WorldWideScience

Sample records for assessing health effects

  1. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-10-01

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

  2. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

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

  3. Risk assessment and toxicology databases for health effects assessment

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

  4. Editorial: Lead Risk Assessment and Health Effects

    Science.gov (United States)

    Mielke, Howard W.

    2016-01-01

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

  5. Editorial: Lead Risk Assessment and Health Effects

    Directory of Open Access Journals (Sweden)

    Howard W. Mielke

    2016-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-07-01

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

  8. Health effects assessment of chemical exposures: ARIES methodology

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-01

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

  9. Health effects assessment of chemical exposures: ARIES methodology

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. 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.

  12. 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)

  13. Assessing Time-Varying Causal Effect Moderation in Mobile Health

    OpenAIRE

    Boruvka, Audrey; Almirall, Daniel; Witkiewitz, Katie; Murphy, Susan A.

    2016-01-01

    In mobile health interventions aimed at behavior change and maintenance, treatments are provided in real time to manage current or impending high risk situations or promote healthy behaviors in near real time. Currently there is great scientific interest in developing data analysis approaches to guide the development of mobile interventions. In particular data from mobile health studies might be used to examine effect moderators-i.e., individual characteristics, time-varying context or past t...

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

    DEFF Research Database (Denmark)

    Nielsen, Elsa; Dybdahl, Marianne; Larsen, Poul Bo

    Based on an extensive literature survey the reports concludes that particles from wood smoke should be considered as harmful to health and that effects from these particles can not be considered as less severe compared to ambient air particles in general or diesel particles. In DK there is about...

  15. 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)

  16. Health effects of global warming: Problems in assessment

    Energy Technology Data Exchange (ETDEWEB)

    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.

  17. Health effects of global warming: Problems in assessment

    International Nuclear Information System (INIS)

    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

  18. Assessment of Effectiveness of Barleria prionitis on Oral Health

    Science.gov (United States)

    Gupta, Devanand; Gupta, Rajendra Kumar; Jain, Ankita; Bindhumadhav, Suresh; Sangeeta; Garg, Purnima; Chaturvedi, Saurabh; Chattu, Vijay Kumar

    2016-01-01

    Aim: To evaluate the efficacy of Barleria prionitis extract mouthwash in comparison with gold standard chlorhexidine (CHX) mouthwash on the oral health. Materials and Methods: A total of 30 subjects were randomly divided into two groups, B. prionitis group and the CHX gluconate mouthwash group. The data were collected at the baseline and 3 days. The plaque was disclosed using erythrosine disclosing agent and their scores were recorded using the Quigley and Hein plaque index modified by Turesky-Gilmore-Glickman. Statistical analysis was performed to compare the effect of the two drug regime. Results: Our result showed that the CHX and the B. prionitis were statistically equally effective against dental plaque. Although the action of CHX was more pronounced. Conclusions: This study has confirmed antimicrobial potential of the plant B. prionitis, thus supporting its folklore application as preventive remedy against oral microbial diseases. SUMMARY Within the limitation of this trial, herbal mouthwash has been shown to demonstrate similar effects on plaque as compared to the standard drug CHX. Further long term research needs to be done to check the efficacy and effectiveness of herbal products over standard drug regime. PMID:27365983

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

    Science.gov (United States)

    Babo Martins, S; Rushton, J

    2014-12-01

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

  20. Exposure assessment strategies for crystalline silica health effects

    Energy Technology Data Exchange (ETDEWEB)

    Lippman, M. [New York University Medical Center, Tuxedo, NY (United States). Nelson Institute of Environmental Medicine

    1995-12-01

    Occupational exposure to dusts containing crystalline silica has long been associated with the induction of silicosis, a focal fibrosis of the pulmonary parenchyma. Since only the dust that could penetrate to the gas exchange region of the lung, defined as respirable dust, could produce a pneumoconiosis such as silicosis, size-selective respirable dust inlets were developed for air samplers to restrict the dust analyses to the respirable fraction of the airborne dust. Analyses of respirable dust are reported in terms of mass concentration, although a case can be made for associating the hazard more closely with the surface area of the dust. The hazards associated with inhaling crystalline silica within dust mixtures also depend on the properties of the coconstituents of the mixed aerosol, as documented in epidemiological studies on miners. Other considerations affecting exposure assessment strategies are concerns about diseases other than silicosis that may be caused by exposure to dusts containing crystalline silica. These include bronchitis and lung and stomach cancer, which may be related to the thoracic fraction of the airborne dust. Technical issues affecting the selection of size-selective samplers, their siting, sampling periods, flow rates, and sampling schedules can all be important in evaluating the effectiveness of an exposure assessment strategy. Changes in the work environment also need to be considered to the extent that they may affect airborne exposure and dose to target tissues in the lungs. Automation and production rate changes can alter both dust concentrations and size distributions, as well as respiratory patterns of the workers and their proximity to dust sources. These factors can also influence optimal placement of dust samplers and/or monitors. These and other factors are critically reviewed in terms of current and future exposure assessment strategies. 47 refs., 9 figs., 2 tabs.

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

    Science.gov (United States)

    Darden, Michael; Gilleskie, Donna

    2016-08-01

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

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

    Science.gov (United States)

    Darden, Michael; Gilleskie, Donna

    2016-08-01

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

  3. Health Effects Assessment for Hexahydro-1,3,5-Trinitro-1,3,5-Triazine (Rdx)

    Science.gov (United States)

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  4. Extended Cost-Effectiveness Analysis for Health Policy Assessment: A Tutorial.

    Science.gov (United States)

    Verguet, Stéphane; Kim, Jane J; Jamison, Dean T

    2016-09-01

    Health policy instruments such as the public financing of health technologies (e.g., new drugs, vaccines) entail consequences in multiple domains. Fundamentally, public health policies aim at increasing the uptake of effective and efficient interventions and at subsequently leading to better health benefits (e.g., premature mortality and morbidity averted). In addition, public health policies can provide non-health benefits in addition to the sole well-being of populations and beyond the health sector. For instance, public policies such as social and health insurance programs can prevent illness-related impoverishment and procure financial risk protection. Furthermore, public policies can improve the distribution of health in the population and promote the equalization of health among individuals. Extended cost-effectiveness analysis was developed to address health policy assessment, specifically to evaluate the health and financial consequences of public policies in four domains: (1) the health gains; (2) the financial risk protection benefits; (3) the total costs to the policy makers; and (4) the distributional benefits. Here, we present a tutorial that describes both the intent of extended cost-effectiveness analysis and its keys to allow easy implementation for health policy assessment. PMID:27374172

  5. 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.

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

    DEFF Research Database (Denmark)

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

    In the Baltic Sea Action Plan the urgent need to develop biological effects monitoring of hazardous substances and the assessment of ecosystem health has been clearly indicated. These goals will be tackled in the newly launched BEAST project (Biological Effects of Anthropogenic Chemical Stress......: 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...

  7. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

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

  8. Risk assessment and cost-effectiveness of animal health certification methods for livestock export in Somalia

    OpenAIRE

    Knight-Jones, T. J. D.; Njeumi, F.; Elsawalhy, A.; Wabacha, J.; Rushton, J.

    2014-01-01

    Livestock export is vital to the Somali economy. To protect Somali livestock exports from costly import bans used to control the international spread of disease, better certification of livestock health status is required. We performed quantitative risk assessment and cost-effectiveness analysis on different health certification protocols for Somali livestock exports for six transboundary diseases. Examining stock at regional markets alone without port inspection and quarantine was inexpensiv...

  9. 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.

  10. 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.

  11. 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.

  12. Comparisons of the health effects of energy systems: an assessment for France

    International Nuclear Information System (INIS)

    Apart from technical and economic considerations, the development of an industrial technology has a number of side effects whose assessment is necessary for energy choices. Health effects are analyzed in this chapter from this point of view. The kind of synthetic comparative study of industrial risks presented is quite recent - the first of its kind appeared in the 1970s. Since then, however, as such studies developed, both methodology and quantitative evaluations have improved. The uniqueness of this chapter is that it is based on French data and is therefore characteristic of a country with no fossil-fuel resources and within the Western European economic environment. It also provides data on risks in solar electrical plants as well as in nuclear, oil, and coal technologies. The following topics are examined: the various types of health effects; the need to develop scenarios; and the way to deal with specific effects, occupational effects; and so on. 5 figures, 6 tables

  13. Palladium emissions in the environment. Analytical methods, environmental assessment and health effects

    Energy Technology Data Exchange (ETDEWEB)

    Zereini, F. [Frankfurt Univ., Frankfurt am Main (Germany). Inst. for Atmosphere and Environment; Alt, F. (eds.)

    2006-07-01

    To date the investigations of metal emissions from automotive catalysts has focused mainly on platinum. Since 1993, however, platinum has been increasingly replaced by palladium as the predominant substance in pollution-control catalysts. Now the release of palladium in automotive catalysts is becoming just a critical problem as that of platinum. The editors present the latest research results related to all aspects of palladium emissions in the environment, as well as an assessment of their effects on the environment and health. The book focuses on the following topics: analytical methods; sources of palladium emissions; occurrence, chemical behaviour and fate in the environment; bioavailability and biomonitoring; and health-risk potential. (orig.)

  14. Suriname: Health Sector Assessment

    OpenAIRE

    Rena Eichler

    1999-01-01

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

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

    Science.gov (United States)

    Maréchal, Laëtitia; Semple, Stuart; Majolo, Bonaventura; MacLarnon, Ann

    2016-01-01

    Feeding wildlife is a very popular tourist activity, largely because it facilitates the close observation of animals in their natural habitat. Such provisioning may benefit animals by improving their survival and reproductive success, especially during periods of natural food shortage. However, provisioning by tourists may also have negative impacts on the health of the animals involved; to date such impacts are poorly understood. Here, we investigated the effects of tourist provisioning on the health of wild adult Barbary macaques, Macaca sylvanus, in Morocco. We compared health measures between a heavily provisioned group and a group that received negligible food from tourists and, in the former group, we also assessed health measures in relation to the intensity of provisioning. We used a broad range of non-invasive health measures relating to birth rate and survival, disease and injury risk, body size and condition, and physiological stress. Our findings indicate that feeding by tourists may overall have negative impacts on the health of Barbary macaques, being linked in particular to larger body size, elevated stress levels and more alopecia. Finally, we propose a framework to help consider the potential costs and benefits of provisioning, which may facilitate future research and management decisions on whether-and how much-provisioning is acceptable. PMID:27203861

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

    Directory of Open Access Journals (Sweden)

    Laëtitia Maréchal

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

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

    Science.gov (United States)

    Maréchal, Laëtitia; Semple, Stuart; Majolo, Bonaventura; MacLarnon, Ann

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, E.S.

    1992-07-02

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

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

    International Nuclear Information System (INIS)

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

  20. 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

  1. 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.

  2. 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)

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

    International Nuclear Information System (INIS)

    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

  4. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-11-01

    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{sub 2}), nitrogen dioxide (NO{sub 2}), ozone (O{sub 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.

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

    Science.gov (United States)

    Ding, Hongliu; Fu, Tong-Jen

    2016-01-01

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

  7. 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.

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Galen P Dively

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

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

    International Nuclear Information System (INIS)

    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 probability

  11. Risk assessment and cost-effectiveness of animal health certification methods for livestock export in Somalia.

    Science.gov (United States)

    Knight-Jones, T J D; Njeumi, F; Elsawalhy, A; Wabacha, J; Rushton, J

    2014-03-01

    Livestock export is vital to the Somali economy. To protect Somali livestock exports from costly import bans used to control the international spread of disease, better certification of livestock health status is required. We performed quantitative risk assessment and cost-effectiveness analysis on different health certification protocols for Somali livestock exports for six transboundary diseases. Examining stock at regional markets alone without port inspection and quarantine was inexpensive but was ineffective for all but contagious bovine pleuropneumonia, contagious caprine pleuropneumonia and peste des petits ruminants. While extended pre-export quarantine improves detection of infections that cause clinical disease, if biosecurity is suboptimal quarantine provides an opportunity for transmission and increased risk. Clinical examination, laboratory screening and vaccination of animals for key diseases before entry to the quarantine station reduced the risk of an exported animal being infected. If vaccination could be reliably performed weeks before arrival at quarantine its effect would be greatly enhanced. The optimal certification method depends on the disease. Laboratory diagnostic testing was particularly important for detecting infections with limited clinical signs in male animals (only males are exported); for Rift Valley fever (RVF) the probability of detection was 99% or 0% with and without testing. Based on our findings animal inspection and certification at regional markets combined with quarantine inspection and certification would reduce the risk of exporting infected animals and enhance disease control at the regional level. This is especially so for key priority diseases, that is RVF, foot-and-mouth disease and Brucellosis. Increased data collection and testing should be applied at point of production and export.

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

    International Nuclear Information System (INIS)

    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

  13. Effects of a Late Life Suicide Risk Assessment Training on Multidisciplinary Health Care Providers

    Science.gov (United States)

    Huh, J.W. Terri; Weaver, Christopher M.; Martin, Jennifer L.; Caskey, Nicholas H.; O’Riley, Alisa; Kramer, B. Josea

    2016-01-01

    Older adults are among the highest at risk group for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental healthcare. However, providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of health care providers who may see older adults in their care settings. One hundred and thirty two participants from two VA Medical Centers participated in a 6.5 hour long workshop in the assessment and management of suicide risk among older adults. Participants were asked to complete pre- and- post workshop case notes and report on subjective changes in knowledge, attitude, and confidence in assessment and managing suicide risk in older adults. Participants included social workers, nurses, physicians, psychologists, and occupational therapists coming from a variety of care settings including outpatient and inpatient medical, outpatient and inpatient mental health, specialty clinics, and home and community. Following the workshop, participants demonstrated improvement in the overall quality of case notes (p<.01), increased ability to recognize important conceptual suicide risk categories (p<.05), and reported heightened awareness of the importance of late life suicide. Results suggested that educational training may have beneficial impact on multidisciplinary care providers’ ability to identify and manage suicide risk in the elderly. PMID:22288717

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    to consistently include health effects from PM2.5 exposure in LCA practice. As a consequence, different models are currently used to assess life cycle impacts for PM2.5, sometimes leading to inconsistent results. In a global effort initiated by the United Nations Environment Programme (UNEP...

  15. 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).

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

    Science.gov (United States)

    1980-01-01

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

  17. 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

  18. Assessing the public health effects of global warming: New and ongoing international efforts

    Energy Technology Data Exchange (ETDEWEB)

    Patz, J. [Johns Hopkins School of Hygiene and Public Health, Baltimore, MD (United States). Div. of Environmental and Occupational Medicine

    1995-03-01

    The major health outcomes resulting from global warming are expected to occur through alterations in temperature, weather patterns, and sea-level rise. Potential impacts may include increases in heat-related morbidity and mortality, spread of vector-borne diseases, threatened food and fresh water supply, and infrastructural pressures due to extreme weather events and forced human migration. Extensive international coordination will be required both to assess and possibly mitigate these worldwide health ramifications. International organizations have begun to assembly research and monitoring initiatives. CLIMEDAT is a new database sponsored by the World Health Organization to specifically help network international scientists addressing the health-related aspects of global climate change. Under the World Meteorological Organization`s World Climate Program, monitoring systems such as the Global Climate, Global Ocean, and Global Terrestrial Observing Systems are aiding in the global and regional assessment of climate and ecosystem change. The International council of Scientific Unions is encouraging multidisciplinary involvement at several levels; projects include the World Climate Research Program, the International Geosphere-Biosphere Program, the Human Dimensions Program, and Diversitas (which addresses the role of biodiversity change). The mitigating options of reducing greenhouse gas emissions combined with maximizing carbon dioxide sinks will further require full North/South cooperation.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Yari

    2016-02-01

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

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

    International Nuclear Information System (INIS)

    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

  2. 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).

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

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J

    2015-03-18

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

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

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J

    2015-03-18

    Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness. PMID:25785894

  5. Arsenic exposure in Latin America: biomarkers, risk assessments and related health effects.

    Science.gov (United States)

    McClintock, Tyler R; Chen, Yu; Bundschuh, Jochen; Oliver, John T; Navoni, Julio; Olmos, Valentina; Lepori, Edda Villaamil; Ahsan, Habibul; Parvez, Faruque

    2012-07-01

    In Latin America, several regions have a long history of widespread arsenic (As) contamination from both natural and anthropological sources. Yet, relatively little is known about the extent of As exposure from drinking water and its related health consequences in these countries. It has been estimated that at least 4.5 million people in Latin America are chronically exposed to high levels of As (>50 μg/L), some to as high as 2000 μg/L--200 times higher than the World Health Organization (WHO) provisional standard for drinking water. We conducted a systematic review of 82 peer reviewed papers and reports to fully explore the current understanding of As exposure and its health effects, as well as the influence of genetic factors that modulate those effects in the populations of Latin America. Despite some methodological limitations, these studies suggested important links between the high levels of chronic As exposure and elevated risks of numerous adverse health outcomes in Latin America--including internal and external cancers, reproductive outcomes, and childhood cognitive function. Several studies demonstrated genetic polymorphisms that influence susceptibility to these and other disease states through their modulation of As metabolism, with As methyltransferase (AS3MT), glutathione S-transferase (GST), and genes of one-carbon metabolism being specifically implicated. While the full extent and nature of the health burden are yet to be known in Latin America, these studies have significantly enriched knowledge of As toxicity and led to subsequent research. Targeted future studies will not only yield a better understanding of the public health impact of As in Latin America populations, but also allow for effective and timely mitigation efforts.

  6. 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.

