summarized. Risk estimators for each class of contaminants at the SRP have been tabulated for radionuclides, toxic chemicals, and carcinogens from the technical literature. Estimation of human health risk is not an additive process for radiation effects and chemical carcinogenesis since their respective dosimetric models are distinctly different even though the induction of cancer is reported to be the common end result. It is recommended in this report that risk estimation for radionuclides and chemical carcinogens should be tabulated separately and this recommendation has been applied in all environmental information documentation published by the Savannah River Laboratory. Impacts due to toxic chemicals in the biosphere should also be estimated as a separate entity since toxic chemical risk estimators are uniquely different and do not reflect the probability of a detrimental health effect. 23 refs., 4 figs., 13 tabs

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.

Public health and economic risk assessment of waterborne contaminants and pathogens in Finland.

Science.gov (United States)

Juntunen, Janne; Meriläinen, Päivi; Simola, Antti

2017-12-01

This study shows that a variety of mathematical modeling techniques can be applied in a comprehensive assessment of the risks involved in drinking water production. In order to track the effects from water sources to the end consumers, we employed four models from different fields of study. First, two models of the physical environment, which track the movement of harmful substances from the sources to the water distribution. Second, a statistical quantitative microbial risk assessment (QMRA) to assess the public health risks of the consumption of such water. Finally, a regional computable general equilibrium (CGE) model to assess the economic effects of increased illnesses. In order to substantiate our analysis, we used an illustrative case of a recently built artificial recharge system in Southern Finland that provides water for a 300,000 inhabitant area. We examine the effects of various chemicals and microbes separately. Our economic calculations allow for direct effects on labor productivity due to absenteeism, increased health care expenditures and indirect effects for local businesses. We found that even a considerable risk has no notable threat to public health and thus barely measurable economic consequences. Any epidemic is likely to spread widely in the urban setting we examined, but is also going to be short-lived in both public health and economic terms. Our estimate for the ratio of total and direct effects is 1.4, which indicates the importance of general equilibrium effects. Furthermore, the total welfare loss is 2.4 times higher than the initial productivity loss. The major remaining uncertainty in the economic assessment is the indirect effects. Copyright © 2017 Elsevier B.V. All rights reserved.

Hawai'i Island Health Workforce Assessment 2008.

Science.gov (United States)

Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

2009-12-01

Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued

Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

Science.gov (United States)

Wright, John; Parry, Jayne; Scully, Edward

2005-06-01

European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.

Approaches to health assessment related to housing

NARCIS (Netherlands)

Guerra Santin, O.

2006-01-01

This research had the purpose of providing more information about possible approaches and indicators to measure indoor health in relation to housing. In researches related with health and some Life Cycle Assessment (LCA) databases, the model used for health assessment is the Impact Pathway Analysis

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

International Nuclear Information System (INIS)

Wang, F.; Mackenzie, A.; Schopflocher, D.; Shaw, S.; Robb, J.; Gabos, S.

2002-01-01

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

Mutagenesis and teratogenesis as end points in health impact assessment

International Nuclear Information System (INIS)

Bender, M.A.

1976-01-01

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

Assessing harmful effects in systematic Reviews

Directory of Open Access Journals (Sweden)

Woolacott Nerys F

2004-07-01

Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

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

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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

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification.

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Valle, Carmina G; Queen, Tara L; Martin, Barbara A; Ribisl, Kurt M; Mayer, Deborah K; Tate, Deborah F

2018-03-01

Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback. The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions. We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up. For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who

Health Impact Assessment: Linking Public Health to ...

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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.

A new adaptive testing algorithm for shortening health literacy assessments

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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.

[Health technology assessment: a multidisciplinary approach for selecting innovations in the health service].

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Cavallo, Maria Caterina

2013-01-01

Technological evolution and the increasing requests of a more qualified health care have challenged politicians to evaluate the economical sustainability of proposed innovations. The objective of government health policies is to guarantee real advances in the quality of care to all citizens. Since 1965, independent research centers have analyzed this issue for the US Congress. In 1973, Congress endorsed the establishment of an Office of Technology Assessment (OTA) to discover the best strategies for evaluating such advances. OTA have proposed the following criteria to identify possible beneficial innovations to be introduced into routine health care: effectiveness, safeness, worth, costs, cost-effectiveness ratio and cost patient-benefit ratio. This review analyzes in detail the pathway that each medical innovation follows in order to identify which technological evolutions might prove to be truly beneficial and sustainable for the community.

METHODOLOGIES FOR ASSESSING THE EFFECTIVENESS OF MEDICAL ORGANIZATIONS THAT PROVIDE OUTPATIENT CARE

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Mikhail Georgievich Karailanov

2016-08-01

Full Text Available The aim of this study is to analyze the data in the literature, allows to define the basic methodological approaches to the assessment of the effectiveness of health care organizations, as well as important problems of studying the effectiveness of primary health care at the moment. Primary health care is an integral part of the national health system, as a basis for health care delivery system, and includes measures for prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, monitoring of pregnancy, healthy lifestyles, including reduce risk factors for disease. In the modern development of the health priority and remains the problem of assessing the effectiveness of the medical organization. Health Management is impossible without the identification of priority targets, indicators and parameters to achieve their efficient use of financial, material and human resources, which leads to the need for a methodology for assessing the effectiveness of health interventions that will ensure the relationship management processes and planning, as well as to solve practical problems of the industry.

Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess claims about treatment effects: a randomised controlled trial.

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Semakula, Daniel; Nsangi, Allen; Oxman, Andrew D; Oxman, Matt; Austvoll-Dahlgren, Astrid; Rosenbaum, Sarah; Morelli, Angela; Glenton, Claire; Lewin, Simon; Kaseje, Margaret; Chalmers, Iain; Fretheim, Atle; Kristoffersen, Doris Tove; Sewankambo, Nelson K

2017-07-22

As part of the Informed Health Choices project, we developed a podcast called The Health Choices Programme to help improve the ability of people to assess claims about the benefits and harms of treatments. We aimed to evaluate the effects of the podcast on the ability of parents of primary school children in Uganda to assess claims about the effects of treatments. We did this randomised controlled trial in central Uganda. We recruited parents of children aged 10-12 years who were in their fifth year of school at 35 schools that were participating in a linked trial of the Informed Health Choices primary school resources. The parents were randomly allocated (1:1), via a web-based random number generator with block sizes of four and six, to listen to either the Informed Health Choices podcast (intervention group) or typical public service announcements about health issues (control group). Randomisation was stratified by parents' highest level of formal education attained (primary school, secondary school, or tertiary education) and the allocation of their children's school in the trial of the primary school resources (intervention vs control). The primary outcome, measured after listening to the entire podcast, was the mean score and the proportion of parents with passing scores on a test with two multiple choice questions for each of nine key concepts essential to assessing claims about treatments (18 questions in total). We did intention-to-treat analyses. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201606001676150. We recruited parents between July 21, 2016, and Oct 7, 2016. We randomly assigned 675 parents to the podcast group (n=334) or the public service announcement group (n=341); 561 (83%) participants completed follow-up. The mean score for parents in the podcast group was 67·8% (SD 19·6) compared with 52·4% (17·6) in the control group (adjusted mean difference 15·5%, 95% CI 12·5-18·6; pparents had a predetermined

Assessing organizational change in multisector community health alliances.

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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.

Assessing Psychological Health: The Contribution of Psychological Strengths

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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…

Exploring Health Impact Assessment in Europe

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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.

Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

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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.

Integrating a quantitative risk appraisal in a health impact assessment

DEFF Research Database (Denmark)

Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

2013-01-01

BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

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Florian Fischer

2016-01-01

Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

Cost-Effectiveness of a School-Based Emotional Health Screening Program

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Kuo, Elena; Stoep, Ann Vander; McCauley, Elizabeth; Kernic, Mary A.

2009-01-01

Background: School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening…

Risk assessment for improved treatment of health considerations in EIA

International Nuclear Information System (INIS)

Demidova, Olga; Cherp, Aleg

2005-01-01

Environmental Impact Assessment (EIA) and Risk Assessment (RA) processes are rarely used to complement each other despite potential benefits of such integration. This paper proposes a model for procedural and methodological integration of EIA and RA based on reported best practice approaches. The proposed model stipulates 'embedding' RA into EIA and is organized in accordance with the generic stages of the EIA process. The model forms the basis for the proposed Evaluation Package which can be used as a benchmarking tool for evaluating the effectiveness of integration of RA within particular EIAs. The current paper uses the package for evaluating seven Environmental Impact Statements (EISs) of waste incineration facilities in the UK produced between 1990 and 2000. Though RA was found to be an element of these EIAs, its prominence varied considerably from case to case. Systematic application of RA in accordance with the best practice was not observed. Particular omissions were demonstrated in assessing health impacts not directly associated with air emissions, identifying the receptors of health impacts (affected population), interpreting health impacts as health risks, dealing with uncertainties, and risk communications

School Physical Education: The Effectiveness of Health-Related Interventions and Recommendations for Health-Promotion Practice

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Quitério, Ana Luísa Dias

2013-01-01

Objective: To assess the effectiveness of physical education (PE) interventions designed to foster health features among school-aged children, and to present a qualitative perspective of the different approaches that are most effective in promoting health among youth. Design: Systematic review. Method: An extensive electronic literature search was…

Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

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Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

2018-01-05

Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. ©Rebecca Schnall, Hwayoung Cho, Jianfang Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 05.01.2018.

European network for health technology assessment, EUnetHTA: planning, development, and implementation of a sustainable European network for health technology assessment

DEFF Research Database (Denmark)

Kristensen, Finn Børlum; Mäkelä, Marjukka; Neikter, Susanna Allgurin

2009-01-01

OBJECTIVES: The European network on Health Technology Assessment (EUnetHTA) aimed to produce tangible and practical results to be used in the various phases of health technology assessment and to establish a framework and processes to support this. This article presents the background, objectives......, and organization of EUnetHTA, which involved a total of sixty-four partner organizations. METHODS: Establishing an effective and sustainable structure for a transnational network involved many managerial, policy, and methodological tools, according to the objective of each task or Work Package. Transparency...... the use of HTA at national and regional levels. Responsiveness to political developments in Europe should be balanced with maintaining a high level of ambition to promote independent, evidence-based information and well-tested tools for best practice based on a strong network of HTA institutions....

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.

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

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

2015-09-16

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

Assessing the health, functional characteristics, and health needs of youth attending a noncategorical transition support program.

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Woodward, Jason F; Swigonski, Nancy L; Ciccarelli, Mary R

2012-09-01

To assess the health, functional characteristics, and health care service needs of youth and young adults with special health care needs attending a comprehensive, noncategorical transition program. A self-administered survey was developed from national health surveys and clinical experience to assess concepts identified as important for successful transition to adulthood. Surveys were mailed to 198 parents of youth and young adults with special health care needs attending the transition clinic. Parents were asked about the youth's health, functional status, and health care services needed. The clinical database provided demographic and patient health characteristics. Results were compared against the 2005-2006 National Survey of Children with Special Health Care Needs. Forty-four percent of surveys were returned. Average age of youth was 17.5 (11-22) years old and diagnoses included cerebral palsy (36%), spina bifida (10%), developmental delay or Down syndrome (17%), and autism (6%). Most youth needed assistance with personal care (69%) and routine needs (91%) and used assistive devices (59%). Compared with the 2005-2006 National Survey of Children with Special Health Care Needs, parents reported higher needs for all services except mental health care and tobacco or substance use counseling. Forty three percent reported at least one unmet health need. Few parents reported the need for counseling on substance use (1%), sexual health screening (16%), nutrition (34%), and exercise (41%). Youth attending our transition program had more functional limitations, poorer reported health status, different diagnosis distribution, and higher levels of needed health services. Few parents identified needs for other recommended adolescent preventive services. Transition programs should assess patient health characteristics and service needs to design effective patient-centered services. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All

Combining environment and health information systems for the assessment of atmospheric pollution on human health.

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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.

Resiliency and subjective health assessment. Moderating role of selected psychosocial variables

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Michalina Sołtys

2015-12-01

Full Text Available Background Resiliency is defined as a relatively permanent personality trait, which may be assigned to the category of health resources. The aim of this study was to determine conditions in which resiliency poses a significant health resource (moderation, thereby broadening knowledge of the specifics of the relationship between resiliency and subjective health assessment. Participants and procedure The study included 142 individuals. In order to examine the level of resiliency, the Assessment Resiliency Scale (SPP-25 by N. Ogińska-Bulik and Z. Juczyński was used. Participants evaluated subjective health state by means of an analogue-visual scale. Additionally, in the research the following moderating variables were controlled: sex, objective health status, having a partner, professional activity and age. These data were obtained by personal survey. Results The results confirmed the relationship between resiliency and subjective health assessment. Multiple regression analysis revealed that sex, having a partner and professional activity are significant moderators of associations between level of resiliency and subjective health evaluation. However, statistically significant interaction effects for health status and age as a moderator were not observed. Conclusions Resiliency is associated with subjective health assessment among adults, and selected socio-demographic features (such as sex, having a partner, professional activity moderate this relationship. This confirms the significant role of resiliency as a health resource and a reason to emphasize the benefits of enhancing the potential of individuals for their psychophysical wellbeing. However, the research requires replication in a more homogeneous sample.

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

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Springer, Andrew E; Evans, Alexandra E

2016-01-01

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

Assessment of university student health literacy toward Influenza

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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.

Assessment of primary health care: health professionals’ perspective

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Simone Albino da Silva

2014-08-01

Full Text Available Objective To assess primary health care attributes of access to a first contact, comprehensiveness, coordination, continuity, family guidance and community orientation. Method An evaluative, quantitative and cross-sectional study with 35 professional teams in the Family Health Program of the Alfenas region, Minas Gerais, Brazil. Data collection was done with the Primary Care Assessment Tool - Brazil, professional version. Results Results revealed a low percentage of medical experts among the participants who evaluated the attributes with high scores, with the exception of access to a first contact. Data analysis revealed needs for improvement: hours of service; forms of communication between clients and healthcare services and between clients and professionals; the mechanism of counter-referral. Conclusion It was concluded that there is a mismatch between the provision of services and the needs of the population, which compromises the quality of primary health care.

Health technology assessment: research trends and future priorities in Europe.

Science.gov (United States)

Nielsen, Camilla Palmhøj; Funch, Tina Maria; Kristensen, Finn Børlum

2011-07-01

To provide an overview of health services research related to health technology assessment (HTA) and to identify research priorities from a European perspective. Several methods were used: systematic review of articles indexed with the MeSH term 'technology assessment' in PubMed from February 1999-2009; online survey among experts; and conference workshop discussions. Research activity in HTA varies considerably across Europe. The research was categorised into six areas: (1) the breadth of analysis in HTA (such as economic, organizational and social aspects); (2) HTA products developed to meet the needs of policy-makers (such as horizon scanning, mini-HTA, and core HTA); (3) handling life-cycle perspectives in relation to technologies; (4) topics that challenge existing methods and for which HTA should be developed to address the themes more comprehensively (such as public health interventions and organizational interventions); (5) development of HTA capacity and programmes; and (6) links between policy and HTA. An online survey showed that the three areas that were given priority were the relationship between HTA and policy-making (71%), the impact of HTA (62%) and incorporating patient aspects in HTA (50%). Policy-makers highlighted HTA and innovation processes as their main research priority (42%). Areas that the systematic review identified as future priorities include issues within the six existing research areas such as disinvestment, developing evidence for new technologies, assessing the wider effects of technology use, and determining how HTA affects decision-making. In addition, relative effectiveness and individualized treatments are areas of growing interest. The research priorities identified are important for obtaining high quality and cost-effective health care in Europe. Managing the introduction, use and phasing out of technologies challenges health services throughout Europe, and these processes need to be improved to successfully manage future

How lay health workers tailor in effective health behaviour change interventions: a protocol for a systematic review.

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Hodgins, Faith; Gnich, Wendy; Ross, Alastair J; Sherriff, Andrea; Worlledge-Andrew, Heather

2016-06-16

Lay health workers (LHWs) are utilised as a channel of delivery in many health interventions. While they have no formal professional training related to their role, they utilise their connections with the target group or community in order to reach individuals who would not normally readily engage with health services. Lay health worker programmes are often based on psychological theories of behaviour change that point to 'tailoring to individuals' needs or characteristics' as key to success. Although lay health workers have been shown to be effective in many contexts, there is, as yet, little clarity when it comes to how LHWs assess individuals' needs in order to tailor their interventions. This study aims to develop a better understanding of the effective implementation of tailoring in lay health worker interventions by appraising evidence and synthesising studies that report evaluations of tailored interventions. Health and psychology electronic databases (EMBASE, CINAHL, MEDLINE and PsycINFO) will be searched. Reference lists of included studies will also be searched. For articles that are deemed to be potentially relevant, we will employ a 'cluster searching' technique in order to identify all published papers related to a relevant intervention. Cluster searching will be undertaken in an effort to maximise the breadth and depth of description of the intervention. Quantitative studies will be assessed using the Quality Assessment Tool for Quantitative Studies, developed by the Effective Public Health Practice Project, ON, Canada. Qualitative studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research. Sythesising the data will enable the development of a taxonomy of strategies for the criteria used for individual assessment of recipients' needs and the ways in which messages or actions are tailored to these individual criteria by LHWs. This systematic review focuses specifically on how health promotion and

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

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

The Alberta Oil Sands Community Exposure and Health Effects Assessment Program : methods report

International Nuclear Information System (INIS)

2000-01-01

The Alberta Oil Sands Community Exposure and Health Effects Assessment Program involved the development of a holistic approach to the study of personal exposure and the potential health impacts of airborne contaminants including volatile organic compounds (VOCs), sulphur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), ozone (O 3 ) and particulates (both PM10 and PM2.5). Volunteer residents from Fort McMurray, Alberta were recruited to participate in neurocognitive tests and a health and nutrition survey. In addition, the local community identified several priority contaminants which were highlighted during a public hearing of the Alberta Energy and Utilities Board in relation to Syncrude's Mildred Lake Development Project. The approach to the study was based on the direct measurement of all routes of exposure to the contaminants (breathing, ingestion and skin contact), direct measurement of biomarkers, and daily logs of participant's activities. The choice of biomarkers was based on the ability of the laboratory to measure low levels of relevant biological markers, the most appropriate media for measuring the markers, and the burden placed on each volunteer. The final set of biological measures of exposure included trace metals (arsenic, cadmium, lead and uranium) nicotine, and metabolites of the BTEX compounds (benzene, toluene, ethylbenzene, and xylenes). The objective was to determine if chronic or occupational exposure to these contaminants cause structural alterations in the respiratory system that compromise oxygen absorption and lung elasticity. 82 refs., 14 tabs., 15 figs., 3 appendices

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

Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

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Nawaz, Saira; Thomas, Craig; Young, Andrea

2015-01-01

We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

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

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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.

IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT WORK IN A HOSPITAL IN KAZAKHSTAN.

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Kosherbayeva, Lyazzat; Hailey, David; Kurakbaev, Kural; Tsoy, Aleksey; Zhuzzhanov, Ormanbek; Donbay, Abilay; Kumar, Ainur; Nadyrov, Kamalzhan

2016-01-01

The aim of this study was to implement health technology assessment (HA) in the First General City Hospital in Astana, Kazakhstan. We organized trainings to familiarize hospital staff with the purpose and details of HTA. An HTA committee was established, with representation from hospital physicians and managers, and criteria for prioritization of health technologies determined. Clinical departments of the hospital were asked to prepare applications for new technologies for their services. The HTA committee reviewed five applications and selected a technology from one of these, on single incision laparoscopic surgery (SILS), for assessment. A short HTA report on SILS was prepared, covering its safety, clinical effectiveness, and cost effectiveness. The report was used to support a request to the Department of Health for additional funding to implement this technology within the hospital. This funding was approved and SILS was established in several hospital departments. This successful initial experience with HTA has paved the way for its routine use by the hospital for informing decisions on the procurement and use of new health technologies.

mHealth Assessment: Conceptualization of a Global Framework.

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

2017-05-02

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. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the

Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies.

Science.gov (United States)

Dressel, Anne; Schneider, Robert; DeNomie, Melissa; Kusch, Jennifer; Welch, Whitney; Sosa, Mirtha; Yeldell, Sally; Maida, Tatiana; Wineberg, Jessica; Holt, Keith; Bernstein, Rebecca

2017-09-01

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A "Biking for Health" study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

Assessment factors for human health risk assessment: a discussion paper

NARCIS (Netherlands)

Vermeire TG; Stevenson H; Pieters MN; Rennen M; Slob W; Hakkert BC; Nederlandse organisatie voor; CSR; LEO; TNO-ITV

1998-01-01

The general goal of this discussion paper is to contribute towards further harmonisation of the human health risk assessment. It discusses the development of a formal, harmonised set of default assessment factors. The status quo with regard to assessment factors is reviewed. Options are presented

[Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

Science.gov (United States)

Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

2011-04-01

The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. © Georg Thieme Verlag KG Stuttgart · New York.

Depiction of Health Effects of Electronic Cigarettes on YouTube.

Science.gov (United States)

Merianos, Ashley L; Gittens, Olivia E; Mahabee-Gittens, E Melinda

2016-01-01

This study was conducted to assess the quantity, quality, and reach of e-cigarette health effects YouTube videos, and to quantify the description of positive and negative e-cigarette health effects and promotional content in each video. Searches for videos were conducted in 2015 using the YouTube search engine, and the top 20 search results by relevance and view count were identified. Videos were classified by educational/medical news, advertising/marketing, and personal/testimonial categories. A coding sheet was used to assess the presence or absence of negative and positive health effects, and promotional content. Of the 320 videos retrieved, only 55 unique videos were included. The majority of videos (46.9%) were educational/medical/news, 29.7% were personal/testimonial, and 23.4% were advertising/marketing. The three most common negative health effects included discussing nicotine, e-cigarettes not being FDA regulated, and known and unknown health consequences related to e-cigarette use. The top positive health effects discussed were how e-cigarettes can help individuals quit smoking, e-cigarettes are healthier than smoking, and e-cigarettes have no smoke or secondhand smoke exposure. It is critical to monitor YouTube health effects content and develop appropriate messages to inform consumers about the risks associated with use while mitigating misleading information presented.