  7. Groundwater Chemistry and Assessment of Its Effect on Health from the Aspect of Medical Geology

    Directory of Open Access Journals (Sweden)

    Simge Varol

    2008-08-01

    Full Text Available Geology and medicine are the oldest two sciences. Nowadays, medical geology is appeared to associate the researches related to environmental problems studied by geology and medical sciences. In the medical geology, researches related to effect of groundwater on human health is the most important subject. In this paper, elements which are the constituent of groundwater and health problems originated from those elements were explained. In addition, components polluting the groundwater widely were presented in detail. [TAF Prev Med Bull 2008; 7(4.000: 351-356

  8. Health Effects of Coastal Storms and Flooding in Urban Areas: A Review and Vulnerability Assessment

    Science.gov (United States)

    Charles-Guzman, Kizzy; Matte, Thomas

    2013-01-01

    Coastal storms can take a devastating toll on the public's health. Urban areas like New York City (NYC) may be particularly at risk, given their dense population, reliance on transportation, energy infrastructure that is vulnerable to flood damage, and high-rise residential housing, which may be hard-hit by power and utility outages. Climate change will exacerbate these risks in the coming decades. Sea levels are rising due to global warming, which will intensify storm surge. These projections make preparing for the health impacts of storms even more important. We conducted a broad review of the health impacts of US coastal storms to inform climate adaptation planning efforts, with a focus on outcomes relevant to NYC and urban coastal areas, and incorporated some lessons learned from recent experience with Superstorm Sandy. Based on the literature, indicators of health vulnerability were selected and mapped within NYC neighborhoods. Preparing for the broad range of anticipated effects of coastal storms and floods may help reduce the public health burden from these events. PMID:23818911

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-28

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

  12. 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.

  13. Issues in health technology assessment

    International Nuclear Information System (INIS)

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

  14. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

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

  15. 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. PMID:26552201

  16. Application of environmental decision support systems for the assessment of health effects due to environmental pollution

    International Nuclear Information System (INIS)

    The RESTORE Environmental Decision Support System (restoration of radioactive contaminated ecosystems) was developed within the 4th framework programme of the European Commission containing a Geographical Information System combined with radioecological data and models. In order to explore its full potential, different applications of such support system are possible: i) the identification of radioecological sensitive areas, ii) its application to other than radioactive pollution by using the necessary transfer models and parameters e.g. for heavy metals, both for the derivation of remediation strategies, and iii) the combination of information on pollution with epidemiological data on recorded health effects. For this purpose a data base containing spatial and temporal information on radioactive and conventional pollution can be combined with ethnic composition, living habits, education, income, age/sex structure, general sanitary situation, production, import and export overlaid with health data e.g. including congenital malformations, cancer, mental retardation, immunological situation, birth certificates and death certificates. Since a spatial but also temporal resolution of data can be achieved, time trends and spatial trends of a potential impact to human health can be demonstrated. (author)

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Rotariu, G.J.

    1982-02-01

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

  19. Health technology assessment in Singapore.

    Science.gov (United States)

    Pwee, Keng Ho

    2009-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  3. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

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

  4. VA telemental health: suicide assessment.

    Science.gov (United States)

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

    2008-01-01

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

  5. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-01

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

  7. Human health risk assessment in regions surrounding historical mining activities: the effect of change of support

    Energy Technology Data Exchange (ETDEWEB)

    A. Korre; J.R. Gay; S. Durucan [Imperial College London, London (United Kingdom). Department of Earth Science and Engineering

    2007-09-15

    This paper presents a probabilistic exposure model and its adaptation for use with spatially explicit information: soil contaminant concentrations and pH levels, predicted by geostatistical simulation; and population data mapped according to place of residence. Sequential indicator simulation (SIS) is used to provide 1000 plausible maps of soil contaminant concentrations, and results are fed into the exposure model to produce risk maps. Distributions of exposure values are closely related to uncertainty in the soil contaminant values. Using a different support for the estimations has a large effect on the results when comparing exposure values to regulatory cut-offs. Mapping the number of overexposed people allows effective targeting of clean up to reduce efficiently the number of overexposed individuals. Two areas of historical mining activity, a case study from the Southern Urals region of Russia for metal mining and another study from the Tula coal mining region of Russia, are used to demonstrate the importance of the support in the human health risk evaluation.

  8. 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.

  9. Assessment of health risks of policies

    International Nuclear Information System (INIS)

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

  10. Atmospheric particulate mercury in the megacity Beijing: Efficiency of mitigation measures and assessment of health effects

    Science.gov (United States)

    Schleicher, N. J.; Schäfer, J.; Chen, Y.; Blanc, G.; Chen, Y.; Chai, F.; Cen, K.; Norra, S.

    2016-01-01

    Atmospheric particulate mercury (HgP) was studied before, during, and after the Olympic Summer Games in Beijing, China, in August 2008 in order to investigate the efficiency of the emission control measures implemented by the Chinese Government. These source control measures comprised traffic reductions, increase in public transportation, planting of vegetation, establishment of parks, building freeze at construction sites, cleaner production techniques for industries and industry closures in Beijing and also in the surrounding areas. Strictest measures including the "odd-even ban" to halve the vehicle volume were enforced from the 20th of July to the 20th of September 2008. The Olympic period provided the unique opportunity to investigate the efficiency of these comprehensive actions implemented in order to reduce air pollution on a large scale. Therefore, the sampling period covered summer (August, September) and winter (December and January) samples over several years from December 2005 to September 2013. Average HgP concentrations in total suspended particulates (TSP) sampled in August 2008 were 81 ± 39 pg/m3 while TSP mass concentrations were 93 ± 49 μg/m3. This equals a reduction by about 63% for TSP mass and 65% for HgP, respectively, compared to the previous two years demonstrating the short-term success of the measures. However, after the Olympic Games, HgP concentrations increased again to pre-Olympic levels in August 2009 while values in August 2010 decreased again by 30%. Moreover, winter samples, which were 2- to 11-fold higher than corresponding August values, showed decreasing concentrations over the years indicating a long-term improvement of HgP pollution in Beijing. However, regarding adverse health effects, comparisons with soil guideline values and studies from other cities highlighted that HgP concentrations in TSP remained high in Beijing despite respective control measures. Consequently, future mitigation measures need to be tailored more

  11. Health Technology Assessment and patient safety

    OpenAIRE

    Andrew Mulcahy; Tom Walley

    2005-01-01

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

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

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

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-01-01

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

  13. 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...

  14. COSYMA: Health effects models

    International Nuclear Information System (INIS)

    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.)

  15. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Dvorak, A J; Pentecost, E D

    1977-04-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  19. Sensor based soil health assessment

    Science.gov (United States)

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

  20. Health and Environmental Effects Profile for Formaldehyde

    Science.gov (United States)

    The Health and Environmental Effects Profile for formaldehyde was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste and Emergency Response to support listings of hazardous cons...

  1. A First Exploration of Health Impact Assessment of Chemical Exposure: Assigning Weights to Subclinical Effects Based on Animal Studies

    NARCIS (Netherlands)

    Burg, W. ter; Bokkers, B.G.H.; Kroese, E.D.; Schuur, A.G.

    2015-01-01

    ABSTRACT: Health impact assessments (HIA) have become an important tool for applying evidence-based policy. Recently, the concept of HIA has been introduced in the field of chemical substances. Two main issues are encountered, i.e., the focus of risk assessment is deriving safe levels and on first s

  2. Assessment of effects on health due to consumption of bitter bottle gourd (Lagenaria siceraria) juice

    OpenAIRE

    S. K. Sharma; Puri, Rajesh; Jain, Ajay; Sharma, M. P.; Sharma, Anita; Bohra, Shravan; Y.K. Gupta; Saraya, Anoop; S Dwivedi; Gupta, K. C.; Prasad, Mahadeo; Pandey, Janardhan; Dohroo, Netar Prakash; Tandon, Neeraj; Sesikeran, B.

    2012-01-01

    Background & objectives: The bottle gourd (Lagenaria siceraria) is popularly known as lauki, ghia or dudhi in India. Its consumption is advocated by traditional healers for controlling diabetes mellitus, hypertension, liver diseases, weight loss and other associated benefits. However, in last few years there have been reports of suspected toxicity due to consumption of its juice. This led to the constitution of an Expert Committee by Department of Health Research at Indian Council of Medical ...

  3. Radiation release and health effects lessons from the Three Mile Island incident: assessment of objective risks for emergency preparedness planning

    International Nuclear Information System (INIS)

    The accepted theories of radiation health effects are briefly discussed so that the Three Mile Island health effects estimations can be better understood. The author recommends that emergency response planners weigh the objective risks rather than the perceived risks of low-level radiation against those associated with evacuation of large population zones before a final plan is put into effect

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

    Science.gov (United States)

    Khan, M. F.; Latif, M. T.; Saw, W. H.; Amil, N.; Nadzir, M. S. M.; Sahani, M.; Tahir, N. M.; Chung, J. X.

    2016-01-01

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

  5. Health Economic Assessment: Cost-Effectiveness Thresholds and Other Decision Criteria

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2010-04-01

    Full Text Available An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The observed annual variation in incremental cost-effectiveness ratios in New Zealand may originate from yearly differences in new medicines that request reimbursement and in the budget size, and from the fact that decision makers take into account other decision criteria in addition to cost-effectiveness.

  6. 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

  7. 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

  8. Assessment of Felt Needs and Effect of Health Education Intervention on Knowledge Regarding Reproductive Health of School Students in a Slum in Mumbai

    Directory of Open Access Journals (Sweden)

    Padhyegurjar Mansi S

    2012-01-01

    Full Text Available Objectives:To assess the felt needs, level of knowledge and the impact of health education sessions over the period of one year regarding reproductive health among ninth standard school students of a slum area in Mumbai. Material and Methods: The study is school based interventional follow up study.Health education sessions on reproductive health were conducted. Pre test, immediate post test, along with a follow up post test at six months and one year after intervention were administered. SPSS Version 17 and Excel software were used for analysis. Paired‘t’ test and Chi-square test were applied. Results: Base line knowledge in all aspects of reproductive health was observed to be very low as compared to the post tests. Knowledge was retained over the period of one year in questions pertaining to physical changes in boys and girls, female anatomy and role of female in sex determination.However significant loss (p

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

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2010-01-01

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

  10. Physiotherapy students’ mental health assessment

    Directory of Open Access Journals (Sweden)

    Gesouli-Voltyraki –E.

    2012-04-01

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

  11. AN EPIDEMIOLOGICAL FEASIBILITY STUDY AND A BIOMARKER STUDY FOR ASSESSING HEALTH EFFECTS OF ARSENIC IN INNER MONGOLIA, CHINA

    Science.gov (United States)

    Epidemiology Studies: This work will be accomplished through: (a) building data bases; evaluating existing data, including published (mostly in Chinese) and unpublished data on arsenic exposure and health effects in Inner Mongolia and publishing this summary analysis in English l...

  12. Commentary: Assessing the Health Effects of Medicare Coverage for Previously Uninsured Adults: A Matter of Life and Death?

    OpenAIRE

    McWilliams, J. Michael; Meara, Ellen; Zaslavsky, Alan M.; Ayanian, John Z.

    2010-01-01

    In contrast to a previous study we conducted and other evidence, a recent study found no significant effects of Medicare coverage after age 65 on overall health for previously uninsured adults and significant adverse effects on survival for some of these adults. We discuss explanations for these inconsistent findings, particularly the different ways in which deaths were handled, a key methodological challenge in longitudinal analyses of health. We demonstrate that analytic approaches suitable...

  13. Projection models for health effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume IV. SPAHR user's guide

    International Nuclear Information System (INIS)

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume gives the more advanced user of the SPAHR computer package the information required to create tailor-made programs for addressing specific issues not covered by the three interactive packages. It assumes that the user is familiar with the concepts and terms relating to demography and health risk assessment

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

    Science.gov (United States)

    Nicholson, P J; D'Auria, D A

    1999-04-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  16. Use of studies with laboratory animals to assess the potential early health effects of combined internal alpha and beta irradiation

    International Nuclear Information System (INIS)

    The potential health impacts of radionuclides released in nuclear accidents are of major concern to the public and to regulatory and other governmental agencies. One mode of potential exposure is by inhalation of airborne radionuclides, which could lead to combined internal irradiation by high (alpha) and low (beta) linear energy transfer (LET) radiations. Epidemiological data for health effects of human inhalation exposure are too limited to derive reliable estimates of risks of potential health effects. However, results of studies in which beagle dogs were exposed by inhalation to insoluble radioactive aerosols can be used to estimate expected effects in humans. Data for mortality from radiation pneumonitis and pulmonary fibrosis caused by internal irradiation of dog lungs by alpha or beta radiations are used to derive the relative biological effectiveness (RBE) of alpha irradiation compared to beta irradiation; predict the expected combined effects of alpha and beta irradiation of dog lungs; and extrapolate the results to humans. The extrapolation to humans assumed that, for similar ages at exposure, dog and human lungs have similar sensitivities to lung irradiation. Results of theoretical calculations related to mortality from early effects indicated that the synergistic effects of high- and low-LET radiations should depend on the percentages of the total dose contributed by high- and low-LET radiations, and for very low or very high doses, synergistic effects should be negligible. 23 refs., 8 figs

  17. 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. PMID:26375320

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  19. Soil health: looking for suitable indicators. What should be considered to assess the effects of use and management on soil health?

    Directory of Open Access Journals (Sweden)

    Elke Jurandy Bran Nogueira Cardoso

    2013-08-01

    Full Text Available Soil Health refers to the ecological equilibrium and the functionality of a soil and its capacity to maintain a well balanced ecosystem with high biodiversity above and below surface, and productivity. To understand and use soil health as a tool for sustainability, physical, chemical, and biological properties must be employed to verify which respond to the soil use and management within a desired timescale. Attributes with a rapid response to natural or anthropogenic actions are considered good indicators of soil health. Among the physical indicators, soil texture, aggregation, moisture, porosity, and bulk density have been used, while among chemical indicators total C and N, mineral nutrients, organic matter, cation exchange capacity, among others are well established. However, most of them generally have a slow response, when compared to the biological ones, such as microbial biomass C and N, biodiversity, soil enzymes, soil respiration, etc., in addition to macro and mesofauna. Thus, a systemic approach based on different kinds of indicators (physical, chemical and biological in assessing soil health would be safer than using only one kind of attribute. Many human activities have caused desertification, loss of biodiversity, disruption of aggregates, loss of organic matter and nutrients, among others. Today, it is imperious to maintain soil health and productivity with increasing emphasis on reforestation and recuperation of degraded areas through the use of organic amendments, reintroduction of plants, soil fauna and microorganisms. This review focused on an integrative view on indicators of soil health to be used as tools for prediction of sustainability in production systems.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-09-01

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

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

    OpenAIRE

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

    2014-01-01

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

  3. 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.

  4. Application of environmental Decision Support Systems (Ed's) for the assessment of health effects due to environmental pollution

    International Nuclear Information System (INIS)

    Environmental Decision Support System containing a Geographical Information System (GIS) combined with (radio)ecological data and models were developed within different research activities in radioecology and geography for environmental management, especially after accidental release of pollutants into the environment. It may be possible to achieve the full potentials of EDSS, through its application in a variety of ways. These include: 1. Identification of radio-ecological sensitive areas, 2. extending its use in the identification of non-radioactive pollution (e.g., heavy metals) by using the necessary transfer models and parameters and 3. its effective use in defining the role of environmental pollution on health effects. In order to achieve the latter (e.g., defining the role of environmental pollution on health effects), a database containing spatial and temporal information on radioactive and conventional pollution can be combined with ethnic composition, living habits, education, income, age/sex structure, general sanitary situation, production, import and export overlaid with health data (e.g., congenital malformations, cancer, mental retardation, immunological situation, birth and death certificates etc.). Since a spatial as well as temporal resolution of data can be achieved, time trends and spatial trends of a potential impact to human health can be demonstrated. (author)

  5. 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.

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

    DEFF Research Database (Denmark)

    Larsen, Klaus; Merlo, Juan

    2005-01-01

    The logistic regression model is frequently used in epidemiologic studies, yielding odds ratio or relative risk interpretations. Inspired by the theory of linear normal models, the logistic regression model has been extended to allow for correlated responses by introducing random effects. However......, the model does not inherit the interpretational features of the normal model. In this paper, the authors argue that the existing measures are unsatisfactory (and some of them are even improper) when quantifying results from multilevel logistic regression analyses. The authors suggest a measure of...... regression. For this purpose, the authors propose an odds ratio measure, the interval odds ratio, that takes these difficulties into account. The authors demonstrate the two measures by investigating heterogeneity between neighborhoods and effects of neighborhood-level covariates in two examples...

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

    Directory of Open Access Journals (Sweden)

    Zallaghi

    2014-10-01

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

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

    OpenAIRE

    Wasem, Jürgen; Hessel, Franz; Aidelsburger, Pamela

    2004-01-01

    Aim: On behalf of the German Agency for Health Technology Assessment (DAHTA@DIMDI) a rapid economic HTA was conducted. Aim of the HTA was to evaluate the cost-effectiveness of quantitative ultrasound (QUS) for screening of osteoporotic fracture risk. Study population was formed by postmenopausal women. QUS was compared to the dual X-ray absorptiometry (DXA) as the most frequently used method of measurement. Methods: According to the recommendations for rapid economic HTA a comprehensive liter...

  9. The internationalization of health technology assessment.

    Science.gov (United States)

    Menon, D; Marshall, D

    1996-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Xiaowei Yang

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

  13. HEALTH AND ENVIRONMENTAL EFFECTS PROFILE FOR TCMTB

    Science.gov (United States)

    The Health and Environmental Effects Profile for TCMTB was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste to support listings of hazardous constituents of a wide range of wa...

  14. HEALTH AND ENVIRONMENTAL EFFECTS PROFILE FOR TEMEPHOS

    Science.gov (United States)

    The Health and Environmental Effects Profile for Temephos was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste to support listings of hazardous constituents of a wide range of...