[Foundations for the institutionalization of health technology assessment in Chile].

Science.gov (United States)

Castillo-Riquelme, Marianela; Santelices C, Emilio

2014-01-01

The Chilean health system has not been completely oblivious to health technology assessment (HTA). In fact, significant advances in the areas of health prioritization using criteria of disease burden, effectiveness and cost-effectiveness among others, can be acknowledged. The introduction of the reform of Explicit Health Guarantees (GES) has been an important milestone in this arena, allowing the consideration of other dimensions such as social preferences in health. However, the application of HTA encompasses the entire health system and in that sense the institutionalization of a process properly defined and extensively validated in our country, is imminent. This paper discusses the foundations on which progress must be made in institutionalizing HTA, starting from the architecture of our health care system and in light of the economic and social reality. We review some background information first, and then discuss some important considerations in our context, including information on the institutional and legal framework. It concludes with the authors' view on some key elements to consider in HTA in Chile, which does not necessarily represent the vision of the Ministry of Health.

A new approach to criteria for health risk assessment

International Nuclear Information System (INIS)

Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

2012-01-01

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

[Health impact assessment of "white-collar exemption" in Japan].

Science.gov (United States)

Fujino, Yoshihisa; Matsuda, Shinya

2007-03-01

This work conducted a health impact assessment (HIA) of the Japanese Government's proposal concerning the introduction of so called "white-collar exemption" into the Japanese labor market. We adopted the Merseyside model and performed a rapid health impact assessment to assess the potential health effects of white-collar exemption. In this HIA, several health determinants which may possibly be affected, both positively and negatively, were identified based on experts' judgments. Literature evidence was assessed using PubMed and other databases. In addition, we searched for the opinions of those affected by white-collar exemption from internet web sites, and six concerns were identified. Long working hours were identified as the most serious concern by both experts and those affected. White-collar exemption may increase irregular working patterns which may be related to sleep disorder, stress, and cardiovascular disease. Family function and social participation will also be affected by irregular working patterns. On the other hand, in terms of stress, white-collar exemption may benefit from a higher degree of job control. There are possibilities that white-collar exemption may enable an improved work-life balance and enable access of some groups of the population, such as people with disabilities or parents looking after children, greater access to the labour market. However, it is uncertain whether the benefits of white-collar exemption would overcome those of the current free-time or flex-time systems. The present work provides a wide range of health impacts of white-collar exemption, and will hopefully attract the attentions of decision-makers and those likely to be affected in order to contribute to policy-making.

Learning, assessment and professional identity development in public health training.

Science.gov (United States)

Wood, Annette

2016-06-01

Professional identity formation is important for new recruits to training programmes. The integration of the accumulation of knowledge and assessment is a key aspect in its acquisition. This study assessed this interaction in Public Health Training in one English region. Semi-structured interviews were held with 15 registrars from the West Midlands Public Health Training Programme. Pre-interview questionnaires gathered background information. A thematic content analysis approach was taken. There was a lack of integration between academic and workplace learning, the professional examination process and professional identity development. Registrars considered sitting the examination and their workplace learning as two parallel processes. Passing the examination was considered a key part in the early development of a professional identity but this was replaced by the opinions of others by the third year of training. Having a Masters' in Public Health was less important but played a different role in their perceived acceptance by the wider Public Health workforce. The lack of integration between assessment and learning seemed to have a detrimental effect on professional identity development. A review of how these two aspects might combine in a more positive manner is needed.

General health literacy assessment of Iranian women in Mashhad.

Science.gov (United States)

Jarahi, Lida; Asadi, Reza; Hakimi, Hamid Reza

2017-11-01

In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. To assess women's health literacy and relative factors in Mashhad (Iran). Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this cross-sectional study by stratified sampling method. The validated Persian version of Rapid Estimate of Adult Literacy in Medicine-revised questionnaire was used. Vocabulary comprehension and reading scores of health literacy was assessed. Comparisons were done in demographic subgroups by ANOVA, Mann-Whitney U, Kruskal-Wallis, Pearson correlation coefficient, and Chi-Square tests. In total, 250 women with a mean age of 32.1±10.23 years and the mean education level of 10.58±3.67 years were studied. The mean reading score was 11.58±2.51 and the mean vocabulary comprehension score was 17.24±4.73. Participants' health literacy score had positive correlation with age and education, and significant difference in health literacy scores between occupational groups was seen. Housewives' health literacy scores were lower than others (pliteracy was a common problem amongst younger women, especially among women who had less education. These women are at risk of early marriage and child bearing and require more health care. Health care professionals should use effective methods for easier transfer recommendation, also, producing medical information booklets, texts, and videos for different community subgroups through public media or even in cyberspace with clear and common words consisting of essential information.

Assessment factors for human health risk assessment: A discussion paper

NARCIS (Netherlands)

Vermeire, T.; Stevenson, H.; Pieters, M.N.; Rennen, M.; Slob, W.; Hakkert, B.C.

1999-01-01

The general goal of this discussion paper is to contribute toward the further harmonization of human health risk assessment. It first discusses the development of a formal, harmonized set of assessment factors. The status quo with regard to assessment factors is reviewed, that is, the type of

Development and Validity Testing of the Worksite Health Index: An Assessment Tool to Help and Improve Korean Employees' Health-Related Outcome.

Science.gov (United States)

Yun, Young Ho; Sim, Jin Ah; Lim, Ye Jin; Lim, Cheol Il; Kang, Sung-Choon; Kang, Joon-Ho; Park, Jun Dong; Noh, Dong Young

2016-06-01

The objective of this study was to develop the Worksite Health Index (WHI) and validate its psychometric properties. The development of the WHI questionnaire included item generation, item construction, and field testing. To assess the instrument's reliability and validity, we recruited 30 different Korean worksites. We developed the WHI questionnaire of 136 items categorized into five domains, namely Governance and Infrastructure, Need Assessment and Planning, Health Prevention and Promotion Program, Occupational Safety, and Monitoring and Feedback. All WHI domains demonstrated a high reliability with good internal consistency. The total WHI scores differentiated worksite groups effectively according to firm size. Each domain was associated significantly with employees' health status, absence, and financial outcome. The WHI can assess comprehensive worksite health programs. This tool is publicly available for addressing the growing need for worksite health programs.

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.

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.

Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center.

Science.gov (United States)

Ali, Dena A

2016-01-01

The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann-Whitney U test, Chi-square test, and Kruskal-Wallis test. P values less than 0.05 were considered to be statistically significant ( P < 0.05). The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students ( P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior. Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.

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)

Health assessment of environmental pollutants: proliferative and degenerative diseases

International Nuclear Information System (INIS)

Stuart, B.O.

1988-01-01

In order to achieve a balanced approach to risk assessment between carcinogenic and non-carcinogenic health effects one must examine the risk of disease or death in the general population exposed to a particular air pollutant that can be related quantitatively to intensity and duration of exposures (National Academy of Sciences, 1983). Such risk assessment should be based upon careful evaluation of scientific findings of dose-response relationships in the chronically exposed population. Quantitative assessment of environmentally produced disease in man has proven to be complex and demanding. A variety of factors play important roles in this task. As an example, there are induction-latency periods for chronic diseases, including cancer, which may range from five to twenty-five years. The diseases themselves, whether proliferative or degenerative, may follow several stages of progression. There is only sparse epidemiological data on serious health effects that may be due to environmental as compared to occupational exposures. Exposures to chemical or radiological air contaminants do not occur singly but to a multiplicity of agents, and disease processes are frequently markedly affected by the interaction of a variety of factors, particularly that of cigarette smoking. There is growing recognition of potentially sensitive subpopulations, including the elderly and the very young, but adequate techniques for assessing the magnitude of increased risks to these groups have not yet been developed

Final report to Halifax Harbour Cleanup Inc. on human health risk assessment

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-12-31

This assessment evaluates the potential of the proposed Halifax Harbor primary sewage treatment plant to meet the objective of the protection and improvement of human health. The assessment was made of a plant which would include an outfall within the inner harbor and a series of outlets designed to handle high flow conditions due to storm events. The assessment focuses on the potential human health effects of microbiological pathogenic organisms, chemical elements, and chemical compounds for three principal uses of the harbor: recreational use in which people have direct contact with the water; consumption of shellfish; and consumption of lobster. The assessment includes hazard characterization, exposure assessment, dose-response assessment, risk characterization, a discussion of the assumptions used and their implications, and a prediction of the sewage treatment facility performance.

COSYMA: Health effects models

International Nuclear Information System (INIS)

Ehrhardt, J.

1995-02-01

As one of the main objectives of the MARIA project (''Methods for Assessing the Radiological Impact of Accidents'') initiated by the Commission of the European Communities the program package COSYMA (''COde SYstem from MARIA'') for assessing the radiological and economic off-site consequences of accidental releases of radioactive material to the atmosphere has been jointly developed by the Kernforschungszentrum Karlsruhe (KfK), FRG, and the National Radiological Protection Board (NRPB), UK. COSYMA includes models and data for assessing a broad spectrum of accident consequences, and they are implemented in independent modules. The subject of this report are those modules, which incorporate models and data for assessing individual and collective risks for deterministic and stochastic health effects. It describes the models implemented, the mathematical algorithms and the required data. Examples are given and explained for the input and output part of the modules. (orig.)

Using primary care electronic health record data for comparative effectiveness research : experience of data quality assessment and preprocessing in The Netherlands

NARCIS (Netherlands)

Huang, Yunyu; Voorham, Jaco; Haaijer-Ruskamp, Flora M.

Aim: Details of data quality and how quality issues were solved have not been reported in published comparative effectiveness studies using electronic health record data. Methods: We developed a conceptual framework of data quality assessment and preprocessing and apply it to a study comparing

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.

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.

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.

Environment, Safety, and Health Self-Assessment Report, Fiscal Year 2008

Energy Technology Data Exchange (ETDEWEB)

Chernowski, John

2009-02-27

Division Self-Assessment annually. The primary focus of the review is workplace safety. The MESH review is an evaluation of division management of ES&H in its research and operations, focusing on implementation and effectiveness of the division's ISM plan. It is a peer review performed by members of the LBNL Safety Review Committee (SRC), with staff support from OCA. Each division receives a MESH review every two to four years, depending on the results of the previous review. The ES&H Technical Assurance Program (TAP) provides the framework for systematic reviews of ES&H programs and processes. The intent of ES&H Technical Assurance assessments is to provide assurance that ES&H programs and processes comply with their guiding regulations, are effective, and are properly implemented by LBNL divisions. The Appendix B Performance Evaluation and Measurement Plan (PEMP) requires that LBNL sustain and enhance the effectiveness of integrated safety, health, and environmental protection through a strong and well-deployed system. Information required for Appendix B is provided by EH&S Division functional managers. The annual Appendix B report is submitted at the close of the fiscal year. This assessment is the Department of Energy's (DOE) primary mechanism for evaluating LBNL's contract performance in ISM.