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  16. Health Technology Assessment and patient safety

    Directory of Open Access Journals (Sweden)

    Andrew Mulcahy

    2005-12-01

    Full Text Available

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

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

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

  17. Assessment of capabilities and research needs in the area of health effects of low-level ionizing radiation. A joint report to the Congress

    International Nuclear Information System (INIS)

    The report summarizes the capabilities, research needs and on-going projects of the Environmental Protection Agency and the Nuclear Regulatory Commission related to the health effects of low-level ionizing radiation. The statutory authorities of both EPA and NRC related to radiation protection and radiation research are also briefly described. An introductory general section describes current efforts to improve Federal radiation research and general methods used by both agencies for radiation dose assessment and the estimation of the potential health effects of low-level ionizing radiation. Separate sections describe the respective authorities, needs, capabilities, and current research programs of the two agencies. The report was prepared to fulfill a requirement by the US Congress which is contained in Section 5(c) of Public Law 95-601

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

    Directory of Open Access Journals (Sweden)

    Altaf Alam Noonari

    2016-04-01

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

  19. A school-based strategy to assess children's environmental exposures and related health effects in economically disadvantaged urban neighborhoods.

    Science.gov (United States)

    Sexton, K; Greaves, I A; Church, T R; Adgate, J L; Ramachandran, G; Tweedie, R L; Fredrickson, A; Geisser, M; Sikorski, M; Fischer, G; Jones, D; Ellringer, P

    2000-01-01

    The School Health Initiative: Environment, Learning, Disease (SHIELD) study is a novel school-based investigation of children's environmental health in economically disadvantaged urban neighborhoods of Minneapolis. This article describes the study design and summarizes lessons learned about recruiting and monitoring this historically understudied population. The SHIELD study focused on measuring children's exposures to multiple environmental stressors [volatile organic chemicals (VOCs), environmental tobacco smoke, allergens, bioaerosols, metals, pesticides, polychlorinated biphenyls (PCB), phthalates] and exploring related effects on respiratory health (e.g., lung function) and learning outcomes (e.g., standardized test scores, academic achievement). It involved intensive exposure monitoring, including environmental measurements inside and outside the children's schools and inside their homes, personal measurements with passive dosimeters worn by the children, and biological marker measurements in blood and urine. The SHIELD participants comprised a stratified random sample of 153 "index" children and 51 of their siblings enrolled in grades 2-5 at two adjacent elementary schools. The Minneapolis Public Schools (MPS) assisted with identifying, contacting, recruiting, and monitoring this population, which traditionally is difficult to study because families/children are highly mobile, speak a diversity of languages, frequently do not have a telephone, endure economic hardships, often do not trust researchers, and have a spectrum of unconventional lifestyles and living arrangements. Using a school-based approach, the overall SHIELD enrollment (response) rate was 56.7%, with a wide disparity between English-speaking (41.7%) and non-English-speaking (71.0%) families/children. Most children remained involved in the study through both monitoring sessions and exhibited an acceptable degree of compliance with study protocols, including providing blood and urine samples

  20. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

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

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

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

  1. Private Health Sector Assessment in Kenya

    OpenAIRE

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  3. 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.

  4. Risk assessment in support of plant health

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Philip Ayieko

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

  6. An Assessment of Environmental Health Needs

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

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

  7. Ethical perspectives on health technology assessment.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2004-01-01

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

  8. [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.

  9. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

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

  10. Smart Sensors Assess Structural Health

    Science.gov (United States)

    2010-01-01

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

  11. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

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

  12. 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

  13. Bearing Health Assessment Based on Chaotic Characteristics

    Directory of Open Access Journals (Sweden)

    Chen Lu

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  15. Assessment of health impacts in electricity generation and use

    Energy Technology Data Exchange (ETDEWEB)

    Morris, S.C.

    1995-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Rafiei Masoud

    2009-01-01

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

  17. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

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

  18. Risk assessment in support of plant health

    Directory of Open Access Journals (Sweden)

    Jeger M

    2012-10-01

    Full Text Available

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

  19. Assessing the oral health literacy: A review

    Directory of Open Access Journals (Sweden)

    Sudhir Hongal

    2013-10-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    NARCIS (Netherlands)

    S.K. Lhachimi (Stefan)

    2011-01-01

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

  3. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume V. SPAHR programmer's guide

    International Nuclear Information System (INIS)

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, numbers of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume contains a programmer's guide to SPAHR

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

    Science.gov (United States)

    Rice, J A

    1993-01-01

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

  5. Evidence-Based Practice: A Review of Theoretical Assumptions and Effectiveness of Teaching and Assessment Interventions in Health Professions

    Science.gov (United States)

    Thomas, Aliki; Saroyan, Alenoush; Dauphinee, W. Dale

    2011-01-01

    Health care professionals are expected to use a systematic approach based on evidence, professional reasoning and client preferences in order to improve client outcomes. In other words, they are expected to work within an evidence-based practice (EBP) context. This expectation has had an impact on occupational therapy academic programs' mandates…

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

    Directory of Open Access Journals (Sweden)

    Lachlan McIver

    2014-05-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2004-03-01

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

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

    OpenAIRE

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

    2012-01-01

    Abstract Background In the absence of current cumulative dietary exposure assessments, this analysis was conducted to estimate exposure to multiple dietary contaminants for children, who are more vulnerable to toxic exposure than adults. Methods We estimated exposure to multiple food contaminants based on dietary data from preschool-age children (2–4 years, n=207), school-age children (5–7 years, ...

  10. Bisphenol A environmental exposure and the detrimental effects on human metabolic health: is it necessary to revise the risk assessment in vulnerable population?

    Science.gov (United States)

    Valentino, R; D'Esposito, V; Ariemma, F; Cimmino, I; Beguinot, F; Formisano, P

    2016-03-01

    In the last decades, many reports have focused the attention on deleterious effects of novel environmental chemical compounds, including bisphenol A (BPA), on human health. BPA, a common and widely chemical contaminant acting as endocrine disruptor, accumulates in adipose tissue and may affect adipocyte metabolic and inflammatory functions. BPA, at low chronic doses, is now considered as an obesogen compound, and might contribute to the rise of metabolic syndrome, visceral adiposity and diabetes epidemics. The BPA worldwide presence in the environment is responsible for chronic exposure during vulnerable periods, such as foetal and neonatal life. The BPA source of contamination can occur via food, beverage, wastewater, air, dust and soil. BPA, as lipophilic compound, may accumulate into the adipose tissue already during foetal life and may affect adulthood health, through adverse effects on the growth and development of organs and tissues. Thus, based on several studies, it would be crucial to consider further actions aimed to refine risk assessment at least in vulnerable population, such as foetuses, infants and young children, to prevent metabolic diseases and obesity. PMID:26105974

  11. Health Knowledge Effects: An Integrated Community Health Promotion Platform.

    Science.gov (United States)

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu

    2016-03-01

    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform. PMID:26657621

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

    Directory of Open Access Journals (Sweden)

    Currie Leanne M

    2011-08-01

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

  13. 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…

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Health Effects of Air Pollution

    Science.gov (United States)

    ... air pollution How to protect yourself from air pollution Chemicals Noise Quizzes Links to more information girlshealth glossary girlshealth.gov home http://www.girlshealth.gov/ Home The environment and your health Air Health effects of air pollution ... Health effects of air pollution Breathing air that ...

  16. In Vitro Assessment of Cadmium Bioavailability in Chinese Cabbage Grown on Different Soils and Its Toxic Effects on Human Health.

    Science.gov (United States)

    Aziz, Rukhsanda; Rafiq, Muhammad Tariq; He, Zhenli; Liu, Di; Sun, Kewang; Xiaoe, Yang

    2015-01-01

    The minimum concentration of cadmium (Cd), by Chinese cabbage grown on Cd contaminated soils that can initiate toxicity in human liver cells using in vitro digestion coupled with Caco-2/HL-7702 cell models was studied. Cadmium bioaccessibility in the gastric phase for yellow soil (YS) cabbage (40.84%) and calcareous soil (CS) cabbage (21.54%) was significantly higher than small intestinal phase with the corresponding values of 21.2% and 11.11%, respectively. Cadmium bioavailability was higher in YS cabbage (5.27%-14.66%) than in CS cabbage (1.12%-9.64%). Cadmium concentrations (>0.74 μg) transported from YS and CS cabbage were able to induce oxidative (MDA, H2O2) stress by inhibiting antioxidant (SOD, GPx) enzyme activities in human liver cells (HL-7702). Additionally the study revealed that the ingestion of Cd contaminated Chinese cabbage grown in acidic soil (yellow soil) weakened the antioxidant defense system under all levels of contamination (2, 6, and 9 mg·kg(-1)) which ultimately escalated the oxidative stress in liver cells; however, in case of CS cabbage, a marked oxidative stress was observed only at 9 mg kg(-1) Cd level of soil. Therefore, it is necessary to monitor Cd concentrations in leafy vegetables grown on acidic soils to minimize human health risk.

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

    Science.gov (United States)

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

    2001-01-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

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

    International Nuclear Information System (INIS)

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

  20. Potential Developmental and Early Life Health Effects of Nanomaterials: Data Gaps and Research Needs for Risk Assessment

    Science.gov (United States)

    Although research examining the toxicology of nanomaterials has been ongoing for many years, early studies largely focus on respiratory effects, and are limited by lack of appropriate dose metrics and a limited understanding of the role of the physicochemical properties of nanoma...

  1. Ecosystem Health Assessment in Wuli Lake

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2012-06-01

    The Skindex-16 questionnaire was recently developed as a measure of dermatological health-related quality of life (HRQoL), including symptoms, emotions and functional aspects. Bepotastine besilate is a selective histamine H(1) -receptor antagonist and a second-generation non-sedating antihistamine to treat various dermatological disorders. We assessed changes of the HRQoL instrument (Skindex-16) on patients with pruritus, including those with atopic dermatitis (AD) over bepotastine treatment period. The patients' personal assessment of the intensity of pruritus was determined using the Visual Analog Scale (VAS) for pruritus. Patients answered the Skindex-16 at baseline and at week 4. Forty-eight of 51 enrolled dermatological patients completed the Skindex-16. Of the 48 patients, 11 had AD and 37 had other conditions. Improvement in the clinical evaluation and VAS score was significant in all patients, the AD group and the other disorders group between baseline and week 4. Skindex-16 showed significantly lower scores for each of the three scales (symptoms, emotions and functioning) and the global score at baseline compared to that at week 4 in all patients and the other disorders. In contrast, there was a significant reduction in the emotions and global score among the AD patients. We found a significant correlation between falls in emotions score of Skindex-16 and falls in VAS scores for pruritus in the AD group. Bepotastine could be effective in the management of patients' HRQoL and useful in patients suffering with pruritus. We suggested that pruritus of AD patients could exert a stronger emotional effect due to the skin condition compared to the symptomatic or functional effects. PMID:22035542

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Vogt Rainbow

    2012-11-01

    Full Text Available Abstract Background In the absence of current cumulative dietary exposure assessments, this analysis was conducted to estimate exposure to multiple dietary contaminants for children, who are more vulnerable to toxic exposure than adults. Methods We estimated exposure to multiple food contaminants based on dietary data from preschool-age children (2–4 years, n=207, school-age children (5–7 years, n=157, parents of young children (n=446, and older adults (n=149. We compared exposure estimates for eleven toxic compounds (acrylamide, arsenic, lead, mercury, chlorpyrifos, permethrin, endosulfan, dieldrin, chlordane, DDE, and dioxin based on self-reported food frequency data by age group. To determine if cancer and non-cancer benchmark levels were exceeded, chemical levels in food were derived from publicly available databases including the Total Diet Study. Results Cancer benchmark levels were exceeded by all children (100% for arsenic, dieldrin, DDE, and dioxins. Non-cancer benchmarks were exceeded by >95% of preschool-age children for acrylamide and by 10% of preschool-age children for mercury. Preschool-age children had significantly higher estimated intakes of 6 of 11 compounds compared to school-age children (p Conclusions Dietary strategies to reduce exposure to toxic compounds for which cancer and non-cancer benchmarks are exceeded by children vary by compound. These strategies include consuming organically produced dairy and selected fruits and vegetables to reduce pesticide intake, consuming less animal foods (meat, dairy, and fish to reduce intake of persistent organic pollutants and metals, and consuming lower quantities of chips, cereal, crackers, and other processed carbohydrate foods to reduce acrylamide intake.

  6. Teaching health assessment in the virtual classroom.

    Science.gov (United States)

    Lashley, Mary

    2005-08-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  9. 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.

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

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency (IAEA) has been supporting, over the years, several coordinated research programmes (CRPs) on various research topics related to environmental issues impacting human health. The primary aim of these CRPs has been to help enhance the research and development capabilities in the Member States, particularly among developing countries; to identify the sources of various environmental contaminants and evaluate their fate; and to provide for the basis of improved health among human populations by the use of nuclear and related analytical techniques. The CRP on Assessment of Levels and Health-Effects of Airborne Particulate Matter in Mining, Metal Refining and Metal Working Industries using nuclear and related analytical techniques focused on improving the competence for research on workplace monitoring in a variety of industrial environments. The personal monitoring of the APM (airborne particulate matter) of the exposed workforce was carried out for the first time by many participants. Nuclear and related analytical techniques, including the application of proton micro-beam, were used to generate the trace element concentration profiles in various biomarkers tissues of the exposed workers. The quality assurance/quality control (QA/QC) aspects related to the CRP were addressed through intercomparison analyses of APM on filter paper samples and freeze dried human urine samples to generate validated data. These data have helped to generate correlations between the occupational exposure measured and the magnitude of the biological response. Such new information is essential to evolve procedures to considerably reduce/eliminate the pollutants in the workplace environment and to make informed decisions on the evolution of standards in working environments aimed at preserving the health of workers. The purpose of this TECDOC is to provide an overview of the activities performed under the CRP by the participants. The overall achievements

  11. A study to assess the effectiveness of planned health teaching programme using child-to –child approach on knowledge of selected first aid measures among school children in selected schools at Dharapuram in Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    B.Muneeswari

    2014-01-01

    Full Text Available “All citizens – All health workers” Everyone, even the children also have responsible to involve in health services & act as change agents for health promotion. The study was to assess the effectiveness of teaching programme using child-to-child approach on knowledge of selected first aid measures in children. The aim of the study to assess effectiveness of planned health teaching programme on selected first aid measures among school children using child-to-child approach. Quasi experimental design was adopted. The present study was conducted at Dharapuram in Erode district, Tamil Nadu India. The samples were 200 selected by simple random sampling method. The results showed that (‘Z’ value =1.96 mean pre and post-tests value were 10.26 and 21.55. The study concluded that about 68.5percent of students gained adequate knowledge after teaching programme using child-to-child approach.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

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

  14. 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

  15. Microbiological risk assessment and public health

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2015-12-01

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

  17. Assessing Hmong farmers' safety and health.

    Science.gov (United States)

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

    2014-05-01

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

  18. A framework for assessing e-health preparedness.

    Science.gov (United States)

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

    2005-01-01

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

  19. Probiotics and oral health effects in children

    DEFF Research Database (Denmark)

    Twetman, Svante; Stecksén-Blicks, Christina

    2008-01-01

    BACKGROUND: Probiotics are living micro-organisms added to food which beneficially affect the host by improving its intestinal microbial balance. OBJECTIVE: This paper aims to present a general background on probiotics and its health effects in children, and to examine the evidence for oral...... colonization and the possible impact on oral health in children and young adults. METHODS: For delivery and general health effects, recent systematic reviews, meta-analyses, and other relevant papers were used. Concerning oral installation and oral effects, a broad search for publications in English...... of daily consumption of probiotic milk. CONCLUSION: Bacteriotheraphy in the form of probiotic bacteria with an inhibitory effect on oral pathogens is a promising concept, especially in childhood, but this may not necessarily lead to improved oral health. Further placebo controlled trials that assess...

  20. Environmental, health and safety assessment of photovoltaics

    Science.gov (United States)

    Rose, E. C.

    1983-01-01

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

  1. 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.

  2. ATMOSPHERIC HEALTH EFFECTS FRAMEWORK (AHEF) MODEL

    Science.gov (United States)

    The Atmospheric and Health Effects Framework (AHEF) is used to assess theglobal impacts of substitutes for ozone-depleting substances (ODS). The AHEF is a series of FORTRAN modeling modules that collectively form a simulation framework for (a) translating ODS production into emi...

  3. Health Effects of Tsunamis

    Science.gov (United States)

    ... Emergency Wound Care Wound Management for Healthcare Pros Power Outages When the Power Goes Out Worker Safety Vaccine Storage Returning Home ... medical care for injuries. Flood waters can pose health risks such as ... are caused by the physical impact of people being washed into debris such as ...

  4. Survivors of war in the Northern Kosovo (II): baseline clinical and functional assessment and lasting effects on the health of a vulnerable population

    OpenAIRE

    Rexhaj Berina; Rushiti Feride; Pacolli Sebahate; Wang Shr-Jie; Modvig Jens

    2010-01-01

    Abstract Background This study documents torture and injury experience and investigates emotional well-being of victims of massive violence identified during a household survey in Mitrovicë district in Kosovo. Their physical health indicators such as body mass index (BMI), handgrip strength and standing balance were also measured. A further aim is to suggest approaches for developing and monitoring rehabilitation programmes. Methods A detailed assessment was carried out on 63 male and 62 fema...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

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

    Science.gov (United States)

    Chantler, Cyril

    2004-01-01

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

  7. Forest ecosystem health assessment and analysis in China

    Institute of Scientific and Technical Information of China (English)

    XIAOFengjin; OUYANGHua; ZHANGQiang; FUBojie; ZHANGZhicheng

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lysdahl, Kristin Bakke

    2016-03-01

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

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Willich, Stefan

    2008-03-01

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

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

    Science.gov (United States)

    Gallos, Parisis; Mantas, John

    2015-01-01

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

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

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

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

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

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

    Science.gov (United States)

    Springer, Andrew E.; Evans, Alexandra E.

    2016-01-01

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

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

    Science.gov (United States)

    Yang, Bong-min

    2012-05-01

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

  16. An Assessment of Integrated Health Management Frameworks

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-18

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

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

    Institute of Scientific and Technical Information of China (English)

    XIAO Guo-qing; YAN Xiang-nong

    2007-01-01

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

  18. Gestalt Effect of Self Assessment

    Science.gov (United States)

    McDonald, Betty

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Maha I.A. Moaty

    2015-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Assessing the Health Effects of Long-Term Exposure to Insecticide-Treated Mosquito Nets in the Control of Malaria in Endemic Regions

    Directory of Open Access Journals (Sweden)

    Ebere C. Anyanwu

    2004-01-01

    Full Text Available Malaria is a protozoan disease caused in humans by the genus Plasmodium of which four species are known: P. falciparum, P. vivax, P. ovale, and P. malariae. It is transmitted through the bite of infected female mosquitoes of the genus Anopheles. Malaria is endemic in tropical and subtropical regions of the world. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Approximately 40% of the world's population, mostly those living in the poorest nations, are at risk. Much of the deaths due to malaria occur in Africa, mostly among children. The search for prevention and control interventions that are effective and sustainable remains an abiding challenge for national governments and international health agencies. To this end, the World Health Organization and several nongovernmental organizations are investing in the use of insecticide-treated mosquito nets (ITMNs as a viable option. Trials of ITMNs in the 1980s and 1990s showed that they reduce deaths in young children by an average of 20% and multilateral agencies, spearheaded by Roll Back Malaria (RBM, seek to have 60% of the populations at risk sleeping under ITMNs by 2005. All pesticides are toxic by nature and present risks of adverse effects that depend on toxicity of the chemical and the degree of exposure. While there is agreement that ITMNs can be effective in reducing malaria morbidity and mortality under field trials, a number of factors relating to their sustainability and contribution to health improvement in less-developed countries have yet to be determined. In particular, the adverse effects associated with their long-term use and misuse has yet to be fully evaluated. Although this paper examines potential neurotoxic and neurobehavioral effects of long-term use of ITMNs and discusses priority public health actions for protecting the health of users, it forms the basis for further research.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Leys, Mark

    2003-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  6. Clean Slate transportation and human health risk assessment

    International Nuclear Information System (INIS)

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

  7. Approaches to integrated monitoring for environmental health impact assessment

    Directory of Open Access Journals (Sweden)

    Liu Hai-Ying

    2012-11-01

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

  8. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...

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

    Science.gov (United States)

    Lee, Yuri; Kim, Soyoon; Kim, Ganglip

    2012-09-01

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

  10. Assessing Your Weight and Health Risk

    Science.gov (United States)

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

  11. Ozone health effects

    International Nuclear Information System (INIS)

    Ozone is a principal component of photochemical air pollution endogenous to numerous metropolitan areas. It is primarily formed by the oxidation of NOx in the presence of sunlight and reactive organic compounds. Ozone is a highly active oxidizing agent capable of causing injury to the lung. Lung injury may take the form of irritant effects on the respiratory tract that impair pulmonary function and result in subjective symptoms of respiratory discomfort. These symptoms include, but are not limited to, cough and shortness of breath, and they can limit exercise performance. The effects of ozone observed in humans have been primarily limited to alterations in respiratory function, and a range of respiratory physiological parameters have been measured as a function of ozone exposure in adults and children. These affects have been observed under widely varying (clinical experimental and environmental settings) conditions

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

    Directory of Open Access Journals (Sweden)

    Huda M Haroun

    2010-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

    Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation. PMID:26908982

  14. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

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

  15. Noise Pollution and Health Effects

    Directory of Open Access Journals (Sweden)

    Geravandi

    2015-01-01

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

  16. 78 FR 26026 - Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides-Health Criteria

    Science.gov (United States)

    2013-05-03

    ... AGENCY Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides--Health... Science Assessment for Nitrogen Oxides--Health Criteria.'' The draft document was prepared by the National... Integrated Science Assessment (ISA) for the health effects of nitrogen oxides (NO X ), which will provide...

  17. Social and ethical analysis in health technology assessment.

    Science.gov (United States)

    Tantivess, Sripen

    2014-05-01

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

  18. The University Environment: A Comprehensive Assessment of Health-Related Advertisements

    Science.gov (United States)

    Szymona, Katie; Quick, Virginia; Olfert, Melissa; Shelnutt, Karla; Kattlemann, Kendra K.; Brown-Esters, Onikia; Colby, Sarah E.; Beaudoin, Christina; Lubniewski, Jocelyn; Maia, Angelina Moore; Horacek, Tanya; Byrd-Bredbenner, Carol

    2012-01-01

    Purpose: Little is known about health-related advertising on university environments. Given the power of advertising and its potential effect on health behaviors, the purpose of this paper is to assess the health-related advertisement environment and policies on university campuses. Design/methodology/approach: In total, ten geographically and…

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

    Directory of Open Access Journals (Sweden)

    Marten J. Poley

    2015-10-01

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

  20. The Fit for School health outcome study - a longitudinal survey to assess health impacts of an integrated school health programme in the Philippines

    OpenAIRE

    Monse, Bella; Benzian, Habib; Naliponguit, Ella; Belizario, Vincente; Schratz, Alexander; Palenstein Helderman, Wim Van

    2013-01-01

    Background Child health in many low- and middle-income countries lags behind international goals and affects children’s education, well-being, and general development. Large-scale school health programmes can be effective in reducing preventable diseases through cost-effective interventions. This paper outlines the baseline and 1-year results of a longitudinal health study assessing the impact of the Fit for School Programme in the Philippines. Methods A longitudinal 4-year cohort study was c...

  1. Winning big but feeling no better? The effect of lottery prizes on physical and mental health

    OpenAIRE

    Apouey, Bénédicte; Clark, Andrew E.

    2013-01-01

    We use British panel data to determine the exogenous impact of income on a number of individual health outcomes: general health status, mental health, physical health problems, and health behaviors (drinking and smoking). Lottery winnings allow us to make causal statements regarding the effect of income on health, as the amount won by winners is largely exogenous. Positive income shocks have no significant effect on self-assessed overall health, but a large positive effect on mental health. T...

  2. Urban Ecosystem Health Assessment: Perspectives and Chinese Practice

    Directory of Open Access Journals (Sweden)

    Lixiao Zhang

    2013-11-01

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

  3. 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.

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

    Science.gov (United States)

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

    2010-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-01-15

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

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

    Science.gov (United States)

    Skouloudis, Andreas N; Kassomenos, Pavlos

    2014-08-01

    The use of emerging technologies for environmental monitoring with satellite and in-situ sensors have become essential instruments for assessing the impact of environmental pollution on human health, especially in areas that require high spatial and temporal resolution. This was until recently a rather difficult problem. Regrettably, with classical approaches the spatial resolution is frequently inadequate in reporting environmental causes and health effects in the same time scale. This work examines with new tools different levels of air-quality with sensor monitoring with the aim to associate those with severe health effects. The process established here facilitates the precise representation of human exposure with the population attributed in a fine spatial grid and taking into account environmental stressors of human exposure. These stressors can be monitored with innovative sensor units with a temporal resolution that accurately describes chronic and acute environmental burdens. The current understanding of the situation in densely populated areas can be properly analyzed, before commitments are made for reductions in total emissions as well as for assessing the effects of reduced trans-boundary fluxes. In addition, the data processed here with in-situ sensors can assist in establishing more effective regulatory policies for the protection of vulnerable population groups and the satellite monitoring instruments permit abatement strategies that are close to real-time over large geographical areas.

  7. Health effects of smokeless tobacco

    Energy Technology Data Exchange (ETDEWEB)

    1986-02-28

    Pharmacologic and physiologic effects of snuff and chewing tobacco include the gamut of cardiovascular, endocrinologic, neurologic, and psychological effects that are associated with nicotine. A review of studies appearing in the scientific literature involving various populations and approaches indicates that the use of snuff or chewing tobacco is associated with a variety of serious adverse effects and especially with oral cancer. The studies suggest that snuff and chewing tobacco also may affect reproduction, longevity, the cardiovascular system, and oral health. The Council on Scientific Affairs concludes there is evidence demonstrating that use of snuff or chewing tobacco is associated with adverse health effects such as oral cancer, urges the implementation of well-planned and long-term studies that will further define the risks of using snuff and chewing tobacco, and recommends that the restrictions applying to the advertising of cigarettes also be applied to the advertising of snuff and chewing tobacco.

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

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-01

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

  9. Private Health Sector Assessment in Tanzania

    OpenAIRE

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

    2013-01-01

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

  10. Effects of Exposure to Carbon Dioxide and Bioeffluents on Perceived Air Quality, Self-assessed Acute Health Symptoms and Cognitive Performance

    DEFF Research Database (Denmark)

    Zhang, Xiaojing; Wargocki, Pawel; Lian, Zhiwei;

    2016-01-01

    quality, increased the intensity of reported headache, fatigue, sleepiness and difficulty in thinking clearly, and reduced speed of addition, the response time in a redirection task and the number of correct links made in the cue-utilisation test. This suggests that moderate concentrations of bioeffluents...... ratings, physiological responses and cognitive performance were measured. No statistically significant effects on perceived air quality, acute health symptoms or cognitive performance were seen during exposures when CO2 was added. Exposures to bioeffluents with CO2 at 3,000 ppm reduced perceived air...

  11. Survivors of war in the Northern Kosovo (II: baseline clinical and functional assessment and lasting effects on the health of a vulnerable population

    Directory of Open Access Journals (Sweden)

    Rexhaj Berina

    2010-09-01

    Full Text Available Abstract Background This study documents torture and injury experience and investigates emotional well-being of victims of massive violence identified during a household survey in Mitrovicë district in Kosovo. Their physical health indicators such as body mass index (BMI, handgrip strength and standing balance were also measured. A further aim is to suggest approaches for developing and monitoring rehabilitation programmes. Methods A detailed assessment was carried out on 63 male and 62 female victims. Interviews and physical examination provided information about traumatic exposure, injuries, and intensity and frequency of pain. Emotional well-being was assessed using the "WHO-5 Well-Being" score. Height, weight, handgrip strength and standing balance performance were measured. Results Around 50% of victims had experienced at least two types of torture methods and reported at least two injury locations; 70% had moderate or severe pain and 92% reported constant or periodic pain within the previous two weeks. Only 10% of the victims were in paid employment. Nearly 90% of victims had experienced at least four types of emotional disturbances within the previous two weeks, and many had low scores for emotional well-being. This was found to be associated with severe pain, higher exposure to violence and human rights violations and with a low educational level, unemployment and the absence of political or social involvement. Over two thirds of victims were overweight or obese. They showed marked decline in handgrip strength and only 19 victims managed to maintain standing balance. Those who were employed or had a higher education level, who did not take anti-depressant or anxiety drugs and had better emotional well-being or no pain complaints showed better handgrip strength and standing balance. Conclusions The victims reported a high prevalence of severe pain and emotional disturbance. They showed high BMI and a reduced level of physical fitness

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

    International Nuclear Information System (INIS)

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

  13. Bridge health assessment system with fatigue analysis algorithm

    Science.gov (United States)

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

    2005-05-01

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

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

    OpenAIRE

    Princess Christina Campbell; Patrick Chukwuemeka Korie; Feziechukwu Collins Nnaji

    2014-01-01

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

  15. Guide to Assessing Health Care Organizations

    OpenAIRE

    International Finance Corporation

    2015-01-01

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

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

    Science.gov (United States)

    Thriene, B

    2003-02-01

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

  17. ORGANIZATIONAL ASSESSMENT: EFFECTIVENESS VS. EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Ilona Bartuševičienė

    2013-06-01

    Full Text Available Purpose – Organizational assessment has always been the key element of the discussion among scientists as well as business people. While managers are striving for better performance results, scientists are reaching for best ways to evaluate the organization. One of the most common ways to assess the performance of the entity is to measure the effectiveness or the efficiency of the organization. Those two concepts might look synonymous, yet as the findings revealed they have a distinct meaning. The purpose of this article is to reveal those differences and explore organizational assessment within effectiveness and efficiency plane. Design/methodology/approach – Scientific literature analysis, comparative and summarization methods will be used during the research to better understand the challenges of the issue. Findings – Effectiveness and efficiency are exclusive performance measures, which entities can use to assess their performance. Efficiency is oriented towards successful input transformation into outputs, where effectiveness measures how outputs interact with the economic and social environment. Research limitations/implications –In some cases effectiveness concept is being used to reflect overall performance of the organization, since it is a broader concept compared to the efficiency. It gets challenging to explore the efficiency factor if it is included under effectiveness assessment. Practical implications – The assessment of the organizational performance helps companies to improve their reports, assures smoother competition in the global market and creates a sustainable competitive advantage. Originality/Value – The paper revealed that organization can be assessed either within effectiveness or efficiency perspective. Organization striving for excellent performance should be effective and efficient, yet as the findings revealed, inefficient, yet effective organization can still survive yet at a high cost. Keywords

  18. Chemical-based risk assessment and in vitro models of human health effects induced by organic pollutants in soils from the Olona valley

    Energy Technology Data Exchange (ETDEWEB)

    Baderna, Diego, E-mail: diego.baderna@marionegri.it; Colombo, Andrea; Amodei, Giorgia; Cantù, Stefano; Teoldi, Federico; Cambria, Felice; Rotella, Giuseppe; Natolino, Fabrizio; Lodi, Marco; Benfenati, Emilio

    2013-10-01

    Risk assessment of soils is usually based on chemical measurements and assuming accidental soil ingestion and evaluating induced toxic and carcinogenic effects. Recently biological tools have been coupled to chemical-based risk assessment since they integrate the biological effects of all xenobiotics in soils. We employed integrated monitoring of soils based on chemical analyses, risk assessment and in vitro models in the highly urbanized semirural area of the Olona Valley in northern Italy. Chemical characterization of the soils indicated low levels of toxic and carcinogenic pollutants such as PAHs, PCDD/Fs, PCBs and HCB and human risk assessment did not give any significant alerts. HepG2 and BALB/c 3T3 cells were used as a model for the human liver and as a tool for the evaluation of carcinogenic potential. Cells were treated with soil extractable organic matters (EOMs) and the MTS assay, LDH release and morphological transformation were selected as endpoints for toxicity and carcinogenicity. Soil EOMs induced dose-dependent inhibition of cell growth at low doses and cytotoxicity after exposure to higher doses. This might be the result of block of cell cycle progression to repair DNA damage caused by oxidative stress; if this DNA damage cannot be repaired, cells die. No significant inductions of foci were recorded after exposure to EOMs. These results indicate that, although the extracts contain compounds with proven carcinogenic potential, the levels of these pollutants in the analyzed soils were too low to induce carcinogenesis in our experimental conditions. In this proposed case study, HepG2 cells were found an appropriate tool to assess the potential harm caused by the ingestion of contaminated soil as they were able to detect differences in the toxicity of soil EOMs. Moreover, the cell transformation assay strengthened the combined approach giving useful information on carcinogenic potential of mixtures. Highlights: • A combined approach for risk

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Potent health effects of pomegranate

    OpenAIRE

    Aida Zarfeshany; Sedigheh Asgary; Shaghayegh Haghjoo Javanmard

    2014-01-01

    Accumulating data clearly claimed that Punica granatum L. (pomegranate) has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than th...

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  7. Comments on “Simoens, S. Health Economic Assessment: A Methodological Primer. Int. J. Environ. Res. Public Health 2009, 6, 2950-2966”—New Zealand in Fact Has No Cost-Effectiveness Threshold

    Directory of Open Access Journals (Sweden)

    Scott Metcalfe

    2010-04-01

    Full Text Available The Journal recently incorrectly ascribed cost-effectiveness thresholds to New Zealand, alongside other countries. New Zealand has no such thresholds when deciding the funding of pharmaceuticals. As we fund pharmaceuticals within a fixed budget, and cost-effectiveness is only one of nine decision criteria used to inform decisions, thresholds cannot be inferred or calculated. Thresholds inadequately account for opportunity cost and affordability, and are incompatible with budgets and maximising health gains. In New Zealand, pharmaceutical investments can only be considered ‘cost-effective’ when prioritised against other proposals at the time, and threshold levels must inevitably vary with available funds and the other criteria.

  8. Winning big but feeling no better? The effect of lottery prizes on physical and mental health

    OpenAIRE

    Apouey, Bénédicte H; Clark, Andrew E.

    2014-01-01

    We use British panel data to determine the exogenous impact of income on a number of individual health outcomes: general health status, mental health, physical health problems, and health behaviours (drinking and smoking). Lottery winnings allow us to make causal statements regarding the effect of income on health, as the amount won by winners is largely exogenous. Positive income shocks have no significant effect on self-assessed overall health, but a significant positive effect on mental he...

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

    Science.gov (United States)

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. PMID:26399633

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

    Science.gov (United States)

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner.

  11. [Health effects of electromagnetic fields].

    Science.gov (United States)

    Röösli, Martin

    2013-12-01

    Use of electricity causes extremely low frequency magnetic fields (ELF-MF) and wireless communication devices emit radiofrequency electromagnetic fields (RF-EMF). Average ELF-MF exposure is mainly determined by high voltage power lines and transformers at home or at the workplace, whereas RF-EMF exposure is mainly caused by devices operating close to the body (mainly mobile and cordless phones). Health effects of EMF are controversially discussed. The IARC classified ELF-MF and RF-EMF as possible carcinogenic. Most consistent epidemiological evidence was found for an association between ELF-MF and childhood leukaemia. If causal, 1 - 4 percent of all childhood leukaemia cases could be attributed to ELF-MF. Epidemiological research provided some indications for an association between ELF-MF and Alzheimer's diseases as well as amyotrophic lateral sclerosis, although not entirely consistent. Regarding mobile phones and brain tumours, some studies observed an increased risk after heavy or long term use on the one hand. On the other hand, brain tumour incidence was not found to have increased in the last decade in Sweden, England or the US. Acute effects of RF-EMF on non-specific symptoms of ill health seem unlikely according to randomized and double blind provocation studies. However, epidemiological research on long term effects is still limited. Although from the current state of the scientific knowledge a large individual health risk from RF-EMF exposure is unlikely, even a small risk would have substantial public health relevance because of the widespread use of wireless communication technologies.

  12. Can Health Technology Assessment (HTA provide a solution to tackle the increasing health-care expenditure in India?

    Directory of Open Access Journals (Sweden)

    Amit Dang

    2016-01-01

    Full Text Available The private health-care system in India is effective but expensive. Due to the absence of a comprehensive and well-penetrated insurance scheme that caters to the majority of the Indian population, most of the private health care consultations are out-of-pocket (OOP, and this is pushing many people to poverty. In this article, we describe the concept of health technology assessment (HTA, and review its possible role in improving the health-care system in India. We additionally comment on its present status and possible role of its implementation in the Indian context.