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

Science.gov (United States)

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

2007-11-01

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

SUBJECTIVE HEALTH ASSESSMENT AND HEALTH BEHAVIOUR OF ADULT INHABITANTS OF TOWNS LOCATED IN THE VICINITY OF WIND FARMS IN POLAND

Directory of Open Access Journals (Sweden)

Bożena Mroczek

2010-06-01

Full Text Available Background. The development of wind power industry is beneficial both for human beings and their environment, even so it causes anxiety of people living near wind farms. It is highly related to insufficient information on the effect of wind farms on human health. The aim of this study was to assess subjective health, existing problems and health behaviours demonstrated by the residents of places located near wind farms. Materials of methods. The study was performed in January and February 2009. The research tool was a questionnaire consisting of the Norwegian version of The SF-36 General Health Questionnaire, the Visual Analog Scale (VAS for health assessment, and author’s questions. Information was obtained from 343 respondents, whose average age was 45 years. Out of them 57% had a job, while 12% were unemployed. All respondents were country dwellers. Results: General health was assessed as excellent or very good by 30%, as bad by 10.8%. One-fourth of respondents observed the worsening of their health. Some 59.2% claimed that wind farms were over 1500 m from their houses; people living in the shortest distance form a wind mill (700 m constituted 8%. One-third thought that windmills were safe for health; 69.1% did not regard windmills beneficial to themselves, and 2.6% could not see any advantages for the local community. Overweight and obesity were found in 42.34%, and 96.8% suffered from chronic diseases. Conclusions: 1. Subjective quality of life assessment depends directly on internal conditions of an individual. Construction of wind farms is not evaluated as an investment that changes the life of an individual. It is thought to have no effect on the assessment of health or its worsening. 2. Risk behaviours in the group examined do not differ from those observed in the general population. The factors which make the behaviours different are gender, age below 65 and occupational inactivity.

Assessment of the feasibility of studying the potential health effects of the West Valley Solidification Project. Phase II

International Nuclear Information System (INIS)

Matanoski, G.M.

The activities at West Valley involve potential exposure to ionizing radiation. The health effects from radiation are well known and the projected levels of exposure in this situation are so low as to pose no known health hazard in the community. In such a situation it is not reasonable to propose an expensive, comprehensive and physically invasive screening program for the public unless one could justify the benefits. This report describes a feasible population-based surveillance or disease monitoring system which could be implemented in the West Valley area in order to assess the relevance of any changes in incidence of disease which might be attributable to radiation. The proposed plan is both practical and inexpensive. It would anticipate any potential changes in the health status of the population and provide a means to objectively interpret such changes before major concerns develop

An integrated framework for health and ecological risk assessment

International Nuclear Information System (INIS)

Suter, Glenn W.; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

2005-01-01

The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species

Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

Science.gov (United States)

Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

2009-01-01

COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

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.

Environment, safety and health progress assessment manual

International Nuclear Information System (INIS)

1992-12-01

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

Assessment of the Health Impacts of Climate Change in Kiribati

Science.gov (United States)

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

2014-01-01

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 priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

Health Effects of PCBs in Residences and Schools (HESPERUS)

DEFF Research Database (Denmark)

Bräuner, Elvira; Andersen, Zorana Jovanovic; Frederiksen, Marie

2016-01-01

Polychlorinated-biphenyls (PCBs) were introduced in the late 1920s and used until the 1970s when they were banned in most countries due to evidence of environmental build-up and possible adverse health effects. However they still persist in the environment, indoors and in humans. Indoor air...... in contaminated buildings may confer airborne exposure markedly above background regional PCB levels. To date, no epidemiological studies have assessed the health effects from exposure to semi-volatile PCBs in the indoor environment. Indoor air PCBs are generally less chlorinated than PCBs that are absorbed via...... the diet, or via past occupational exposure; therefore their health effects require separate risk assessment. Two separate cohorts of individuals who have either attended schools (n = 66,769; 26% exposed) or lived in apartment buildings (n = 37,185; 19% exposed), where indoor air PCB concentrations have...

Depiction of Health Effects of Electronic Cigarettes on YouTube

Science.gov (United States)

Merianos, Ashley L.; Gittens, Olivia E.; Mahabee-Gittens, E. Melinda

2016-01-01

Background This study was conducted to assess the quantity, quality, and reach of e-cigarette health effects YouTube videos, and to quantify the description of positive and negative e-cigarette health effects and promotional content in each video. Method Searches for videos were conducted in 2015 using the YouTube search engine, and the top 20 search results by relevance and view count were identified. Videos were classified by educational/medical news, advertising/marketing, and personal/testimonial categories. A coding sheet was used to assess the presence or absence of negative and positive health effects, and promotional content. Results Of the 320 videos retrieved, only 55 unique videos were included. The majority of videos (46.9%) were educational/medical/news, 29.7% were personal/testimonial, and 23.4% were advertising/marketing. The three most common negative health effects included discussing nicotine, e-cigarettes not being FDA regulated, and known and unknown health consequences related to e-cigarette use. The top positive health effects discussed were how e-cigarettes can help individuals quit smoking, e-cigarettes are healthier than smoking, and e-cigarettes have no smoke or secondhand smoke exposure. Conclusions It is critical to monitor YouTube health effects content and develop appropriate messages to inform consumers about the risks associated with use while mitigating misleading information presented. PMID:28217030

Health Heritage© a web-based tool for the collection and assessment of family health history: initial user experience and analytic validity.

Science.gov (United States)

Cohn, W F; Ropka, M E; Pelletier, S L; Barrett, J R; Kinzie, M B; Harrison, M B; Liu, Z; Miesfeldt, S; Tucker, A L; Worrall, B B; Gibson, J; Mullins, I M; Elward, K S; Franko, J; Guterbock, T M; Knaus, W A

2010-01-01

A detailed family health history is currently the most potentially useful tool for diagnosis and risk assessment in clinical genetics. We developed and evaluated the usability and analytic validity of a patient-driven web-based family health history collection and analysis tool. Health Heritage(©) guides users through the collection of their family health history by relative, generates a pedigree, completes risk assessment, stratification, and recommendations for 89 conditions. We compared the performance of Health Heritage to that of Usual Care using a nonrandomized cohort trial of 109 volunteers. We contrasted the completeness and sensitivity of family health history collection and risk assessments derived from Health Heritage and Usual Care to those obtained by genetic counselors and genetic assessment teams. Nearly half (42%) of the Health Heritage participants reported discovery of health risks; 63% found the information easy to understand and 56% indicated it would change their health behavior. Health Heritage consistently outperformed Usual Care in the completeness and accuracy of family health history collection, identifying 60% of the elevated risk conditions specified by the genetic team versus 24% identified by Usual Care. Health Heritage also had greater sensitivity than Usual Care when comparing the identification of risks. These results suggest a strong role for automated family health history collection and risk assessment and underscore the potential of these data to serve as the foundation for comprehensive, cost-effective personalized genomic medicine. Copyright © 2010 S. Karger AG, Basel.

Environment, Safety and Health Progress Assessment of the Hanford Site

International Nuclear Information System (INIS)

1992-05-01

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

Aries: system for health effects assessment in industrial Risk

International Nuclear Information System (INIS)

Rabago, I.; Vidania, R. de; Sierra, I.

1992-01-01

In this word we present a general description of ARIES*, a tool designed in order to support the assessment of expected heath derived from an accidental release of toxic compounds. ARIES includes two secuential 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 for the quantitative published a new report were it will be described with detail the procedure designed for 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 from animals), as inputs for different kinds of models. from these, and other physilogical values ARIES calculates the inhaled equivalent doses and the expected associated effects as a function of the exposure times. 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 and additional support to the assessment. Both steps, just refered, are integrated into a logical informatic support. The informatic code is developed in dbase languaje 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 analisys 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

Effectiveness of motivational interviewing at improving oral health: a systematic review

Directory of Open Access Journals (Sweden)

Andreia Morales Cascaes

2014-02-01

Full Text Available OBJECTIVE : To analyze the effectiveness of motivational interviewing (MI at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride and dental clinical outcomes (dental plaque, dental caries and periodontal status. METHODS : A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS : Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8 assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets. Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS : We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

Health Equity Assessment Toolkit (HEAT: software for exploring and comparing health inequalities in countries

Directory of Open Access Journals (Sweden)

Ahmad Reza Hosseinpoor

2016-10-01

Full Text Available Abstract Background It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality, or observed differences between subgroups of a population. Monitoring health inequalities allows for the identification of health topics where major group differences exist, dimensions of inequality that must be prioritised to effect improvements in multiple health domains, and also population subgroups that are multiply disadvantaged. While availability of data to monitor health inequalities is gradually improving, there is a commensurate need to increase, within countries, the technical capacity for analysis of these data and interpretation of results for decision-making. Prior efforts to build capacity have yielded demand for a toolkit with the computational ability to display disaggregated data and summary measures of inequality in an interactive and customisable fashion that would facilitate interpretation and reporting of health inequality in a given country. Methods To answer this demand, the Health Equity Assessment Toolkit (HEAT, was developed between 2014 and 2016. The software, which contains the World Health Organization’s Health Equity Monitor database, allows the assessment of inequalities within a country using over 30 reproductive, maternal, newborn and child health indicators and five dimensions of inequality (economic status, education, place of residence, subnational region and child’s sex, where applicable. Results/Conclusion HEAT was beta-tested in 2015 as part of ongoing capacity building workshops on health inequality monitoring. This is the first and only application of its kind; further developments are proposed to introduce an upload data feature, translate it into different languages and increase interactivity of the software. This article will present the main features and functionalities of HEAT and discuss its relevance and use for health inequality monitoring.

Risk assessment in support of plant health

DEFF Research Database (Denmark)

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

2012-01-01

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......With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU). Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop...... types and plants in the environment. There has been an increasing trend towards producing scientific opinions which are full pest risk assessments for the whole EU territory. In its work, and as a contribution to the wider development of risk assessment methodology, the Panel has developed a series...

Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

Science.gov (United States)

Mittelmark, M B

2001-09-01

The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

Guidelines for developing effective health education service in a national health agency.

Science.gov (United States)

Ochor, J O

1983-01-01

The constraints facing health education include: the fragmentation and dispersal of health-educational services among different agencies and personnel; lack of policy guidelines; ineffectively organized and inefficiently managed health education systems; poor hierarchical status and inadequacy of resources. To resolve these constraints, national health education systems in health agencies should be developed on the basis of stipulated guidelines that could ensure their viability, efficiency and effectiveness. A study at the African Regional Health Education Centre, Ibadan, Nigeria, has yielded thirty synthesized guidelines. The "guidelines" were empirically tested as an evaluation tool by assessing the operational and organizational status of Oyo State Health Education Unit, Ibadan, Nigeria. These guidelines are adaptable to local conditions to enhance the re-organization, re-orientation and consolidation of health education in national health agencies.

Self-assessment and woman’s health control location after gynaecological operations

Directory of Open Access Journals (Sweden)

Angelina Rogala

2016-07-01

Full Text Available Introduction: Surgical treatment in gynaecology has a specific influence on a woman’s life and has a psychological effect because of the organs involved. Self-assessment and women’s health control location after gynaecological operation determine the treatment and rehabilitation process. Aim of the research : Self-assessment and women’s health control location after gynaecological operation evaluation was the aim of this study. Material and methods : There were 167 women after gynaecological treatment evaluated. Patients were registered in the Obstetrics and Gynaecology department and the Gynaecology outpatient Clinic in Chełm Public Specialist Hospital. MHCL version B scale with polish adaptation (Z. Juszyński and sociodemographic, self-evaluation, and health control questionnaires created by the authors were used. This analysis used Kołmogorow-Smirnow, U Mann-Whitney and Kruskal-Wallis tests. Confidence intervals of p < 0.05 and p < 0.01 were established. IBM SPSS Statistics software was used. Results and conclusions : Most of the women after their gynaecological operations (61.1% revealed their health perception as good and only one (0.6% as poor. Over half of the patients self-assessed themselves as a valuable person (56.3% and womanlike (55.1%, whilst a small number of patients stated as not attractive, impoverished, worse than others, useless, or worthless. The highest self-assessment scores were from women in early stages after their operation, e.g. from one month to one year after treatment (M = 14.95. MHLC scale analysis showed that most of the patients overbalanced internal health self-control (M = 25.33, indicating that life control is dependent on the patient. Respondents who stated their health status as poor in every health control scale had higher results. Age and education had a significant influence on the MHCL and self-assessment scales (p < 0.001.

A Review of Data Quality Assessment Methods for Public Health Information Systems

Directory of Open Access Journals (Sweden)

Hong Chen

2014-05-01

Full Text Available High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.

Health effects of global warming: Problems in assessment

International Nuclear Information System (INIS)

Longstreth, J.

1993-06-01

Global warming is likely to result in a variety of environmental effects ranging from impacts on species diversity, changes in population size in flora and fauna, increases in sea level and possible impacts on the primary productivity of the sea. Potential impacts on human health and welfare have included possible increases in heat related mortality, changes in the distribution of disease vectors, and possible impacts on respiratory diseases including hayfever and asthma. Most of the focus thus far is on effects which are directly related to increases in temperature, e.g., heat stress or perhaps one step removed, e.g., changes in vector distribution. Some of the more severe impacts are likely to be much less direct, e.g., increases in migration due to agricultural failure following prolonged droughts. This paper discusses two possible approaches to the study of these less-direct impacts of global warming and presents information from on-going research using each of these approaches

Assessing the impact of hazardous waste on children's health: The exposome paradigm.

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Sarigiannis, D A

2017-10-01

Assessment of the health impacts related to hazardous waste is a major scientific challenge with multiple societal implications. Most studies related to associations between hazardous waste and public health do not provide established of mechanistic links between environmental exposure and disease burden, resulting in ineffective waste management options. The exposome concept comes to overhaul the nature vs. nurture paradigm and embraces a world of dynamic interactions between environmental exposures, endogenous exposures and genetic expression in humans. In this context, the exposome paradigm provides a novel tool for holistic hazardous waste management. Waste streams and the related contamination of environmental media are not viewed in isolation, but rather as components of the expotype, the vector of exposures an individual is exposed to over time. Thus, a multi-route and multi-pathway exposure estimation can be performed setting a realistic basis for integrated health risk assessment. Waste management practices are thus assessed not only regarding their technological edge and efficacy but also their effects on human health at the individual and community level, considering intra-subject variability in the affected population. The effectiveness of the exposome approach is demonstrated in the case of Athens, the capital of Greece, where the health effects associated to long term and short term exposure to two major waste management facilities (landfill and plastic recycling) are presented. Using the exposome analysis tools, we confirmed that proximity to a landfill is critical for children neurodevelopment. However, this effect is significantly modified by parameters such as parental education level, socioeconomic status and nutrition. Proximity to a plastics recycling plant does not pose significant threats under normal operating conditions; yet, in the case of an accidental fire, release of persistent carcinogenic compounds (dioxins and furans) even for a

Indoor air quality investigation and health risk assessment at correctional institutions.

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Ofungwu, Joseph

2005-04-01

A comprehensive indoor air-quality (IAQ) investigation was conducted at a state correctional facility in New Jersey, USA with a lengthy history of IAQ problems. The IAQ investigation comprised preliminary indoor air screening using direct readout instrumentation, indoor air/surface wipe sampling and laboratory analysis, as well as a heating, ventilation, and air-conditioning system evaluation, and a building envelope survey. In addition to air sampling, a human health risk assessment was performed to evaluate the potential for exposure to site-related air contaminants with respect to the inmate and worker populations. The risk assessment results for the prison facility indicated the potential for significant health risks for the inmate population, possibly reflecting the effects of their confinement and extended exposure to indoor air contaminants, as compared to the prison guard and worker population. Based on the results of the risk assessment, several mitigation measures are recommended to minimize prison population health risks and improve indoor air quality at prison facilities.

Critical analysis of e-health readiness assessment frameworks: suitability for application in developing countries.

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Mauco, Kabelo Leonard; Scott, Richard E; Mars, Maurice

2018-02-01

Introduction e-Health is an innovative way to make health services more effective and efficient and application is increasing worldwide. e-Health represents a substantial ICT investment and its failure usually results in substantial losses in time, money (including opportunity costs) and effort. Therefore it is important to assess e-health readiness prior to implementation. Several frameworks have been published on e-health readiness assessment, under various circumstances and geographical regions of the world. However, their utility for the developing world is unknown. Methods A literature review and analysis of published e-health readiness assessment frameworks or models was performed to determine if any are appropriate for broad assessment of e-health readiness in the developing world. A total of 13 papers described e-health readiness in different settings. Results and Discussion Eight types of e-health readiness were identified and no paper directly addressed all of these. The frameworks were based upon varying assumptions and perspectives. There was no underlying unifying theory underpinning the frameworks. Few assessed government and societal readiness, and none cultural readiness; all are important in the developing world. While the shortcomings of existing frameworks have been highlighted, most contain aspects that are relevant and can be drawn on when developing a framework and assessment tools for the developing world. What emerged is the need to develop different assessment tools for the various stakeholder sectors. This is an area that needs further research before attempting to develop a more generic framework for the developing world.

Statistical health-effects study

International Nuclear Information System (INIS)

Gilbert, E.S.; Sever, L.E.

1983-01-01

A principal objective of this program is to determine if there are demonstrable effects of radiation exposure to the Hanford worker by analyzing mortality records of this population. A secondary purpose is to improve methodology for assessing health effects of chronic low-level exposure to harmful agents or substances, particularly i an occupational setting. In the past year we have updated our analyses and initiated new areas of analysis. Complete documentation was provided for our computer program for the mortality study, and a user's manual is under development. A case-control study of birth defects was started in FY 1982

Assessment of health community at the level of Health center Rakovica: Goals and opportunities

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Šćepanović Aleksandar

2017-01-01

Full Text Available Assessment of the health status of the population is the foundation for troubleshooting health of the community. For this first step in solving the problems of health need to have adequate data. The basis for the registration of medical information is medical documentation. The aim is to assess the role and place of assessment of the health status of the community according to the literature in this field. We analyzed the available literature in the field of social medicine and health statistics, enlightened assessment of health in the community. The data necessary for determining the state of health can be related to many characteristics. The data can be accessed: review of available medical records and life statistics. Data analysis is performed with respect to the individual, family, group or the entire community. Based on the analysis and evaluation of health status can begin activities in the planning of preventive measures that should be implemented. To evaluate prevention plan is necessary to select and collect the appropriate data for the evaluation. The analysis and evaluation of individuals involved in cooperation with a team of health care health center for the level of Rakovica. Based on the good judgment of health condition can make appropriate plans of action to protect the health of the community.

Health impact assessment in planning: Development of the design for health HIA tools

International Nuclear Information System (INIS)

Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

2010-01-01

How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

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Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-03-22

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Health technology assessment in India: the potential for improved healthcare decision-making.

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Kumar, Mrityunjai; Ebrahim, Shah; Taylor, Fiona C; Chokshi, Maulik; Gabbay, John

2014-01-01

Health technology assessment (HTA) is a multidisciplinary approach that uses clinical effectiveness, cost-effectiveness, policy and ethical perspectives to provide evidence upon which rational decisions on the use of health technologies can be made. It can be used for a single stand-alone technology (e.g. a drug, a device), complex interventions (e.g. a rehabilitation service) and can also be applied to individual patient care and to public health. It is a tool for enabling the assessment and comparison of health technologies using the same metric of cost-effectiveness. This process benefits the patient, the health service, the healthcare payer and the technology producer as only technologies that are considered cost-effective are promoted for widespread use. This leads to greater use of effective technologies and greater health gain. The decision-making process in healthcare in India is complex owing to multiplicity of organizations with overlapping mandates. Often the decision-making is not evidence-based and there is no mechanism of bridging the gap between evidence and policy. Elsewhere, HTA is a frequently used tool in informing policy decisions in both resource-rich and resource-poor countries. Despite national organizations producing large volumes of research and clinical guidelines, India has not yet introduced a formal HTA programme. The incremental growth in healthcare products, services, innovation in affordable medical devices and a move towards universal healthcare, needs to be underpinned with an evidencebase which focuses on effectiveness, safety, affordability and acceptability to maximize the benefits that can be gained with a limited healthcare budget. Establishing HTA as a formal process in India, independent of healthcare providers, funders and technology producers, together with a framework for linking HTA to policy-making, would help ensure that the population gets better access to appropriate healthcare in the future. Copyright 2014, NMJI.

Categories of adverse health effects from indoor air pollution

International Nuclear Information System (INIS)

Weetman, D.F.; Munby, J.

1994-01-01

There is a lack of precision in the definition of health, which leads to confusion in the assessment of adverse effects arising from indoor air pollution. Adverse health effects range from annoyance to life-threatening conditions. Survey responses suggest that males and females differ in their perception of a healthy person, but both sexes envisage a male in terms of positive fitness, strength, energy and the possession of an athletic body, rather than how long one was likely to live. Psychological fitness was relatively unimportant in describing the health of others, but was rates as very important with respect to one's own health. Mortality statistics tend to obscure the proportion of the population who suffer chronic illness that is not life threatening. Although health is largely determined by genetic constitution, lifestyle and environmental factors, the morale of an individual is also important. A new classification of the adverse effects on health of indoor air pollution is proposed: this includes 'comfort' responses, such as sick building syndrome (category 1); acute chemical effects, the nature of which depends upon the specific intoxicant (category 2B), and perceived chronic grave risk, including cancer causation (category 3). The magnitude of risk in this latter category is imprecise, because its measurement involves the technique of quantitative risk assessment. (author) 1 fig., 2 tabs., 158 refs

The 6/94 gap in health impact assessment

International Nuclear Information System (INIS)

Erlanger, Tobias E.; Krieger, Gary R.; Singer, Burton H.; Utzinger, Juerg

2008-01-01

Health impact assessment (HIA), a methodology that aims to facilitate the mitigation of negative and enhancement of positive health effects due to projects, programmes and policies, has been developed over the past 20-30 years. There is an underlying assumption that HIA has become a full fledged critical piece of the impact assessment process with a stature equal to both environmental and social impact assessments. This assumption needs to be supported by evidence however. Within the context of projects in developing country settings, HIA is simply a slogan without a clearly articulated and relevant methodology, offered by academia and having little or no salience in the decision-making process regarding impacts. This harsh assertion is supported by posing a simple question: 'Where in the world have HIAs been carried out?' To answer this question, we systematically searched the peer-reviewed literature and online HIA-specific databases. We identified 237 HIA-related publications, but only 6% of these publications had a focus on the developing world. What emerges is, therefore, a huge disparity, which we coin the 6/94 gap in HIA, even worse than the widely known 10/90 gap in health research (10% of health research funding is utilized for diseases causing 90% of the global burden of disease). Implications of this 6/94 gap in HIA are discussed with pointed emphasis on extractive industries (oil/gas and mining) and water resources development. We conclude that there is a pressing need to institutionalize HIA in the developing world, as a consequence of current predictions of major extractive industry and water resources development, with China's investments in these sectors across Africa being particularly salient

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.