  13. Can Health Technology Assessment (HTA) provide a solution to tackle the increasing health-care expenditure in India?

    Science.gov (United States)

    Dang, Amit; Vallish, B N

    2016-01-01

    The private health-care system in India is effective but expensive. Due to the absence of a comprehensive and well-penetrated insurance scheme that caters to the majority of the Indian population, most of the private health care consultations are out-of-pocket (OOP), and this is pushing many people to poverty. In this article, we describe the concept of health technology assessment (HTA), and review its possible role in improving the health-care system in India. We additionally comment on its present status and possible role of its implementation in the Indian context. PMID:27350708

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

    Science.gov (United States)

    Chanchang, Chamchan; Sithisarankul, Pornchai; Supanitayanon, Thanawat

    2016-01-01

    Port development in Thailand is an essential part of the national maritime interest in connection with ship and shore activities. The growth of maritime industry and transportation has led to the expansion of ports' areas and capacity. Each port type causes different environmental impacts. Therefore, the Port Authority of Thailand has set up guidelines on ports' environmental management. This is divided into 3 major phases; namely, planning, construction and operation commencement periods. The Report of Environmental and Health Impact Assessment (EIA, HIA and EHIA) is regarded as the environmental management process in the planning period. It is a key tool to anticipate and prevent any adverse effects that might occur on the environment as well as community health resulting from the project implementation. This measure, in turn, creates advance preparation on both the preventive and problem-solving means before the project gets off the ground. At present, the majority of new projects on port development have still been in the process of information gathering for EHIA submission. Some cannot start to operate due to their EHIA failure. For example, the Tha-sala port which did not pass EHIA, mainly because emphasis had been focused on adhering to legal regulations without taking into consideration the in-depth analysis of data being conducted by community entities in the area. Thus caused the project to be finally abolished. Impact assessment on environment and health should be aimed at detailed understanding of the community in each particular area so that effective data of objective achievement in preventing environmental problems could actually be carried out and welcomed by the concerned society. PMID:27364177

  15. Mental health assessment of rape offenders

    OpenAIRE

    Sarkar, Jaydip

    2013-01-01

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

  16. Health Effects of Too Much Sun

    Science.gov (United States)

    ... navigation (navigation may have changed) Section navigation The environment and your health: Green living Sun Health effects of too much sun How to protect yourself from the sun Water Air Chemicals Noise Quizzes Links to ... The environment and your health Sun Health effects of too ...

  17. Regional comprehensive assessment on environment-health of China

    Institute of Scientific and Technical Information of China (English)

    WANGWuyi; LIRibang; LIAOYongfeng; LIHairong; YANGLinsheng; TANJianan

    2004-01-01

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

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

    Science.gov (United States)

    Holcík, J; Koupilová, I

    1999-11-01

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

  19. A global human health risk assessment for Decamethylcyclopentasiloxane (D5).

    Science.gov (United States)

    Franzen, Allison; Van Landingham, Cynthia; Greene, Tracy; Plotzke, Kathy; Gentry, Robinan

    2016-02-01

    Decamethylcyclopentasiloxane (D5) is a low-molecular-weight cyclic siloxane used primarily as an intermediate in the production of several widely-used industrial and consumer products and intentionally added to consumer products, personal products and some dry cleaning solvents. The global use requires consideration of consumer use information and risk assessment requirements from various sources and authoritative bodies. A global "harmonized" risk assessment was conducted to meet requirements for substance-specific risk assessments conducted by regulatory agencies such as USEPA's Integrated Risk Information System (IRIS), Health Canada and various independent scientific committees of the European Commission, as well as provide guidance for chemical safety assessments under REACH in Europe, and other relevant authoritative bodies. This risk assessment incorporates global exposure information combined with a Monte Carlo analysis to determine the most significant routes of exposure, utilization of a multi-species, multi-route physiologically based pharmacokinetic (PBPK) model to estimate internal dose metrics, benchmark modeling to determine a point of departure (POD), and a margin of safety (MOS) evaluation to compare the estimates of intake with the POD. Because of the specific pharmacokinetic behaviors of D5 including high lipophilicity, high volatility with low blood-to-air partition coefficients and extensive metabolic clearance that regulate tissue dose after exposure, the use of a PBPK model was essential to provide a comparison of a dose metric that reflects these processes. The characterization of the potential for adverse effects after exposure to D5 using a MOS approach based on an internal dose metric removes the subjective application of uncertainty factors that may be applied across various regulatory agencies and allows examination of the differences between internal dose metrics associated with exposure and those associated with adverse effects. PMID

  20. Scientific Opinion on the hazard assessment of endocrine disruptors: Scientific criteria for identification of endocrine disruptors and appropriateness of existing test methods for assessing effects mediated by these substances on human health and the environment

    Directory of Open Access Journals (Sweden)

    EFSA Panel on Scientific Committee (SC

    2013-03-01

    Full Text Available Upon request of the European Commission, the Scientific Committee (SC of the European Food Safety Authority reviewed existing information related to the testing and assessment of endocrine active substances (EASs and endocrine disruptors (EDs. This work was conducted by a working group of experts in endocrinology, risk assessment and toxicology, together with observers from other EU agencies, namely EMA, ECHA and EEA. To distinguish between EDs and other groups of substances with different modes of action, it was concluded that an ED is defined by three criteria: the presence of i an adverse effect in an intact organism or a (subpopulation; ii an endocrine activity; and iii a plausible causal relationship between the two. As scientific criteria for adversity have not been generally defined, specific criteria for endocrine disrupting effects could not be identified. Hence, expert judgement is required to assess on a case-by-case basis the (ecotoxicological relevance of changes at the molecular to individual and/or (subpopulation level following exposure to an EAS. The SC concluded that a reasonably complete suite of standardised assays for testing the effects of EASs is (or will soon be available for the oestrogenic, androgenic, thyroid and steroidogenic modalities in mammals and fish, with fewer tests for birds and amphibians. Shortcomings in current tests and for other endocrine modalities and species were reviewed. Critical effect, severity, (irreversibility and potency aspects are part of the hazard characterisation of EDs. To inform on risk and level of concern for the purpose of risk management decisions, risk assessment (taking into account hazard and exposure data/predictions makes best use of available information. Levels of concern are not determined exclusively by risk assessment but also by protection goals set by the risk management.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  2. Assessing health system performance in developing countries: a review of the literature.

    Science.gov (United States)

    Kruk, Margaret Elizabeth; Freedman, Lynn P

    2008-03-01

    With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.

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

    OpenAIRE

    Harriet eWhiley; Alexandra eKeegan; Howard eFallowfield; Kirstin eRoss

    2014-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

  7. 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.

  8. 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.

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

    OpenAIRE

    Savitz, D A; Harlow, S D

    1991-01-01

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

  10. Potent health effects of pomegranate.

    Science.gov (United States)

    Zarfeshany, Aida; Asgary, Sedigheh; Javanmard, Shaghayegh Haghjoo

    2014-01-01

    Accumulating data clearly claimed that Punica granatum L. (pomegranate) has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions. PMID:24800189

  11. Potent health effects of pomegranate

    Directory of Open Access Journals (Sweden)

    Aida Zarfeshany

    2014-01-01

    Full Text Available Accumulating data clearly claimed that Punica granatum L. (pomegranate has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions.

  12. 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…

  13. Health effects of dietary fiber

    Directory of Open Access Journals (Sweden)

    Semih Ötles

    2014-06-01

    Full Text Available Dietary fi bre is a group of food components which is resistant to digestive enzymes and found mainly in cereals, fruits and vegetables. Dietary fi ber and whole grains contain a unique blend of bioactive components including resistant starches, vitamins, minerals, phytochemicals and antioxidants. Dietary fi ber which indigestible in human small intestinal, on the other hand digested completely or partially fermented in the large intestine, is examined in two groups: water-soluble and water insoluble organic compounds. Dietary fi ber can be separated into many different fractions. These fractions include arabinoxylan, inulin, pectin, bran, cellulose, β-glucan and resistant starch. Dietary fi bres compose the major component of products with low energy value that have had an increasing importance in recent years. Dietary fi bres also have technological and functional properties that can be used in the formulation of foods, as well as numerous benefi cial effects on human health. Dietary fi bre components organise functions of large intestine and have important physiological effects on glucose, lipid metabolism and mineral bioavailability. Today, dietary fi bers are known to be protective effect against certain gastrointestinal diseases, constipation, hemorrhoids, colon cancer, gastroesophageal refl ux disease, duodenal ulcer, diverticulitis, obesity, diabetes, stroke, hypertension and cardiovascular diseases. In this review the physicochemical and biological properties of dietary fi bers and their important implications on human health will be investigated.

  14. Health effects of biomass exposure

    International Nuclear Information System (INIS)

    Biomass fuels such as coal, wood, crop residues, kerosene oil and dung-cakes meet the energy needs in the household sector in India and other developing countries. Crop residues and dung-cakes are largely used in rural areas, whereas wood forms the major source of fuel in urban as well as rural areas. Combustion of these fuels produces various kinds of poisonous gases such as CO, smoke, nitrogen dioxide, polycyclic aromatic hydrocarbons and respirable particulates. These gases are released in the domestic environment and they pollute the indoor air. The women and children are the one who suffer most from this air pollution. This results into a variety of health problems principally pertaining to respiratory system among the women and children. Studies on this aspect are reviewed. They point towards the positive relationship between biomass smoke and various health effects, particularly respiratory diseases. Need for research on the ways to prevent pollution due to biomass and resultant health hazards is emphasised. (M.G.B.). 25 refs., 2 tabs

  15. Oral Health of Drug Abusers: A Review of Health Effects and Care

    Directory of Open Access Journals (Sweden)

    Hamed Ekhtiari

    2013-09-01

    Full Text Available Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients’ need for pain control, destigmatization, and HIV transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor collaboration between dental and general health care sectors serving addicts. These interfere with an accurate picture of the situation. Moreover, lack of appropriate policies to improve access to dental services, lack of comprehensive knowledge of and interest among dental professionals in treating addicts, and low demand for non-emergency dental care affect provision of effective interventions. Management of drug addiction as a multi-organ disease requires a multidisciplinary approach. Health care programs usually lack oral health care elements. Published evidence on oral complications related to addiction emphasizes that regardless of these barriers, oral health care at various levels including education, prevention, and treatment should be integrated into general care services for addicts.

  16. An Assessment of Environmental Health Needs for Manned Spacecraft

    Science.gov (United States)

    Macatangay, Ariel V.

    2013-01-01

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

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

    DEFF Research Database (Denmark)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza

    2012-01-01

    increase was used that results in 5% reduction in tobacco consumption among males and 3.4% reduction among females. Considering the four priority smoking-related diseases, lung cancer, chronic obstructive respiratory diseases, coronary heart diseases and stroke, 7668 lives among males and 4658 among......Background: The public health importance of smoking necessitates effective actions to tackle tobacco epidemic and minimize its health consequences. The white paper of the European Commission “Together for Health: A Strategic Approach for the EU 2008-2013” acknowledged the significance of tobacco...... smoking by incorporating the issue into its 1st objective “Fostering good health in an aging Europe”. The aim of the study was to assess the health impact of the most effective tobacco control policy, taxation, on the EU level. Methods: The assessment was based on the mapping of the whole impact scheme...

  18. [The operational role of the occupational health physician in the assessment and management of health risks related to night risks].

    Science.gov (United States)

    Mucci, Nicola; Giorgi, Gabriele; Gonnelli, Irene Margherita; Garbarino, Sergio; Cupelli, Vincenzo; Arcangelil, Giulio

    2016-01-01

    The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers). PMID:27311142

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

    OpenAIRE

    Linda Davies; Mike Drummond; Panos Papanikoloau

    1999-01-01

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

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

    OpenAIRE

    Saymah, Dyaa; Tait, Lynda; Michail, Maria

    2015-01-01

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

  1. Ecosystem Health and Comprehensive Ecological Benefit Assessment of an Artificial Wetland in Western Jilin Province

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    [Objective] This research aimed to assess the state of ecosystem health and comprehensive ecological benefit of an artificial wetland in western Jilin Province. [Method] To investigate the effects of reclaimed water from Yingtai Oil Production Plant on the wetland ecosystem, a comprehensive ecological assessment index of an artificial wetland in the west of Jilin Province was established to measure the ecological economic and social benefits. The quantitative evaluation on the ecosystem health and comprehen...

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

    Science.gov (United States)

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

    2012-01-01

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

  3. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  5. Utilisation of medical technology assessment in health policy

    NARCIS (Netherlands)

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

    1997-01-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

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

    NARCIS (Netherlands)

    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 p

  8. 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

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

    International Nuclear Information System (INIS)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Reflections on the social epidemiologic dimension of health technology assessment.

    Science.gov (United States)

    Kazanjian, Arminée

    2004-01-01

    Certain key parameters such as safety, efficacy, effectiveness, and cost effectiveness have long been established as key in HTA analysis. Equally important, however, are sociolegal and epidemiologic perspectives. A comprehensive analytic framework will consider the implications of using a technology in the context of societal norms, cultural values, and social institutions and relations. The methodology in which this expanded framework has been developed is termed 'Strategic HTA' to denote its power for the decision-making process. In addition to systematic reviews of published evidence, it incorporates analyses of the influence of dominant social relations on technological development and diffusion. This essay discusses the social epidemiologic aspects of health technology assessment, which includes factors such as sex and gender. It seeks to show how it is possible to bring data from wide-ranging disciplinary perspectives within the parameters of a single scientific inquiry; to draw from them scientifically defensible conclusions; and thereby to realize a deeper understanding of technology impact within a health care system. Armed with such an understanding, policy officials will be better prepared to resolve the competitive clamor of stakeholder voices, and to make the most "equitable" use of the available resources. PMID:15209176

  12. Informative value of Patient Reported Outcomes (PRO) in Health Technology Assessment (HTA)

    OpenAIRE

    Brettschneider, Christian; Lühmann, Dagmar; Raspe, Heiner

    2011-01-01

    Background "Patient-Reported Outcome" (PRO) is used as an umbrella term for different concepts for measuring subjectively perceived health status e. g. as treatment effects. Their common characteristic is, that the appraisal of the health status is reported by the patient himself. In order to describe the informative value of PRO in Health Technology Assessment (HTA) first an overview of concepts, classifications and methods of measurement is given. The overview is complemented by an empir...

  13. Guidelines for Exposure Assessment in Health Risk Studies Following a Nuclear Reactor Accident

    OpenAIRE

    Bouville, André; Linet, Martha S.; Hatch, Maureen; Mabuchi, Kiyohiko; Simon, Steven L.

    2013-01-01

    Background: Worldwide concerns regarding health effects after the Chernobyl and Fukushima nuclear power plant accidents indicate a clear need to identify short- and long-term health impacts that might result from accidents in the future. Fundamental to addressing this problem are reliable and accurate radiation dose estimates for the affected populations. The available guidance for activities following nuclear accidents is limited with regard to strategies for dose assessment in health risk s...

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

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

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

  15. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

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

    Directory of Open Access Journals (Sweden)

    Nunzia Linzalone

    2014-12-01

    Full Text Available 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.

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

    Science.gov (United States)

    Butt, Zeeshan

    2016-09-01

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

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

    Science.gov (United States)

    Butt, Zeeshan

    2016-09-01

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

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

    Science.gov (United States)

    Hagströmer, Maria; Wisén, Anita; Hassmén, Peter

    2015-01-01

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

  20. The Assessment of Hedge Effectiveness

    Directory of Open Access Journals (Sweden)

    Cristina BUNEA-BONTAS

    2012-04-01

    Full Text Available Earnings volatility can be a significant source of concern for a company, putting pressure on its capital base and share price. Prudent management of the company’s exposure to different risks typically involves hedging solutions. Hedging is important for corporate risk management, involving reducing the exposure of the company to specific risks. The aim of this paper is to examine the basic requirements for assessing the hedge effectiveness, this being a vital stage in applying hedge accounting, that gives the possibility to assess if the companies match the timing of the gains and losses of hedged items and their hedging derivatives. The article identifies some difficulties encountered by companies and choices that they must make in assessing hedge effectiveness.

  1. 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.

  2. Health effects of exhaust particles

    Energy Technology Data Exchange (ETDEWEB)

    Pihlava, T.; Uuppo, M.; Niemi, S.