Assessing Performance and Learning in Interprofessional Health Care Teams.

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Ekmekci, Ozgur; Sheingold, Brenda; Plack, Margaret; LeLacheur, Susan; Halvaksz, Jennifer; Lewis, Karen; Schlumpf, Karen; Greenberg, Larrie

2015-01-01

Teamwork has become an integral part of health care delivery. Such emphasis on teamwork has generated the need to systematically measure and improve the learning and performance of health care teams. The purpose of this study was to develop a comprehensive assessment instrument, the Interprofessional Education and Practice Inventory (IPEPI), to evaluate learning and performance in interprofessional health care teams. The 12-month study commenced in three 4-month phases: (1) a panel of 25 national and international experts participated in the Delphi process to identify factors influencing team learning and team performance; (2) the research team analyzed the findings from the two Delphi rounds to develop the IPEPI; and (3) a cohort of 27 students at the university engaged in clinical simulations to test and refine the IPEPI. Findings suggest key factors that significantly influence team learning and performance include whether the group is able to foster a climate of mutual respect, adopt effective communication strategies, develop a sense of trust, and invite contributions from others. Additionally, in assessing organizational factors, participants indicated those factors that significantly influence team learning and performance include whether the organization is patient-centered, creates a culture of safety (not blame), and supports individual and team learning. These findings highlight the critical role assessment plays in enhancing not just interprofessional education or interprofessional practice, but in essence advancing interprofessional education and practice--which requires an integrated examination of how health care professionals learn and perform in teams.

Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

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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.

Tool for assessing health and equity impacts of interventions modifying air quality in urban environments.

Science.gov (United States)

Cartier, Yuri; Benmarhnia, Tarik; Brousselle, Astrid

2015-12-01

Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hygienic environmental assessment and health of children in Penza

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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.

Sense of coherence modifies the effect of overtime work on mental health.

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Ohta, Masanori; Higuchi, Yoshiyuki; Yamato, Hiroshi; Kumashiro, Masaharu; Sugimura, Hisamichi

2015-01-01

In the occupational health field, it is important to know how workload influences mental health. Overtime work and job strain appear to affect the mental health status of workers. Sense of coherence (SOC) may mediate the relationship between work stress and mental health. Since SOC represents a personal ability to manage psychological stressors, we hypothesized that a strong SOC would modify the adverse effect of an objective measure of overtime work on mental health. A total of 1,558 Japanese workers employed in an information technology company were asked to complete a 3-item SOC Questionnaire and 28-item General Health Questionnaire (GHQ) to assess mental health status. Workload was assessed by the actual amount of overtime work hours recorded by the company. Multiple regression analysis revealed a main effect of overtime work (β=0.08, p=0.0003) and SOC scores (β=0.41, p work and SOC scores (β=0.05, p=0.051). Simple slope analysis supported this association (-1 SD below the mean, simple slope=0.04, SE=0.01, p health impacts of workload as measured by an objective index of overtime work, and should be considered when assessing the effects of workload on mental health.

Facilitating communities in designing and using their own community health impact assessment tool

International Nuclear Information System (INIS)

Cameron, Colleen; Ghosh, Sebanti; Eaton, Susan L.

2011-01-01

Reducing health inequities and improving the health of communities require an informed public that is aware of the social determinants of health and how policies and programs have an impact on the health of their communities. People Assessing Their Health (PATH) is a process that uses community-driven health impact assessment to build the capacity of people to become active participants in the decisions that affect the well-being of their community. The PATH process is both a health promotion and a community development approach that builds people's ability to bring critical analysis to a situation and to engage in effective social action to bring about desired change. Because it increases analytical skills and provides communities with their own unique tool to assess the potential impact of projects, programs or policies on the health and well-being of their community it is an empowering process. PATH was originally used in three communities in northeastern Nova Scotia, Canada in 1996 when the Canadian health care system was being restructured to a more decentralized system. Since then it has been used in other communities in Nova Scotia and India. This paper will describe the PATH process and the use of the community health impact assessment as well as the methodology used in the PATH process. The lessons learned from PATH's experiences of building capacity among the community in Canada and India will be presented.

Not feeling well … true or exaggerated? Self-assessed health as a leading health indicator.

Science.gov (United States)

Becchetti, Leonardo; Bachelet, Maria; Riccardini, Fabiola

2018-02-01

We provide original, international evidence documenting that self-assessed health (SAH) is a leading health indicator, that is, a significant predictor of future changes in health conditions, in a large sample of Europeans aged above 50 and living in 13 different countries. We find that, after controlling for attrition bias, lagged SAH is significantly and negatively correlated with changes in the number of chronic diseases, net of the correlations with levels, and changes in sociodemographic factors and health styles, country and regional health system effects, and declared symptoms. Illness-specific estimates document that lagged SAH significantly correlates with arthritis, cholesterol, and lung diseases (and weakly so with ulcer, hypertension, and cataracts) and has a significant correlation with the probability of contracting cancer. Interpretations and policy implications of our findings are discussed in the paper. Copyright © 2017 John Wiley & Sons, Ltd.

Health impact assessment in environmental impact assessment in China: Status, practice and problems

International Nuclear Information System (INIS)

Chang, I-Shin; Yilihamu, Qimanguli; Wu, Jing; Wu, Huilei; Nan, Bo

2017-01-01

In China, the environmental impact assessment (EIA) system has gradually developed into an integrated evaluation system, owing to continuous improvement on institutional framework, system infrastructure, technical methods and professionals training, since EIA was first introduced in 1979. Though health impact assessment (HIA) is a part of the EIA system, the development of HIA is so slow as to remain at the early developing stage. This research aims to understand the extent and main issues concerning “health considerations” under the context of EIA, in China. Through case study on 42 environmental impact statements, the results demonstrate that HIA was not implemented in most of the cases, and health issues were not even mentioned in more than half of these cases. Where HIA was implemented, various problems were revealed through this study, including lacks of systematic approaching tools, insufficient supporting data on health effects, ineffective public participation, limited health considerations on biophysics, and so forth. Nevertheless, these problems can be attributed to lacks of legal supports, systematic evaluation methods, knowledge on evaluation technologies, and professional training institutions for HIA in China. In order to improve HIA methodologies, technologies, and management, to perfect HIA evaluation system, and to enhance public participation system within HIA, some recommendations from institutional, technical, administrative, and managerial aspects were then proposed in this study. - Highlights: •The status and deficiencies of HIA in EIA in China were identified and evaluated. •There were great industrial differences for the implementation of HIA in EIA. •Public participation was not well executed within HIA in EIA.

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

Science.gov (United States)

Kneale, Laura; Choi, Yong; Demiris, George

2016-01-01

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

Assessment and development of implementation models of health ...

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

Assessment and development of implementation models of health-related ... The Contribution of Civil Society Organizations in Achieving Health for All ... Health Information for Maternal and Child Health Planning in Urban Bangladesh.

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

Bearing Health Assessment Based on Chaotic Characteristics

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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.

Health Technology Assessment and vaccine: new needs and opportunities?

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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

Clean Slate transportation and human health risk assessment

International Nuclear Information System (INIS)

1997-02-01

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

Health effects of low-level ionising radiation: biological basis for risk assessment

International Nuclear Information System (INIS)

Upton, A.C.

1987-01-01

The biological basis for risk assessment is discussed. The risks of carcinogenic effects, teratogenic effects, and genetic (heritable) effects are estimated to vary in proportion with the dose of radiation in the low-dose domain; however, the risks also appear to vary with the LET of the radiation, age at the time of irradiation, and other variables. Although the data suffice to place the risks in perspective with other hazards of modern life, further research to refine the reliability of the risk assessment is called for. (author)

Lessons learned: Needs for improving human health risk assessment at USDOE Sites

International Nuclear Information System (INIS)

Hamilton, L.D.; Holtzman, S.; Meinhold, A.F.; Morris, S.C.; Rowe, M.D.; Daniels, J.I.; Layton, D.W.; Anspaugh, L.R.

1993-09-01

Realistic health risk assessments were performed in a pilot study of three U.S. Department of Energy (USDOE) sites. These assessments, covering a broad spectrum of data and methods, were used to identify needs for improving future health risk assessments at USDOE sites. Topics receiving specific recommendations for additional research include: choice of distributions for Monte Carlo simulation; estimation of risk reduction; analysis of the U.S. Department of Agriculture Database on food and nutrient intakes; investigations on effects of food processing on contaminant levels; background food and environmental concentrations of contaminants; method for handling exposures to groundwater plumes, methods for analyzing less than lifetime exposure to carcinogens; and improvement of bioaccumulation factors

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

Science.gov (United States)

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

2016-01-01

Background 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. Methods 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. Results 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. Conclusion 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. PMID:27380417

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

Directory of Open Access Journals (Sweden)

Shilu Tong

2013-03-01

Full Text Available Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA, there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Assessing the Efficacy of a School Health Education Advocacy Lesson with College Students

Science.gov (United States)

Wallen, Michele; Chaney, Beth H.; Birch, David A.

2012-01-01

Purpose: The researchers evaluated the efficacy of an advocacy lesson to assess change in intentions to advocate for school health education. This study also measured changes in participants' understanding the importance of school health education and perceived effectiveness in applying advocacy skills. Methods: A convenience sample of college…

Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects: a cluster-randomised controlled trial.

Science.gov (United States)

Nsangi, Allen; Semakula, Daniel; Oxman, Andrew D; Austvoll-Dahlgren, Astrid; Oxman, Matt; Rosenbaum, Sarah; Morelli, Angela; Glenton, Claire; Lewin, Simon; Kaseje, Margaret; Chalmers, Iain; Fretheim, Atle; Ding, Yunpeng; Sewankambo, Nelson K

2017-07-22

Claims about what improves or harms our health are ubiquitous. People need to be able to assess the reliability of these claims. We aimed to evaluate an intervention designed to teach primary school children to assess claims about the effects of treatments (ie, any action intended to maintain or improve health). In this cluster-randomised controlled trial, we included primary schools in the central region of Uganda that taught year-5 children (aged 10-12 years). We excluded international schools, special needs schools for children with auditory and visual impairments, schools that had participated in user-testing and piloting of the resources, infant and nursery schools, adult education schools, and schools that were difficult for us to access in terms of travel time. We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books, and a teachers' guide). Teachers attended a 2 day introductory workshop and gave nine 80 min lessons during one school term. The lessons addressed 12 concepts essential to assessing claims about treatment effects and making informed health choices. We did not intervene in the control schools. The primary outcome, measured at the end of the school term, was the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores on the same test. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201606001679337. Between April 11, 2016, and June 8, 2016, 2960 schools were assessed for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n=60, 76 teachers and 6383 children) or control group (n=60, 67 teachers and 4430 children

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...... to generate knowledge and evidence about the patient aspects of a given technology. This raises questions about how knowledge is produced in HTA reports and what kind of knowledge is considered relevant. This article uses a Danish HTA on patient education from 2009 as empirical material for a critical...