    2013-11-01

    This report introduces general information about diesel particles and their health effects. The purpose of this report is to introduce particulate matter pollution and present some recent studies made regarding the health effects of particulate matter. The aim is not to go very deeply into the science, but instead to keep the text understandable for the average layman. Particulate matter is a complex mixture of extremely small particles and liquid droplets. These small particles are made up of a number of components that include for example acids, such as nitrates and sulphates, as well as organic chemicals, metals and dust particles from the soil. Particulate matter comes from several sources, such as transportation emissions, industrial emissions, forest fires, cigarette smoke, volcanic ash and climate variations. Particles are divided into coarse particles with diameters less than 10 ..m, fine particles with diameters smaller than 2.5 ..m and ultra-fine particles with diameters less than 0.1 ..m. The particulate matter in diesel exhaust gas is a highly complex mixture of organic, inorganic, solid, volatile and partly volatile compounds. Many of these particles do not form until they reach the air. Many carcinogenic compounds have been found in diesel exhaust gas and it is considered carcinogenic to humans. Particulate matter can cause several health effects, such as premature death in persons with heart or lung disease, cancer, nonfatal heart attacks, irregular heartbeat, aggravated asthma, decreased lung function and an increase in respiratory symptoms, such as irritation of the airways, coughing or difficulty breathing. It is estimated that in Finland about 1300 people die prematurely due to particles and the economic loss in the EU due to the health effects of particles can be calculated in the billions. Ultra-fine particles are considered to be the most harmful to human health. Ultrafine particles usually make the most of their quantity and surface area

  3. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  5. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    This Practical Radiation Technical Manual is one of a series which has been designed to provide guidance on radiological protection for employers, Radiation Protection Officers, managers and other technically competent persons who have a responsibility to ensure the safety of employees working with ionizing radiation. The Manual may be used with the appropriate IAEA Practical Radiation Safety Manuals to provide adequate training, instruction or information on health effects and medical surveillance for all employees engaged in work with ionizing radiation. Sources of ionizing radiations have a large number of applications in the workplace. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not harmful. Some applications involve sources that could deliver more significant radiation doses, particularly when poor methods are practised or an accident occurs. The radiations cannot be seen, felt or sensed by the human body in any way and excessive exposures may cause detriment to the health of a worker in a way that is not immediately apparent. When the symptoms occur, weeks or possibly years later, an untrained worker or inexperienced medical staff probably cannot recognize the effects to be due to the radiation exposure. This Manual explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit if it forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Dandan Xu

    2015-01-01

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

  8. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

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

  9. HELLE: Health Effects of Low Level Exposures

    International Nuclear Information System (INIS)

    Perspectives for Risk Assessment''. The central question was the extent to which the sometimes fast-growing knowledge about molecular and cellular effects offers the desired basis for extrapolation. Against this setting, a number of more specific questions which have been hotly debated for some time were also addressed. One of the primary questions concerned the traditional but increasingly questioned division between stochastic and non-stochastic working agents, and the corresponding division between exposure-effect relations without a threshold and with a threshold. Thoughts were also exchanged on what is often referred to as hormesis: the notion that low levels of exposure could actually improve health. For the purpose of illuminating the many aspects of these issues, experts from a number of areas were invited. In addition to this, three agents were selected to serve as points of crystallization for the general debate: ionizing radiation, ultraviolet (UV) radiation and dioxins. The present report calls attention to a selection of issues which emerged during the discussions on the above-mentioned central topic. Various more detailed questions and the wider context of the points considered are described at greater length in the enclosed conference report and in the background documents attached to the report. What follows is a series of considerations regarding the scientific basis for the derivation of recommended exposure levels, viewed in the light of current procedures and against the background of the work of the Health Council. In the preparation of the following comments and recommendations, various Dutch experts have been consulted

  10. Health Technology Assessment of the Negative Pressure Wound Therapy for the treatment of acute and chronic wounds: efficacy, safety, cost effectiveness, organizational and ethical impact

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2012-06-01

    Full Text Available

    Background: the aim of the study was to assess the safety, efficacy and cost-effectiveness of negative Pressure wound therapy (nPT for people with chronic and acute wounds.

    Methods: the scope and the final draft of the report have been submitted to the stakeholders (producers, payers and patients. safety issues were addressed through a systematic review of the meta-literature. efficacy was addressed through a systematic review and meta-analysis of randomized controlled trials (rcTs comparing nPT and other standard therapies in patients with chronic or acute lesions. cost-consequence was analyzed through a systematic review of the existing studies.

    Results: we retrieved 19 studies, 13 of which were included in the meta-analysis. Many studies had biases that may have resulted in a better performance for nPT. nPT showed: a slightly shorter healing time (-10.4 days, p=0.001, with no heterogeneity, apart from one small study with very positive results, and 40% more patients healed (p=0.002, no heterogeneity.We identified 15 original research papers on nPT costs and cost per outcome. The costs-per-patient- treated varied from +29% to -60%, with several studies reporting savings for nPT.

    Conclusions: despite serious methodological flaws, the body of evidence available was sufficient to prove some clinical benefit of nPT in severe chronic and acute wound treatment. There is a need for independent and contextualized cost analyses....

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

    Directory of Open Access Journals (Sweden)

    Yzermans CJ

    2010-06-01

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

  12. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume V. SPAHR programmer's guide

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.; Lundy, R.T.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, numbers of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume contains a programmer's guide to SPAHR.

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

    Science.gov (United States)

    Nikolova, Rouja; Aleksiev, Lyubomir; Vukov, Mircho

    2007-01-01

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

  14. 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.

  15. Health and environmental effects of nuclear weapons

    International Nuclear Information System (INIS)

    This report briefly reviews previous WHO work on the health consequences of nuclear war and concentrates on current information about the effects of nuclear weapons on health, and related environmental problems. 15 refs

  16. Health Effects of Ozone and Particle Pollution

    Science.gov (United States)

    ... Health Risks Health Effects of Ozone and Particle Pollution Two types of air pollution dominate in the ... So what are ozone and particle pollution? Ozone Pollution It may be hard to imagine that the ...

  17. Health assessment of hazardous air pollutants, The Netherlands

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-10-01

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

  18. Effects of nuclear war on health and health services

    International Nuclear Information System (INIS)

    This report reviews the findings since 1987 in the field of research related to the possible impact of nuclear war and nuclear explosions on health and health services. An annex contains the finding and conclusions of a 1989 United Nations study on the climatic and other effects of nuclear war. 1 tab

  19. Co-ordinated research project on assessment of levels and health-effects of airborne particulate matter in mining, metal refining and metal working industries using nuclear and related analytical techniques. Report on the second research co-ordination meeting

    International Nuclear Information System (INIS)

    Overall objectives: To demonstrate the applicability of nuclear and related techniques in studies that may impact on human health, giving emphasis to the solution of problems that have been identified to be of high priority in national and international programmes for sustainable development. Specific objectives: To develop strategies and techniques for sampling of workplace airborne particulate matter (APM) and of human tissues and body fluids (hair, blood, etc.) of exposed and non-exposed persons; To development suitable analytical procedures for analysis of such types of samples, using nuclear and related analytical techniques; To carry out workplace and personal monitoring of APM and characterise the health effects of such exposure in terms of the observed elemental concentration; To carry out tissue analyses of the workers so exposed for biological monitoring and the health effects studies. Achievements: a) Specific industries not previously monitored in individual countries have been targeted in respect of pollution assessment. Some examples are: Stainless steel processing and construction; Galvanising industry; Zinc smelting operations; Mineral fertiliser industry. b) Validation of analytical techniques through quality control exercises: NAT-3 Interlaboratory comparison for the determination of trace and minor elements in urban dust artificially loaded on air filters; NAT-4 Proficiency test on selected trace elements in lyophilised urine and air filters. c) Capacity building through the establishment of new multidisciplinary teams, personnel training and laboratory expertise. d) The sampling procedures have been harmonised through: The application of the ''Gent'' sampler for APM collection, IAEA procedures and IUPAC guidelines for sampling and sample handling of hair, blood and urine. e) All participants performed surveys on targeted industries and selected pollutants. f) The scientific output of the CRP is materialised in various national and international

  20. Redistributive effects in public health care financing.

    Science.gov (United States)

    Honekamp, Ivonne; Possenriede, Daniel

    2008-11-01

    This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing. PMID:18347823

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

    Directory of Open Access Journals (Sweden)

    Harriet eWhiley

    2014-09-01

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

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

    Science.gov (United States)

    Barratt, Barnaby B.; Rand, Marsha A.

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  4. Health Impact Assessment of increased cycling to place of work or education in Copenhagen

    OpenAIRE

    Holm, Astrid Ledgaard; Glümer, Charlotte; Diderichsen, Finn

    2012-01-01

    Objective To quantify the effects of increased cycling on both mortality and morbidity. Design Health Impact Assessment. Setting Cycling to place of work or education in Copenhagen, Denmark. Population Effects were calculated based on the working-age population of Copenhagen. Main outcome measures The primary outcome measure was change in burden of disease (measured as disability-adjusted life years (DALY)) due to changed exposure to the health determinants physical inactivity, air pollution ...

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

    Science.gov (United States)

    Khoja, Shariq; Scott, Richard; Gilani, Salman

    2008-01-01

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

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

    OpenAIRE

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

    2007-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  8. Health State Preference Assessment in Diabetic Peripheral Neuropathy

    OpenAIRE

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

    2002-01-01

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

  9. In vitro reporter gene assays for assessment of PPAR- and Nrf2-mediated health effects of tomato and its bioactive constituents

    NARCIS (Netherlands)

    Gijsbers, L.

    2013-01-01

    The consumption of food products with health-promoting properties, such as for example margarines with plant sterols, fruit juice enriched with calcium and cereals with (soluble) fibre, has increased rapidly during the last years. The present thesis provides proof-of-principle that reporter gene ass

  10. Health effects of ionizing radiation

    International Nuclear Information System (INIS)

    Ionizing radiation is energy that travels through space as electromagnetic waves or a stream of fast moving particles. In the workplace, the sources of ionizing radiation are radioactive substances, nuclear power plants, x-ray machines and nuclear devices used in medicine, research and industry. Commonly encountered types of radiation are alpha particles, beta particles and gamma rays. Alpha particles have very little penetrating power and pose a risk only when the radioactive substance is deposited inside the body. Beta particles are more penetrating than alpha particles and can penetrate the outer body tissues causing damage to the skin and the eyes. Gamma rays are highly penetrating and can cause radiation damage to the whole body. The probability of radiation-induced disease depends on the accumulated amount of radiation dose. The main health effects of ionizing radiation are cancers in exposed persons and genetic disorders in the children, grandchildren and subsequent generations of the exposed parents. The fetus is highly sensitive to radiation-induced abnormalities. At high doses, radiation can cause cataracts in the eyes. There is no firm evidence that ionizing radiation causes premature aging. Radiation-induced sterility is highly unlikely for occupational doses. The data on the combined effect of ionizing radiation and other cancer-causing physical and chemical agents are inconclusive

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  13. Physical education teacher effectiveness in a public health context.

    Science.gov (United States)

    McKenzie, Thomas L; Lounsbery, Monica A F

    2013-12-01

    The health benefits of physical activity are well documented, and the important role that schools and physical education (PE) can play in reducing sedentary behavior and contributing to population health has been identified. Although effective teaching is ultimately judged by student achievement, a major component of teacher and school effectiveness studies has been student engagement. Thus, in PE, it is important to assess the teaching and learning processes related to expected outcomes, including what students and teachers do and how lessons are delivered. Within a public health context, it is then important to assess how teachers provide students with ample health-enhancing physical activity to help them become physically fit and to learn generalizable movement and behavioral skills designed to promote physical activity and fitness outside of class time. In this article, we emphasize that the future of PE in our nation's schools will depend on the ability of schools to provide programs that are perceived to be of importance to the public; moreover, we believe that the future of PE rests on the effectiveness of PE teachers to operate within a public health context. In addition, we also provide a summary of teacher effectiveness research within a public health context and offer visions for the future assessment and evaluation of PE teacher effectiveness that move beyond the PE lesson to include components of the comprehensive school physical activity model.

  14. Assessment of health risks caused by air pollutants

    International Nuclear Information System (INIS)

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

  15. Evaluate, Assess, Treat: Development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues

    OpenAIRE

    DeBate, Rita D.; Cragun, Deborah; Gallentine, Ashley A.; Severson, Herbert H; Shaw, Tracey; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Hendricson, William; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A.

    2012-01-01

    Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues while interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e., early detection of oral manifestations of disordered eating behaviors, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting wi...

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

    OpenAIRE

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

    2012-01-01

    Taxes and subsidies are increasingly being considered as potential policy instruments to incentivize consumers to improve their food and beverage consumption patterns and related health outcomes. This study provided a systematic review of recent U.S. studies on the price elasticity of demand for sugar-sweetened beverages (SSBs), fast food and fruits and vegetables as well as the direct associations of prices/taxes with body weight outcomes. Based on the recent literature, the price elasticity...

  17. Critical analysis of a method for assessing health effects of the toxic and persistent atmospheric pollutants from waste to energy plants

    International Nuclear Information System (INIS)

    Municipal solid waste (MSW) incineration is primarily a management tool, but it may also be used like a source of energy. Considering the risks to health posed by MSW incineration, it is also appropriate to make some comparisons with alternatives forms of waste management. The municipal solid incineration with energy recovery (so called waste-to-energy plants) and the indicators in the risk assesment are presented in the paper. A particular aspect is related to the organic micro-pollutant benzo[a]pyrene (BaP) role for the human health risk assesment in waste-to-energy plants. There are also pointed out details on the group of the organic compounds Polycyclic Aromatic Hydrocarbons, PAH, from which BaP is part, and on the dioxins and furans (PCDD/Fs). As persistent organic pollutants all the pollutants first mentioned above are to be taken into account in the health risk assesment. The present paper points out how BaP can be a useful indicator of PAH in case of the waste incinerators process so as 2, 3, 7, 8 Tetrachlorodibenzo-p-dioxin is for dioxins. (authors)

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

    Science.gov (United States)

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

    2006-12-01

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

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

    International Nuclear Information System (INIS)

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

  20. Competencies for public health finance: an initial assessment and recommendations.

    Science.gov (United States)

    Gillespie, Kathleen N; Kurz, Richard S; McBride, Timothy; Schmitz, Homer H

    2004-01-01

    The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers. PMID:15552772

  1. A comparison between integrated risk assessment and classical health/environmental assessment: Emerging beneficial properties

    International Nuclear Information System (INIS)

    Both humans and wildlife are exposed to various types of halogenated organic compounds such as polychlorinated biphenyls (PCBs) and dichlorodiphenyltrichloroethane (DDT), typically old chemicals, and tris(4-chlorophenyl) methane (TCPM) and brominated flame retardants, some new chemicals, simultaneously. Classical risk assessment has evaluated health and ecological risks independently by experts from different disciplines. Taking into considerations the recent concerns about endocrine disrupting chemicals and the progress of research in related areas, we integrated and assessed data on exposure and potential effects in humans and wildlife. Comparisons were made for organ concentrations, body burdens of several organochlorine compounds (OCs), metabolic capacities between humans and various wildlife. When we integrate the knowledge on effects and exposure in humans and in wildlife, new insights were suggested about similarities and/or differences in potential effects among various human populations living on different foods and having different body burdens. Combining existing information with emerging knowledge of mechanisms of actions on endocrine disrupting chemicals after exposure to above chemicals during early developmental stages will further elucidate potential risks from exposure to those chemicals

  2. Assessment of health impacts of decreased smoking prevalence in Copenhagen

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Brønnum-Hansen, Henrik; Robinson, Kirstine Magtengaard;

    2014-01-01

    , but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. Methods: The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data......, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re......-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame. Conclusions: By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence...

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Teachers' Assessment Literacy and Washback Effect of Assessment

    Directory of Open Access Journals (Sweden)

    Niveen R. M. Elshawa

    2016-07-01

    Full Text Available Assessment literacy, as a term, is not well known in the educational field. This is unfortunate because teachers' assessment knowledge and competence can have an important influence on the way they teach and the way their students learn.  The relationship between the degree of assessment literacy a teacher has and the washback of this type of assessment is not clearly identified, especially in higher education context.  In view of this gap, this article attempts to examine important assessment literacy issues in relation to student learning: definition and importance of assessment literacy, assessment in higher education and assessment practices through reviewing related studies. The review pinpoints the harmful effects of being assessment illiterate for both teachers and students.Keywords: assessment, assessment literacy, student learning, washback

  5. Assessing Health Literacy in Diverse Primary Care Settings

    Science.gov (United States)

    McCune, Renee L.

    2010-01-01

    Patient health literacy skills are critical to effective healthcare communication and safe care delivery in primary care settings. Methods and strategies to identify patient health literacy (HL) capabilities and provider/staff knowledge, attitudes and beliefs (KAB) regarding HL must be known before addressing provider/staff communication skills.…

  6. Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement.

    NARCIS (Netherlands)

    Arah, O.A.; Klazinga, N.S.; Delnoij, D.M.J.; Asbroek, A.H.A. ten; Custers, T.

    2003-01-01

    ISSUES: Countries and international organizations have recently renewed their interest in how health systems perform. This has led to the development of performance indicators for monitoring, assessing, and managing health systems to achieve effectiveness, equity, efficiency, and quality. Although t

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

    Science.gov (United States)

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

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

  8. Studies on assessment of health effects of radiation processed foods: Part 1. genetic toxicological evaluation in somatic and germ cells of laboratory animals

    International Nuclear Information System (INIS)

    The studies summarized in this report form a part of the program on the safety evaluation of radiation-processed foods, an important component of the development of radiation technology for food preservation from the public health point of view. These studies contributed significantly and critically to the acceptance of safety of radiation processed foods by regulatory agencies both at the national and international levels. This report contains only genetic studies, one aspect of this program, while the remaining studies will be summarized in a separate report

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. PILOT VOLUNTEER TRAINING FOR WETLAND MONITORING AND HEALTH ASSESSMENT

    Science.gov (United States)

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

  11. Mapping of health technology assessment in selected countries

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Science.gov (United States)

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

  14. Documenting the Effects of Armed Conflict on Population Health.

    Science.gov (United States)

    Levy, Barry S; Sidel, Victor W

    2016-01-01

    War and other forms of armed conflict have profound adverse effects on population health. It is important to document these effects to inform the general public and policy makers about the consequences of armed conflict, provide services to meet the needs of affected populations, protect human rights and document violations of international humanitarian law, and help to prevent future armed conflict. Documentation can be accomplished with surveillance, epidemiological surveys, and rapid assessment. Challenges include inadequate or absent data systems, social breakdown, forced migration, reporting biases, and the fog of war. The adverse effects of the Iraq War on population health demonstrate how the effects of armed conflict on population health can be documented. We recommend the establishment of an independent mechanism, operated by the United Nations or a multilateral organization, to investigate and document the effects of armed conflict on population health. PMID:26989827

  15. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    van Es, Harold

    2016-04-01

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

  16. The impact of behavioral and mental health risk assessments on goal setting in primary care.

    Science.gov (United States)

    Krist, Alex H; Glasgow, Russell E; Heurtin-Roberts, Suzanne; Sabo, Roy T; Roby, Dylan H; Gorin, Sherri N Sheinfeld; Balasubramanian, Bijal A; Estabrooks, Paul A; Ory, Marcia G; Glenn, Beth A; Phillips, Siobhan M; Kessler, Rodger; Johnson, Sallie Beth; Rohweder, Catherine L; Fernandez, Maria E

    2016-06-01

    Patient-centered health risk assessments (HRAs) that screen for unhealthy behaviors, prioritize concerns, and provide feedback may improve counseling, goal setting, and health. To evaluate the effectiveness of routinely administering a patient-centered HRA, My Own Health Report, for diet, exercise, smoking, alcohol, drug use, stress, depression, anxiety, and sleep, 18 primary care practices were randomized to ask patients to complete My Own Health Report (MOHR) before an office visit (intervention) or continue usual care (control). Intervention practice patients were more likely than control practice patients to be asked about each of eight risks (range of differences 5.3-15.8 %, p set goals for six risks (range of differences 3.8-16.6 %, p controls, intervention patients felt clinicians cared more for them and showed more interest in their concerns. Patient-centered health risk assessments improve screening and goal setting.Trial RegistrationClinicaltrials.gov identifier: NCT01825746.