Radioactivity in the environment and its effects on health

International Nuclear Information System (INIS)

Sene, Monique; Schuler, Matthieu; Couvez, Celine; Rollinger, Francois; Bruno, Valerie; Renaud, Philippe; Laurier, Dominique; Gariel, Jean-Christophe; Estevao, Mathieu; Le Berre, David; Quere, Emmanuel; Josset, Mylene; Bernollin, Antoine; Saut, Catherine; Mailliat, Alain; Dryjanski, Claudie; Varin, Jean-Christophe; Villers, Anita; Gazal, Suzanne; Gerber, Mariette; Reynal, Nathalie; Vicaud, Alain; Renaud, Philippe; Roussel-Debet, S.; Leprieur, F.; Pourcelot, L.; Saey, L.; Tournieux, D.; Caldeira-Ideias, P.; Manificat, G.; Grammont, Vincent; Behar, Abraham; Gerber, Mariette

2015-11-01

This document gathers Power Point presentations. After a presentation of the new public portal of the French national network of measurements of radioactivity in the environment, a first session addressed the control of the environment by the different actors present on a territory (associations like CLI or ACRO or ATMO, operators like Areva). The addressed issues have been: the control performed by a CLI (Paluel-Penly) with the support of a departmental laboratory, the radiological monitoring of the environment about the Brennilis site, the study of an environmental marker (tritium in hive products), the specific study of the Durance region, the control of ambient radioactivity on the Nord-Pas-de-Calais coast, and the monitoring of the environment by the operator around La Hague site. The second session addressed the building up of reference radiological assessments: lessons learned from radiological assessments implemented by the IRSN, a citizen mapping of radioactivity in France, and improvement orientations for the monitoring of the environment by different actors. The third session addressed issues spanning from the environment to health: assessment of doses based on the control of the environment, global health impact for a set of nuclear power plants, assessment of the health impact of releases, knowledge status on the effects of low doses, and possible improvements of knowledge on the effects of radioactivity on health

A DECADE OF HEALTH TECHNOLOGY ASSESSMENT IN POLAND.

Science.gov (United States)

Lipska, Iga; McAuslane, Neil; Leufkens, Hubert; Hövels, Anke

2017-01-01

The objective of this study is to illustrate and provide a better understanding of the role of health technology assessment (HTA) processes in decision making for drug reimbursement in Poland and how this approach could be considered by other countries of limited resources. We analyzed the evolution of the HTA system and processes in Poland over the past decade and current developments based on publicly available information. The role of HTA in drug-reimbursement process in Poland has increased substantially over the recent decade, starting in 2005 with the formation the Agency for Health Technology Assessment and Tariff System (AOTMiT). The key success factors in this development were effective capacity building based on the use of international expertise, the implementation of transparent criteria into the drug reimbursement processes, and the selective approach to the adoption of innovative medicines based on the cost-effectiveness threshold among other criteria. While Poland is regarded as a leader in Central and Eastern Europe, there is room for improvement, especially with regard to the quality of HTA processes and the consistency of HTA guidelines with reimbursement law. In the "pragmatic" HTA model use by AOTMiT, the pharmaceutical company is responsible for the preparation of a reimbursement dossier of good quality in line with HTA guidelines while the assessment team in AOTMiT is responsible for critical review of that dossier. Adoption of this model may be considered by other countries with limited resources to balance differing priorities and ensure transparent and objective access to medicines for patients who need them.

Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

Directory of Open Access Journals (Sweden)

Robin C Nesbitt

Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

Science.gov (United States)

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

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 education group increased this score (average: 0.2; 95%CI 0.1-0.4). There have been no differences in the levels of physical activity measured by accelerometry. The interventions have been effective in increasing the practice of physical activity. However, we have observed that the health education intervention was more effective for maintaining the practice of physical activity in the period after intervention. We recommend the use of both interventions to promote physical activity in the Brazilian Unified Health System, according to the local reality of professionals, facilities, and team objectives. Avaliar o efeito de intervenções nos níveis de atividade física de adultos saudáveis, usuários do Sistema Único de Saúde e atendidos pela Estratégia de Saúde da Família. Estudo experimental, não randomizado, com 157 adultos alocados em três grupos: 1) classes de exercícios físicos (n = 54); 2) educação em saúde (n = 54

The DRUID study: racism and self-assessed health status in an indigenous population

Science.gov (United States)

2012-01-01

Background There is now considerable evidence from around the world that racism is associated with both mental and physical ill-health. However, little is known about the mediating factors between racism and ill-health. This paper investigates relationships between racism and self-assessed mental and physical health among Indigenous Australians as well as potential mediators of these relationships. Methods A total of 164 adults in the Darwin Region Urban Indigenous Diabetes (DRUID) study completed a validated instrument assessing interpersonal racism and a separate item on discrimination-related stress. Self-assessed health status was measured using the SF-12. Stress, optimism, lack of control, social connections, cultural identity and reactions/responses to interpersonal racism were considered as mediators and moderators of the relationship between racism/discrimination and self-assessed health status. Results After adjusting for socio-demographic factors, interpersonal racism was significantly associated with the SF-12 mental (but not the physical) health component. Stress, lack of control and feeling powerless as a reaction to racism emerged as significant mediators of the relationship between racism and general mental health. Similar findings emerged for discrimination-related stress. Conclusions Racism/discrimination is significantly associated with poor general mental health among this indigenous population. The mediating factors between racism and mental health identified in this study suggest new approaches to ameliorating the detrimental effects of racism on health. In particular, the importance of reducing racism-related stress, enhancing general levels of mastery, and minimising negative social connections in order to ameliorate the negative consequences of racism. PMID:22333047

The judgement process in evidence-based medicine and health technology assessment

OpenAIRE

Kelly, Michael P; Moore, Tessa A

2011-01-01

This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA). It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources. At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver...

Assessing the health workforce implications of health policy and programming: how a review of grey literature informed the development of a new impact assessment tool.

Science.gov (United States)

Nove, Andrea; Cometto, Giorgio; Campbell, James

2017-11-09

In their adoption of WHA resolution 69.19, World Health Organization Member States requested all bilateral and multilateral initiatives to conduct impact assessments of their funding to human resources for health. The High-Level Commission for Health Employment and Economic Growth similarly proposed that official development assistance for health, education, employment and gender are best aligned to creating decent jobs in the health and social workforce. No standard tools exist for assessing the impact of global health initiatives on the health workforce, but tools exist from other fields. The objectives of this paper are to describe how a review of grey literature informed the development of a draft health workforce impact assessment tool and to introduce the tool. A search of grey literature yielded 72 examples of impact assessment tools and guidance from a wide variety of fields including gender, health and human rights. These examples were reviewed, and information relevant to the development of a health workforce impact assessment was extracted from them using an inductive process. A number of good practice principles were identified from the review. These informed the development of a draft health workforce impact assessment tool, based on an established health labour market framework. The tool is designed to be applied before implementation. It consists of a relatively short and focused screening module to be applied to all relevant initiatives, followed by a more in-depth assessment to be applied only to initiatives for which the screening module indicates that significant implications for HRH are anticipated. It thus aims to strike a balance between maximising rigour and minimising administrative burden. The application of the new tool will help to ensure that health workforce implications are incorporated into global health decision-making processes from the outset and to enhance positive HRH impacts and avoid, minimise or offset negative impacts.

NASA Occupational Health Program FY98 Self-Assessment

Science.gov (United States)

Brisbin, Steven G.

1999-01-01

The NASA Functional Management Review process requires that each NASA Center conduct self-assessments of each functional area. Self-Assessments were completed in June 1998 and results were presented during this conference session. During FY 97 NASA Occupational Health Assessment Team activities, a decision was made to refine the NASA Self-Assessment Process. NASA Centers were involved in the ISO registration process at that time and wanted to use the management systems approach to evaluate their occupational health programs. This approach appeared to be more consistent with NASA's management philosophy and would likely confer status needed by Senior Agency Management for the program. During FY 98 the Agency Occupational Health Program Office developed a revised self-assessment methodology based on the Occupational Health and Safety Management System developed by the American Industrial Hygiene Association. This process was distributed to NASA Centers in March 1998 and completed in June 1998. The Center Self Assessment data will provide an essential baseline on the status of OHP management processes at NASA Centers. That baseline will be presented to Enterprise Associate Administrators and DASHO on September 22, 1998 and used as a basis for discussion during FY 99 visits to NASA Centers. The process surfaced several key management system elements warranting further support from the Lead Center. Input and feedback from NASA Centers will be essential to defining and refining future self assessment efforts.

Short Assessment of Health Literacy for Portuguese-speaking Adults

Directory of Open Access Journals (Sweden)

Daniel Apolinario

2012-08-01

Full Text Available OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76. The instrument showed adequate internal consistency (Cronbach's alpha=0.93 and adequate test-retest reliability (intraclass correlation coefficient=0.95. The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.

[Health research and health technology assessment in Chile].

Science.gov (United States)

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

2014-01-01

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

Health impact assessment of climate change in Bangladesh

International Nuclear Information System (INIS)

Nelson, Deborah Imel

2003-01-01

Global climate change (GCC) may have serious and irreversible impacts. Improved methods are needed to predict and quantify health impacts, so that appropriate risk management strategies can be focused on vulnerable areas. The disability-adjusted life year (DALY) is proposed as an effective tool in environmental health impact assessment (HIA). The DALY accounts for years of life lost to premature death and/or morbidity. Both the DALY and the determinants-of-health approach are applied to HIA of GCC in Bangladesh. Based on historical data, a major storm event may result in approximately 290 DALY per 1000 population, including both deaths and injuries, compared to a current all-cause rate of about 280 per 1000 in the region. A more precise result would require a large input of data; however, this level of analysis may be sufficient to rank risks, and to motivate and target risk management efforts

Health technology assessment in Iran: challenges and views

Science.gov (United States)

Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

2014-01-01

Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

Environmental health risk assessment: Energy systems

International Nuclear Information System (INIS)

Krewski, D.; Somers, E.; Winthrop, S.O.