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

    Directory of Open Access Journals (Sweden)

    P Abooee

    2013-01-01

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

  18. Assessment of health promotion content in undergraduate physiotherapy curricula

    Directory of Open Access Journals (Sweden)

    Kebogile Mokwena

    2015-04-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  20. A study on the application of foreign occupational health and safety checklist in assessing the occupational health intervention effects%职业健康与安全核查表在色纺企业职业卫生干预与评估中的应用

    Institute of Scientific and Technical Information of China (English)

    谢红卫; 张美辨; 邹华; 俞文兰

    2015-01-01

    目的:研究 HS (健康、安全)核查表在色纺企业职业卫生干预与评估中的作用。方法2013年联合应用职业病危害控制效果评价方法和改良的某跨国公司 HS 核查表对某色纺企业进行干预与评估,并比较干预前后核查表符合率、作业场所有害物质剂量水平、职业卫生干预核心内容符合率和个人防护用品使用率及正确使用率。结果干预前后,核查表符合率从31.25%上升到79.17%;HS 核查表各项职业卫生核心内容符合率、工人个人防护用品使用率及正确使用率均明显上升(P <0.05);作业场所粉尘浓度超标率从83.33%下降到16.67%。结论联合应用职业病危害控制效果评价和改良的核查表,干预与评估效果明显。%Objective Study the intervention effects occupational HS (health and safety)checklist of the comprehensive intervention effects on colored textile manufacture.Methods Combined the application of occupational disease hazard control effect assessment and HS checklist to intervene and assessment a colored textile manufacture,and then compare the intervention effects.Results The qualified rate of checklist has been increased from 31.25% to 79.17% after intervention.The qualified rate of main contents of occupational health intervention (monitoring occupational disease health risk factors,protecting facilities for occupational disease,facilities for emergency rescue,construction of hygiene,work -related welfare facilities,occupational health surveillance,occupational health management,chemical management, employee participation and suppliers security) also has been significantly improved (P <0.05 ).Furthermore,the unqualified rates of dust concentration in workplace descreased from 83.33% to 16.67%.Conclusion The application of occupational disease hazard control effect assessment combined with HS checklist improved intervention effect and this technique could be spread.

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

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

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

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

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

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

  3. Health Effects of PCBs in Residences and Schools (HESPERUS): PCB – health Cohort Profile

    Science.gov (United States)

    Bräuner, Elvira Vaclavik; Andersen, Zorana Jovanovic; Frederiksen, Marie; Specht, Ina Olmer; Hougaard, Karin Sørig; Ebbehøj, Niels; Bailey, Janice; Giwercman, Aleksander; Steenland, Kyle; Longnecker, Matthew Paul; Bonde, Jens Peter

    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 been measured were created. An individual estimate of long-term airborne PCB exposure was assigned based on measurements. The cohorts will be linked to eight different national data sources on mortality, school records, residential history, socioeconomic status, and chronic disease and reproductive outcomes. The linking of indoor air exposures with health outcomes provides a dataset unprecedented worldwide. We describe a project, called HESPERUS (Health Effects of PCBs in Residences and Schools), which will be the first study of the long term health effects of the lower-chlorinated, semi-volatile PCBs in the indoor environment. PMID:27090775

  4. Model-based assessment of estuary ecosystem health using the latent health factor index, with application to the richibucto estuary.

    Directory of Open Access Journals (Sweden)

    Grace S Chiu

    Full Text Available The ability to quantitatively assess ecological health is of great interest to those tasked with monitoring and conserving ecosystems. For decades, biomonitoring research and policies have relied on multimetric health indices of various forms. Although indices are numbers, many are constructed based on qualitative procedures, thus limiting the quantitative rigor of the practical interpretations of such indices. The statistical modeling approach to construct the latent health factor index (LHFI was recently developed. With ecological data that otherwise are used to construct conventional multimetric indices, the LHFI framework expresses such data in a rigorous quantitative model, integrating qualitative features of ecosystem health and preconceived ecological relationships among such features. This hierarchical modeling approach allows unified statistical inference of health for observed sites (along with prediction of health for partially observed sites, if desired and of the relevance of ecological drivers, all accompanied by formal uncertainty statements from a single, integrated analysis. Thus far, the LHFI approach has been demonstrated and validated in a freshwater context. We adapt this approach to modeling estuarine health, and illustrate it on the previously unassessed system in Richibucto in New Brunswick, Canada, where active oyster farming is a potential stressor through its effects on sediment properties. Field data correspond to health metrics that constitute the popular AZTI marine biotic index and the infaunal trophic index, as well as abiotic predictors preconceived to influence biota. Our paper is the first to construct a scientifically sensible model that rigorously identifies the collective explanatory capacity of salinity, distance downstream, channel depth, and silt-clay content-all regarded a priori as qualitatively important abiotic drivers-towards site health in the Richibucto ecosystem. This suggests the potential

  5. Modification by influenza on health effects of air pollution in Hong Kong

    OpenAIRE

    Wong, Chit Ming; YANG, LIN; Thach, Thuan Quoc; Chau, Patsy Yuen Kwan; Chan, King Pan; Thomas, G. Neil; Lam, Tai Hing; Wong, Tze Wai; Hedley, Anthony J.; Peiris, J. S. Malik

    2009-01-01

    Background: Both influenza viruses and air pollutants have been well documented as major hazards to human health, but few epidemiologic studies have assessed effect modification of influenza on health effects of ambient air pollutants. Objectives: We aimed to assess modifying effects of influenza on health effects of ambient air pollutants. Methods: We applied Poisson regression to daily numbers of hospitalizations and mortality to develop core models after adjustment for potential time-varyi...

  6. Environment, safety and health progress assessment of the Fernald Environmental Management Project (FEMP)

    International Nuclear Information System (INIS)

    This report documents the results of the Environment, Safety, and Health (ES ampersand H) Progress Assessment of the Fernald Environmental Management Project (FEMP), Fernald, Ohio, conducted from October 15 through October 25, 1991. The Secretary of Energy directed that small, focused, ES ampersand H Progress Assessments be performed as part of the continuing effort to institutionalize line management accountability and the self-assessment process in the areas of ES ampersand H. The FEMP assessment is the pilot assessment for this new program. The objectives for the FEMP ES ampersand H Progress Assessment were to assess: (1) how the FEMP has progressed since the 1989 Tiger Assessment; (2) how effectively the FEMP has corrected specific deficiencies and associated root causes identified by that team; and (3) whether the current organization, resources, and systems are sufficient to proactively manage ES ampersand H issues

  7. Frameworks for Hospital-Based Health Technology Assessment to Resolve Financial Issues in South Korea

    Directory of Open Access Journals (Sweden)

    Jiwon Yang

    2016-06-01

    Full Text Available Objectives: The aim was to design frameworks and develop a detailed process regarding Hospital-Based Health Technology Assessment (HB-HTA in South Korea. Methods: We conducted a literature review and interviewed in writing or in person experts to assess the need for and existing types of HB-HTA. Results: HB-HTA in advanced countries can be classified into four types according to the condition of hospitals and type of assessment. Further, the expert interviews revealed the necessity of HB-HTA for the efficient introduction of new health technologies and financial cost reduction in hospitals. Finally, three ideal HB-HTA models for use in South Korea were suggested as part of the identified framework: an education and dissemination model, a governmenthospital joint research model, and a self-research model. Conclusions: The suggested three models will contribute to the provision of safe, effective, and cost-effective health technologies and efficient resources allocation in hospitals.

  8. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

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

    2016-08-01

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

  11. Health effects associated with waterpipe smoking

    OpenAIRE

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

    2015-01-01

    Objective It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. Data sources Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms ‘waterpipe’ and its synony...

  12. Assessment of community health needs of Chongqing residents: a qualitative study

    Institute of Scientific and Technical Information of China (English)

    Li Ying; Li Daikun; He Jia; Shi Kai; Liu HongHong; Zhang Hu

    2008-01-01

    Objective: The aim of this preliminary qualitative study was to gain insight into community health needs in order to develop health program for community in Chongqing. Methods: Totally 40 participants were assigned into 6 focus group discussions. All groups were led by local language speakers, and their talking was recorded after gaining informed consent. Transcribed data were coded and subjected to thematic analysis. Results: The main obtained themes were that community health problems were chronic noncommunicable disease, main health service needs included regularly free check-up and health education, and perceived health risk factors were unhealthy lifestyle and behavior as well as environment problems. Conclusion: Our community health needs assessment (CHNA) with FGDs indicate that residents realize the importance of prevention of disease. Our study identifies that primarily community health promotion is one of the priorities of community health service needs, including reorienting health service, health education, guiding behavior or lifestyle, and creating healthy environments. The findings of this study can provide guidance to the development of more effective and pertinent health program in this community.

  13. Environmental Health Risk Assessment and Countermeasures on a Fire Extinguisher

    Energy Technology Data Exchange (ETDEWEB)

    Park, J.K.; Jeong, D.W. [Korea Environment Institute, Seoul (Korea)

    2001-12-01

    Brominated flame retardants encompass a large number of different organic compounds sharing the common feature of containing bromine, which has an inhibitory effect on the development of fire. The substances are added to plastic materials, insulation foam, and other materials so as to enable the products to comply with fire safety requirements and wishes. The most problematic groups of compounds are polybrominated biphenyls(PBBs) and polybrominated diphenyl ethers(PBDEs). The objective of this project is to develop a management strategy for all problematic brominated flame retardants. A number of studies have shown that several of the brominated flame retardants occur in increasing concentrations in nature and in human beings. This is of concern because certain of the brominated flame retardants are suspected of having undesirable effects on the environment and health. The substances are generally very stable, especially so in the case of PBBs and PBDEs. These are strong reasons for hastening the phase-out of PBBs and PBDEs as group. Moreover, PBBs and PBDEs have attracted international attention. Within the OECD, business organisations have made voluntary agreements concerning PBBs and PBDEs. Rules of the EU forbid the use of PBBs in textiles coming into contact with the skin. The environmental and health risks of PBDEs are currently being evaluated as a part of an EU programme for existing substances. In Germany, PBBs and PBDEs are restricted through the Dioxin Ordinance and voluntary agreements with industry. Brominated flame retardants encompass a large number of different organic compounds sharing the common feature of containing bromine, which has an inhibitory effect on the development of fire. The substances are added to plastic materials, insulation foam, and other materials so as to enable the products to comply with fire safety requirements and wishes. The most problematic groups of compounds are polybrominated biphenyls(PBBs) and polybrominated diphenyl

  14. Who comes to a workplace health risk assessment?

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

    Sharma, Jayendra

    2016-07-01

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

  16. The Role of decision-analytic modelling in German health technology assessments

    OpenAIRE

    Kuhlmann, Alexander; Treskova, Marina; Braun, Sebastian; Graf von der Schulenburg, J-Matthias

    2015-01-01

    Background Decision-analytic modelling (DAM) has become a widespread method in health technology assessments (HTA), but the extent to which modelling is used differs among international HTA institutions. In Germany, the use of DAM is optional within HTAs of the German Institute of Medical Documentation and Information (DIMDI). Our study examines the use of DAM in DIMDI HTA reports and its effect on the quality of information provided for health policies. Methods A review of all DIMDI HTA repo...

  17. 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

  18. SPATIAL ANALYSIS BASED HEALTH AND SAFETY RISK ASSESSMENT FOR LINEAR CONSTRUCTION PROJECTS

    OpenAIRE

    H. Atay; G. Toz

    2012-01-01

    This paper describes an on-going study that aims to develop a web-based spatial decision support system model for proactive health and safety management in linear construction projects. Currently, health and safety management is usually performed reactively instead of proactive management since hazard identification and risk assessment is mostly performed on paper based documents that are not effectively used at site. This leads to accidents and fatalities at construction sites. The proposed ...

  19. Assessment of OEP health's risk in nuclear medicine

    Science.gov (United States)

    Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M.

    2012-10-01

    The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 ± 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

  20. Health information: what can mobile phone assessments add?

    Science.gov (United States)

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients' health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures.In this pilot study, two randomly selected groups of patients provided information about their pain for one week postoperatively. One group responded via cell phones, and the other, a control group, responded using paper-based questionnaires.The mobile phone system was found to provide a fast and safe basis for reporting pain postoperatively in real time. The results indicate that on days 3 and 4 the mobile phone group reported significantly higher levels of pain than the control group, and the cholecystectomy patients reported significantly more pain at movement on days 3 and 4 than the hysterectomy patients.The mobile phone approach is an adaptation to modern technology and the mobility of individuals. This technology is user friendly and requires minimal support. However, as the sample size was small (n = 37), further studies are needed before additional conclusions can be drawn. PMID:23209453

  1. Health information: what can mobile phone assessments add?

    Science.gov (United States)

    Stomberg, Margareta Warrén; Platon, Birgitta; Widén, Annette; Wallner, Ingegerd; Karlsson, Ove

    2012-01-01

    In healthcare, pain assessment is a key factor in effectively treating postoperative pain and reducing the risk of developing chronic pain. The overall aim of this study was to investigate whether a mobile phone support system can be used as a basis to continuously document patients' health information in real time and provide conditions for optimal, individual pain management after cholecystectomy and hysterectomy procedures.In this pilot study, two randomly selected groups of patients provided information about their pain for one week postoperatively. One group responded via cell phones, and the other, a control group, responded using paper-based questionnaires.The mobile phone system was found to provide a fast and safe basis for reporting pain postoperatively in real time. The results indicate that on days 3 and 4 the mobile phone group reported significantly higher levels of pain than the control group, and the cholecystectomy patients reported significantly more pain at movement on days 3 and 4 than the hysterectomy patients.The mobile phone approach is an adaptation to modern technology and the mobility of individuals. This technology is user friendly and requires minimal support. However, as the sample size was small (n = 37), further studies are needed before additional conclusions can be drawn.

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

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

    International Nuclear Information System (INIS)

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

  5. A Model for Risk Assessment in Health Care.

    Science.gov (United States)

    Prijatelj, Vesna; Rajkovič, Vladislav; Šušteršič, Olga

    2016-01-01

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

  6. Framework for assessing governance of the health system in developing countries: gateway to good governance.

    Science.gov (United States)

    Siddiqi, Sameen; Masud, Tayyeb I; Nishtar, Sania; Peters, David H; Sabri, Belgacem; Bile, Khalif M; Jama, Mohamed A

    2009-04-01

    Governance is thought to be a key determinant of economic growth, social advancement and overall development, as well as for the attainment of the MDGs in low- and middle-income countries. Governance of the health system is the least well-understood aspect of health systems. A framework for assessing health system governance (HSG) at national and sub-national levels is presented, which has been applied in countries of the Eastern Mediterranean. In developing the HSG framework key issues considered included the role of the state vs. the market; role of the ministries of health vs. other state ministries; role of actors in governance; static vs. dynamic health systems; and health reform vs. human rights-based approach to health. Four existing frameworks were considered: World Health Organization's (WHO) domains of stewardship; Pan American Health Organization's (PAHO) essential public health functions; World Bank's six basic aspects of governance; and United Nations Development Programme (UNDP) principles of good governance. The proposed HSG assessment framework includes the following 10 principles-strategic vision, participation and consensus orientation, rule of law, transparency, responsiveness, equity and inclusiveness, effectiveness and efficiency, accountability, intelligence and information, and ethics. The framework permits 'diagnoses of the ills' in HSG at the policy and operational levels and points to interventions for its improvement. In the case of Pakistan, where the framework was applied, a positive aspect was the growing participation and consensus orientation among stakeholders, while weaknesses were identified in relation to strategic vision, accountability, transparency, effectiveness and efficiency and rule of law. In using the HSG framework it needs to be recognized that the principles are value driven and not normative and are to be seen in the social and political context; and the framework relies on a qualitative approach and does not follow a

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

    Science.gov (United States)

    Fantke, Peter; Friedrich, Rainer; Jolliet, Olivier

    2012-11-15

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

  8. Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

    Directory of Open Access Journals (Sweden)

    Leon Natalie

    2012-11-01

    Full Text Available Abstract Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT, the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains

  9. The Air Toxics Health Effects Database (ATHED)

    International Nuclear Information System (INIS)

    The Air Toxics Health Effects Database (ATHED) is currently used by the EPA's Office of Air Quality Planning and Standards (OAQPS) to support risk assessments for the Residual Risk Program. An assessment of the residual risk is required to be performed at a specified time (typically 8years) following the promulgation of a technology-based Maximum Achievable Control Technologies (MACT) standard. The goal of the Residual Risk Program is to assure that the risk that remains after MACT standards are implemented (i.e., the 'residual risk') is acceptable, and if not, to propose additional regulations to mitigate those risks. ATHED maintains all available reference values for each chemical as separate data records, and includes values for all exposure durations (acute, short-term, subchronic and chronic). These values are used as benchmarks to determine acceptable exposure levels to the hazardous air pollutants (HAPs) listed in Section 112 of the Clean Air Act. ATHED also provides useful background information on the uncertainty and/or modifying factors that were applied in the derivation of each reference value, as well as the point of departure and the critical study/studies. To facilitate comparisons across durations for a specific chemical, ATHED data can be graphically presented

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

    Directory of Open Access Journals (Sweden)

    Paradies Yin C

    2012-02-01

    Full Text Available Abstract 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.