1984-01-01

Most industrialized nations have come to rely on a variety of systems for energy production, both of a conventional and non-conventional nature. In the paper, the spectrum of energy systems currently in use in Canada is outlined along with their potential health risks. Several examples of environmental health studies involving both outdoor and indoor air pollution related to energy production in Canada are reported. The limitations of current technologies for assessing health risks are discussed and possible approaches to managing energy related health risks are indicated. (author)

Measuring and decomposing inequity in self-reported morbidity and self-assessed health in Thailand

Directory of Open Access Journals (Sweden)

Sidorenko Alexandra

2007-12-01

Full Text Available Abstract Background In recent years, interest in the study of inequalities in health has not stopped at quantifying their magnitude; explaining the sources of inequalities has also become of great importance. This paper measures socioeconomic inequalities in self-reported morbidity and self-assessed health in Thailand, and the contributions of different population subgroups to those inequalities. Methods The Health and Welfare Survey 2003 conducted by the Thai National Statistical Office with 37,202 adult respondents is used for the analysis. The health outcomes of interest derive from three self-reported morbidity and two self-assessed health questions. Socioeconomic status is measured by adult-equivalent monthly income per household member. The concentration index (CI of ill health is used as a measure of socioeconomic health inequalities, and is subsequently decomposed into contributing factors. Results The CIs reveal inequality gradients disadvantageous to the poor for both self-reported morbidity and self-assessed health in Thailand. The magnitudes of these inequalities were higher for the self-assessed health outcomes than for the self-reported morbidity outcomes. Age and sex played significant roles in accounting for the inequality in reported chronic illness (33.7 percent of the total inequality observed, hospital admission (27.8 percent, and self-assessed deterioration of health compared to a year ago (31.9 percent. The effect of being female and aged 60 years or older was by far the strongest demographic determinant of inequality across all five types of health outcome. Having a low socioeconomic status as measured by income quintile, education and work status were the main contributors disadvantaging the poor in self-rated health compared to a year ago (47.1 percent and self-assessed health compared to peers (47.4 percent. Residence in the rural Northeast and rural North were the main regional contributors to inequality in self

QUALITY OF HEALTH TECHNOLOGY ASSESSMENT REPORTS PREPARED FOR THE MEDICAL SERVICES ADVISORY COMMITTEE.

Science.gov (United States)

Hua, Martin; Boonstra, Tristan; Kelly, Patrick J; Wilson, Andrew; Craig, Jonathan C; Webster, Angela C

2016-01-01

The Medical Services Advisory Committee (MSAC) makes recommendations to the Australian Government for funding health technologies under the Medicare Benefits Schedule (MBS). Differences in public, clinical, commercial, and political opinions on health expenditure emphasize the importance of defensible funding decisions. We aimed to evaluate the quality of health technology assessment (HTA) reports over time and among health technologies assessed for MSAC. A cohort study was performed of HTA reports prepared for MSAC between 1998 and 2013. We measured the quality of HTA reports using reporting guidelines proposed by the European Collaboration for Assessment of Health Interventions. Individual component scores across eleven domains were calculated, and summed for an overall aggregate score. We used linear regression to investigate any change in quality over time and among the types of technologies assessed. We included 110 HTA reports. The safety (80 percent), effectiveness (84 percent), economic (74 percent), and organizational (99 percent) domains were better reported than the psychological, social, and ethical considerations (34 percent). The basic (75 percent), methodological (62 percent), background (82 percent), contextual (46 percent), status quo (54 percent), and technical information (66 percent) that framed each assessment were inconsistently reported. On average, overall quality scores increased by 2 percent (p technologies (p = 0.22). HTA reports prepared for MSAC are a key tool in allocating scarce health resources. The overall quality of these reports has improved, but the reporting of specific domains and subthemes therein could be better addressed.

Development of bilingual tools to assess functional health patterns.

Science.gov (United States)

Krozy, R E; McCarthy, N C

1999-01-01

The theory and process of developing bilingual assessment tools based on Gordon's 11 functional health patterns. To facilitate assessing the individual, family, and community in a student clinical practicum in a Spanish-speaking country. Multiple family and community health promotion theories; translation theories, Gordon's Manual of Nursing Diagnosis (1982); translation/back-translation involving Ecuadorian faculty and students; student community assessments; faculty and staff workshops in Ecuador. Bilingual, culturally sensitive health assessment tools facilitate history taking, establish nursing diagnoses and interventions, and promote mutual learning. These outcomes demonstrate potential application to other systems in the international nursing community.

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.

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.

Integrating Ecosystem Services Into Health Impact Assessment

Science.gov (United States)

Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

Health Impact Assessment of an oil drilling project in California

Directory of Open Access Journals (Sweden)

Lindsay C. McCallum

2016-04-01

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

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

OpenAIRE

Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-01-01

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within...

Physiotherapy students’ mental health assessment

OpenAIRE

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

2012-01-01

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

Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment Update

Science.gov (United States)

Lee, Christine; Tu, Hong Anh; Wells, David; Holubowich, Corinne

2017-01-01

Background Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa. Based on that assessment, the Ontario Health Technology Advisory Committee recommended against publicly funding the Argus II system for this population. It also recommended that Health Quality Ontario re-evaluate the evidence in 1 year. The objective of this report was to examine new evidence published since the 2016 health technology assessment. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences related to the Argus II system. We performed a systematic literature search for studies published since the 2016 Argus II health technology assessment. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care, and we calculated incremental cost-effectiveness ratios over a 20-year time horizon. We also conducted a five-year budget impact analysis. Finally, we interviewed people with retinitis pigmentosa about their lived experience with vision loss, and with the Argus II system. Results Four publications from one multicentre international study were included in the clinical review. Patients showed significant improvements in visual function and functional outcomes with the Argus II system, and these outcomes were sustained up to a 5-year follow-up (moderate quality of evidence). The safety profile was generally acceptable. In

Preliminary assessment of the environmental and health impacts of nuclear and coal fuel cycles

International Nuclear Information System (INIS)

Yang Yin; Chen Zhuzhou; Pan Ziqiang

1992-01-01

The paper reports on the environmental impacts and health effects of coal and nuclear fuel cycles in China. Data of interest for China are presented in a comparative manner; epidemiological investigations in Shanxi province indicate that the incidences of chronic pulmonary diseases and infant cogenital malformation were apparently increased over the fall-out areas of coal-fired power stations and coal mines. The authors outline the framework of a research project on environmental assessment of nuclear energy and other energy systems. The main features of the project are: environmental and health impacts of coal and nuclear fuel cycles, environmental impact assessment of coal transportation, cost accounting of nuclear and other energy sources, health risk assessment. (author). 24 refs, 4 tabs

Community health needs assessment with precede-proceed model: a mixed methods study

Directory of Open Access Journals (Sweden)

Wang Yang

2009-10-01

Full Text Available Abstract Background Community health services in China have developed over the last few decades. In order to use limited health resources more effectively, we conducted a community health needs assessment. This aimed to provide an understanding of the community's health problems and the range of potential factors affecting risk behaviours for the priority health problems. Methods We used the precede-proceed model for the needs assessment. Triangulation of data, methods and researchers were employed in data collection. Results Main findings include: cardiovascular diseases (CVDs were identified as the priority health problems in the study communities; risk factors associated with CVDs included smoking, physical inactivity and unhealthy eating behaviours, particularly amongst male residents with low education level; factors negatively affecting behaviours were classified into predisposing factors (limited knowledge, beliefs and lack of perceived needs, enabling factors (limited access to health promotion activities, unawareness of health promotion, lack of work-site and school health promotion, absence of health promotion related policy and reinforcing factors (culture. Policies and organization were not perfect; there were limited staff skilled in providing health promotion in the community. Conclusion CVDs were identified by the communities as priority health problems. Future health programs should focus on smoking, physical inactivity and unhealthy eating behaviours. Behaviour change strategies should take predisposing factors, enabling factors and reinforcing factors into consideration. Policies, organization and human resource need strengthening.

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

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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

Epidemiological methods for assessing dose-response and dose-effect relationships

DEFF Research Database (Denmark)

Kjellström, Tord; Grandjean, Philippe

2007-01-01

Selected Molecular Mechanisms of Metal Toxicity and Carcinogenicity General Considerations of Dose-Effect and Dose-Response Relationships Interactions in Metal Toxicology Epidemiological Methods for Assessing Dose-Response and Dose-Effect Relationships Essential Metals: Assessing Risks from Deficiency......Description Handbook of the Toxicology of Metals is the standard reference work for physicians, toxicologists and engineers in the field of environmental and occupational health. This new edition is a comprehensive review of the effects on biological systems from metallic elements...... access to a broad range of basic toxicological data and also gives a general introduction to the toxicology of metallic compounds. Audience Toxicologists, physicians, and engineers in the fields of environmental and occupational health as well as libraries in these disciplines. Will also be a useful...

Health risk assessment for program managers

International Nuclear Information System (INIS)

Jump, R.A.; Williamson, D.S.

1994-01-01

This paper presents the findings of a sensitivity analysis into the independent variables that determine the levels of health risks posed by buried plutonium and americium at a typical contaminated site in an arid region. Environmental Restoration Program Managers often must make decisions concerning cleanup levels, remediation alternatives, schedules, cost estimates, etc. based upon extraordinarily safe assumptions about risk assessment calculation inputs. This study reveals to the Program Manager which variables are major drivers to the calculated levels of risk posed by transuranic radionuclides and which ones have second order effects or less. The findings of this study should indicate which inputs should be the focus of attention during negotiations with regulators and of further empirical investigation

Strengthening health professions regulation in Cambodia: a rapid assessment.

Science.gov (United States)

Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

2016-03-10

This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

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Patrick Harris

2015-01-01

Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

Assessment of Health, Safety and Environmental Risks of Zahedan City Gasoline Stations

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S. Y. Far

2018-04-01

Full Text Available The purpose of this study was to assess the risk and determine the health, safety and environmental status of fuel stations in Zahedan. In this study, failure mode and effects analysis (FMEA method was used for risk assessment in accordance with the HSE guidelines, national and international standards and laws. In this cross-sectional study, 2 governmental stations and 6 active private stations were evaluated after the necessary coordination with the relevant units. As a result of risk assessment, 27 health risks, 55 safety risks and 22 environmental risks were identified. From among all the identified risks, 67 risks had a Risk Priority Number (RPN of less than 91, 31 risks had an RPN ranging between 91 and 201, and 6 risks had an RPN of over 201. The findings of the study indicated that compliance with the HSE requirements was 51.85%, in the area of health, 47.57% in the area of safety and 27.45% in the environmental area. Overall compliance with the HSE requirements was 42.54%. In order to distribute fuel considering health, reducing risk and increasing compliance with the requirements for safety improvement, health and environmental conditions of fuel supplies are essential.

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.

Health self-assessment by hemodialysis patients in the Brazilian Unified Health System

Science.gov (United States)

Moreira, Tiago Ricardo; Giatti, Luana; Cesar, Cibele Comini; Andrade, Eli Iola Gurgel; Acurcio, Francisco de Assis; Cherchiglia, Mariângela Leal

2016-01-01

ABSTRACT OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02), separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88), having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71), spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51), having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62), and reporting some (OR = 2.17; 95%CI 1.66–2.84) or a lot of (OR = 2.74; 95%CI 2.04–3.68) trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84). CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System. PMID:27143610

Health self-assessment by hemodialysis patients in the Brazilian Unified Health System

Directory of Open Access Journals (Sweden)

Tiago Ricardo Moreira

2016-01-01

Full Text Available ABSTRACT OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02, separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88, having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71, spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51, having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62, and reporting some (OR = 2.17; 95%CI 1.66–2.84 or a lot of (OR = 2.74; 95%CI 2.04–3.68 trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84. CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System.

Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

Science.gov (United States)

Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

2009-04-01

Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.