  11. Health Risk Assessment of Inhalable Particulate Matter in Beijing Based on the Thermal Environment

    Directory of Open Access Journals (Sweden)

    Lin-Yu Xu

    2014-11-01

    Full Text Available Inhalable particulate matter (PM10 is a primary air pollutant closely related to public health, and an especially serious problem in urban areas. The urban heat island (UHI effect has made the urban PM10 pollution situation more complex and severe. In this study, we established a health risk assessment system utilizing an epidemiological method taking the thermal environment effects into consideration. We utilized a remote sensing method to retrieve the PM10 concentration, UHI, Normalized Difference Vegetation Index (NDVI, and Normalized Difference Water Index (NDWI. With the correlation between difference vegetation index (DVI and PM10 concentration, we utilized the established model between PM10 and thermal environmental indicators to evaluate the PM10 health risks based on the epidemiological study. Additionally, with the regulation of UHI, NDVI and NDWI, we aimed at regulating the PM10 health risks and thermal environment simultaneously. This study attempted to accomplish concurrent thermal environment regulation and elimination of PM10 health risks through control of UHI intensity. The results indicate that urban Beijing has a higher PM10 health risk than rural areas; PM10 health risk based on the thermal environment is 1.145, which is similar to the health risk calculated (1.144 from the PM10 concentration inversion; according to the regulation results, regulation of UHI and NDVI is effective and helpful for mitigation of PM10 health risk in functional zones.

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

    Directory of Open Access Journals (Sweden)

    Loeste de Arruda-Barbosa

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Farin Fatemi

    2013-09-01

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

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

    Science.gov (United States)

    Li, Yongfa; Li, Dong

    2014-07-15

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

  15. Health Effects of Environmental Pollution.

    Science.gov (United States)

    Environmental Protection Agency, Washington, DC.

    This booklet notes that for a long time the American people were willing to pay any price for progress. Now may refuse to accept an environment that menaces their health and lowers their enjoyment of life. They are embracing a new environmental consciousness, a broader vision of reality, a more profound sense of their place in nature. Among the…

  16. Potential effects on health of global warming

    Energy Technology Data Exchange (ETDEWEB)

    Haines, A. (Univ. College London Medical School, London (United Kingdom). Whittington Hospital); Parry, M. (Univ. of Oxford (United Kingdom). Environmental Change Unit)

    1993-12-01

    Prediction of the impacts of global climate change on health is complicated by a number of factors. These include: the difficulty in predicting regional changes in climate, the capacity for adaptation to climate change, the interactions between the effects of global climate change and a number of other key determinants of health, including population growth and poverty, and the availability of adequate preventive and curative facilities for diseases that may be effected by climate change. Nevertheless, it is of importance to consider the potential health impacts of global climate change for a number of reasons. It is also important to monitor diseases which could be effected by climate change in order to detect changes in incidence as early as possible and study possible interactions with other factors. It seems likely that the possible impacts on health of climate change will be a major determinant of the degree to which policies aimed at reducing global warming are followed, as perceptions of the effect of climate change to human health and well-being are particularly likely to influence public opinion. The potential health impacts of climate change can be divided into direct (primary) and indirect (secondary and tertiary) effects. Primary effects are those related to the effect of temperature on human well-being and disease. Secondary effects include the impacts on health of changes in food production, availability of water and of sea level rise. A tertiary level of impacts can also be hypothesized.

  17. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel;

    2013-01-01

    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...... 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...... is close to 1700 deaths postponed and 16 000 life years saved annually in Hungary. CONCLUSION: The provision of smoke-free public places has an unambiguously positive impact on the health of the public, especially in a country with a high burden of smoking-related diseases. The study described offers...

  18. The health-care system: an assessment and reform agenda.

    Science.gov (United States)

    Mataria, Awad; Khatib, Rana; Donaldson, Cam; Bossert, Thomas; Hunter, David J; Alsayed, Fahed; Moatti, Jean-Paul

    2009-04-01

    Attempts to establish a health plan for the occupied Palestinian territory were made before the 1993 Oslo Accords. However, the first official national health plan was published in 1994 and aimed to regulate the health sector and integrate the activities of the four main health-care providers: the Palestinian Ministry of Health, Palestinian non-governmental organisations, the UN Relief and Works Agency, and a cautiously developing private sector. However, a decade and a half later, attempts to create an effective, efficient, and equitable system remain unsuccessful. This failure results from arrangements for health care established by the Israeli military government between 1967 and 1994, the nature of the Palestinian National Authority, which has little authority in practice and has been burdened by inefficiency, cronyism, corruption, and the inappropriate priorities repeatedly set to satisfy the preferences of foreign aid donors. Although similar problems exist elsewhere, in the occupied Palestinian territory they are exacerbated and perpetuated under conditions of military occupation. Developmental approaches integrated with responses to emergencies should be advanced to create a more effective, efficient, and equitable health system, but this process would be difficult under military occupation. PMID:19268349

  19. The Treatment Effectiveness Assessment (TEA

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-09-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers.  View original paper by Ling W, Farabee D, Liepa D, Wu LT. 

  20. Health impacts of climate change in the Solomon Islands: an assessment and adaptation action plan.

    Science.gov (United States)

    Spickett, Jeffery T; Katscherian, Dianne

    2014-09-01

    The Pacific island countries are particularly vulnerable to the environmental changes wrought by global climate change such as sea level rise, more frequent and intense extreme weather events and increasing temperatures. The potential biophysical changes likely to affect these countries have been identified and it is important that consideration be given to the implications of these changes on the health of their citizens. The potential health impacts of climatic changes on the population of the Solomon Islands were assessed through the use of a Health Impact Assessment framework. The process used a collaborative and consultative approach with local experts to identify the impacts to health that could arise from local environmental changes, considered the risks associated with these and proposed appropriate potential adaptive responses. Participants included knowledgeable representatives from the biophysical, socio-economic, infrastructure, environmental diseases and food sectors. The risk assessments considered both the likelihood and consequences of the health impacts occurring using a qualitative process. To mitigate the adverse effects of the health impacts, an extensive range of potential adaptation strategies were developed. The overall process provided an approach that could be used for further assessments as well as an extensive range of responses which could be used by sectors and to assist future decision making associated with the Solomon Islands' responses to climate change. PMID:25168977

  1. Health Impacts of Climate Change in the Solomon Islands: An Assessment and Adaptation Action Plan

    Science.gov (United States)

    Spickett, Jeffery T; Katscherian, Dianne

    2014-01-01

    The Pacific island countries are particularly vulnerable to the environmental changes wrought by global climate change such as sea level rise, more frequent and intense extreme weather events and increasing temperatures. The potential biophysical changes likely to affect these countries have been identified and it is important that consideration be given to the implications of these changes on the health of their citizens. The potential health impacts of climatic changes on the population of the Solomon Islands were assessed through the use of a Health Impact Assessment framework. The process used a collaborative and consultative approach with local experts to identify the impacts to health that could arise from local environmental changes, considered the risks associated with these and proposed appropriate potential adaptive responses. Participants included knowledgeable representatives from the biophysical, socio-economic, infrastructure, environmental diseases and food sectors. The risk assessments considered both the likelihood and consequences of the health impacts occurring using a qualitative process. To mitigate the adverse effects of the health impacts, an extensive range of potential adaptation strategies were developed. The overall process provided an approach that could be used for further assessments as well as an extensive range of responses which could be used by sectors and to assist future decision making associated with the Solomon Islands’ responses to climate change. PMID:25168977

  2. Health Effects of PCBs in Residences and Schools (HESPERUS)

    DEFF Research Database (Denmark)

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

    2016-01-01

    been measured were created. An individual estimate of long-term airborne PCB exposure was assigned based on measurements. The cohorts will be linked to eight different national data sources on mortality, school records, residential history, socioeconomic status, and chronic disease and reproductive...... 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...... outcomes. The linking of indoor air exposures with health outcomes provides a dataset unprecedented worldwide. We describe a project, called HESPERUS (Health Effects of PCBs in Residences and Schools), which will be the first study of the long term health effects of the lower-chlorinated, semi...

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

    OpenAIRE

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

    1988-01-01

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

  4. Environment, Safety and Health progress assessment of the Idaho National Engineering Laboratory (INEL)

    International Nuclear Information System (INIS)

    The ES ampersand H Progress Assessments are part of the Department's continuous improvement process throughout DOE and its contractor organizations. The purpose of the INEL ES ampersand H Progress Assessment is to provide the Department with concise independent information on the following: (1) change in culture and attitude related to ES ampersand H activities; (2) progress and effectiveness of the ES ampersand H corrective actions resulting from previous Tiger Team Assessments; (3) adequacy and effectiveness of the ES ampersand H self-assessment programs of the DOE line organizations and the site management and operating contractor; and (4) effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES ampersand H problems. It is not intended that this Progress Assessment be a comprehensive compliance assessments of ES ampersand H activities. The points of reference for assessing programs at the INEL were, for the most part, the 1991 INEL Tiger Team Assessment, the INEL Corrective Action Plan, and recent appraisals and self-assessments of INEL. Horizontal and vertical reviews of the following programmatic areas were conducted: Management: Corrective action program; self-assessment; oversight; directives, policies, and procedures; human resources management; and planning, budgeting, and resource allocation. Environment: Air quality management, surface water management, groundwater protection, and environmental radiation. Safety and Health: Construction safety, worker safety and OSHA, maintenance, packaging and transportation, site/facility safety review, and industrial hygiene

  5. Environment, Safety and Health progress assessment of the Idaho National Engineering Laboratory (INEL)

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    The ES&H Progress Assessments are part of the Department`s continuous improvement process throughout DOE and its contractor organizations. The purpose of the INEL ES&H Progress Assessment is to provide the Department with concise independent information on the following: (1) change in culture and attitude related to ES&H activities; (2) progress and effectiveness of the ES&H corrective actions resulting from previous Tiger Team Assessments; (3) adequacy and effectiveness of the ES&H self-assessment programs of the DOE line organizations and the site management and operating contractor; and (4) effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES&H problems. It is not intended that this Progress Assessment be a comprehensive compliance assessments of ES&H activities. The points of reference for assessing programs at the INEL were, for the most part, the 1991 INEL Tiger Team Assessment, the INEL Corrective Action Plan, and recent appraisals and self-assessments of INEL. Horizontal and vertical reviews of the following programmatic areas were conducted: Management: Corrective action program; self-assessment; oversight; directives, policies, and procedures; human resources management; and planning, budgeting, and resource allocation. Environment: Air quality management, surface water management, groundwater protection, and environmental radiation. Safety and Health: Construction safety, worker safety and OSHA, maintenance, packaging and transportation, site/facility safety review, and industrial hygiene.

  6. Proposing a framework for Health Impact Assessment in Iran

    OpenAIRE

    Fakhri, Ali; Harris, Patrick; Maleki, MohammadReza

    2015-01-01

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

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

    OpenAIRE

    Sebastien Borguet; Olivier Léonard

    2011-01-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  9. Effects of subchronic exposures to concentrated ambient particles in mice. IX. Integral assessment and human health implications of subchronic exposures of mice to CAPs.

    Science.gov (United States)

    Lippmann, Morton; Gordon, Terry; Chen, Lung Chi

    2005-04-01

    In order to examine the biologic plausibility of adverse chronic cardiopulmonary effects in humans associated with ambient particulate matter (PM) exposure, we exposed groups of normal mice (C57) and knockout mice that develop atherosclerotic plaque (ApoE-/- and ApoE-/- LDLr-/-) for 6 h/day, 5 days/wk for 5 or 6 mo during the spring/summer of 2003 to either filtered air or 10-fold concentrated ambient particles (CAPs) in Tuxedo, NY (average PM2.5 concentration during exposure = 110 microg/m3). Some of the mice had implanted electrocardiographic monitors. We demonstrated that: (1) this complex interdisciplinary study was technically feasible in terms of daily exposure, collection of air quality monitoring data, the collection, analysis, and interpretation of continuous data on cardiac function, and the collection and analyses of tissues of the animals sacrificed at the end of the study; (2) the daily variations in CAPs were significantly associated, in ApoE-/- mice, with daily variations in cardiac functions; (3) there were significant differences between CAPs and sham-exposed ApoE-/- mice in terms of cardiac function after the end of exposure period, as well as small differences in atherosclerotic plaque density, coronary artery disease, and cell density in the substantia nigra in the brain in the ApoE-/- mice; (4) there are suggestive indications of gene expression changes for genes associated with the control of circadian rhythm in the ApoE-/- LDLr-/- double knockout (DK) mice. These various CAPs-related effects on cardiac function and the development of histological evidence of increased risk of clinically significant disease at the end of exposures in animal models of atherosclerosis provide biological plausibility for the premature mortality associated with PM2.5 exposure in human subjects and provide suggestive evidence for neurogenic disease as well.

  10. The Health Effects of Motorization

    OpenAIRE

    Christopher Millett; Sutapa Agrawal; Ruth Sullivan; Mario Vaz; Anura Kurpad; A V Bharathi; Dorairaj Prabhakaran; Kolli Srinath Reddy; Sanjay Kinra; George Davey Smith; Shah Ebrahim

    2013-01-01

    Editors' Summary Background Noncommunicable diseases (NCDs) and obesity (excessive body fat) are major threats to global health. Every year, more than 36 million people (including 29 million in LMICs) die from NCDs—nearly two-thirds of the world's annual deaths. Cardiovascular diseases (conditions that affect the heart and the circulation), diabetes, cancer, and respiratory diseases are responsible for most NCD-related deaths. Obesity is a risk factor for all these NCDs and the global prevale...

  11. Can clinical use of Social Media improve quality of care in mental Health? A Health Technology Assessment approach in an Italian mental health service.

    Science.gov (United States)

    Di Napoli, Wilma Angela; Nollo, Giandomenico; Pace, Nicola; Torri, Emanuele

    2015-09-01

    Clinical use of modern Information and Communication Technologies such as Social Media (SM) can easily reach and empower groups of population at risk or affected by chronic diseases, and promote improvement of quality of care. In the paper we present an assessment of SM (i.e. e-mails, websites, on line social networks, apps) in the management of mental disorders, carried out in the Mental Health Service of Trento (Italy) according to Health Technology Assessment criteria. A systematic review of literature was performed to evaluate technical features, safety and effectiveness of SM. To understand usage rate and attitude towards new social technologies of patients and professionals, we performed a context analysis by a survey conducted over a group of 88 psychiatric patients and a group of 35 professionals. At last, we made recommendations for decision makers in order to promote SM for the management of mental disorders in a context of prioritization of investments in health care. PMID:26417743

  12. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  13. Towards the regulation of aerosol emissions by their potential health impact: Assessing adverse effects of aerosols from wood combustion and ship diesel engine emissions by combining comprehensive data on the chemical composition and their toxicological effects on human lung cells

    Science.gov (United States)

    Zimmermann, R.; Streibel, T.; Dittmar, G.; Kanashova, T.; Buters, J.; Öder, S.; Paur, H. R.; Dilger, M.; Weiss, C.; Harndorf, H.; Stengel, B.; Hirvonen, M. R.; Jokiniemi, J.; Hiller, K.; Sapcariu, S.; Sippula, O.; Orasche, J.; Müller, L.; Rheda, A.; Passig, J.; Radischat, C.; Czech, H.; Tiita, P.; Jalava, P.; Kasurinen, S.; Schwemer, T.; Yli-Prilä, P.; Tissari, J.; Lamberg, H.; Schnelle-Kreis, J.

    2014-12-01

    Ship engine emissions are important regarding lung and cardiovascular diseases in coastal regions worldwide. Bio mass burning is made responsible for adverse health effects in many cities and rural regions. The Virtual Helmholtz Institute-HICE (www.hice-vi.eu) addresses chemical & physical properties and health effects of anthropogenic combustion emissions. Typical lung cell responses to combustion aerosols include inflammation and apoptosis, but a molecular link with the specific chemical composition in particular of ship emissions has not been established. Through an air-liquid interface exposure system (ALI), we exposed human lung cells at-site to exhaust fumes from a ship engine running on common heavy fuel oil (HFO) and cleaner-burning diesel fuel (DF) as well as to emissions of wood combustion compliances. A special field deployable ALI-exposition system and a mobile S2-biological laboratory were developed for this study. Human alveolar basal epithelial cells (A549 etc.) are ALI-exposed to fresh, diluted (1:40-1:100) combustion aerosols and subsequently were toxicologically and molecular-biologically characterized. Advanced chemical analyses of the exhaust aerosols were combined with transcriptional, proteomic and metabolomic profiling to characterise the cellular responses. The HFO ship emissions contained high concentrations of toxic compounds (transition metals, organic toxicants) and particle masses. The cellular responses included inflammation and oxidative stress. Surprisingly, the DF ship emissions, which predominantly contain rather "pure" carbonaceous soot and much less known toxicants, induced significantly broader biological effects, affecting essential cellular pathways (e.g., mitochondrial function and intracellular transport). Therefore the use of distillate fuels for shipping (this is the current emission reduction strategy of the IMO) appears insufficient for diminishing health effects. The study suggests rather reducing the particle emissions

  14. 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

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

    OpenAIRE

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    Climate change may affect human health via interactions with air pollutants such as ozone and PM2.5. 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 PM2.5. 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 PM2.5 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 analysis

  17. Mycotoxins and their effect on human health

    Directory of Open Access Journals (Sweden)

    Resanović Radmila D.

    2013-01-01

    Full Text Available Health risks associated with the consumption of products contaminated with mycotoxins are worldwide recognized and depend on the extent to which they are consumed in diversified diet. To some extent, the presence of small amount of mycotoxins in cereals and related food products is unavoidable; this requires risk assessments which are to be carried out by regulatory bodies in several countries to help establish regulatory guidelines for the protection of public health. By assessing the levels at which these substances in food may pose a potential risk to human health, it is possible to devise appropriate risk management strategies. However, several important factors have to be taken into account in making a rational risk management decision, such as adequate toxicological data and information concerning the extent of exposure, availability of technically sound analytical procedures (including sampling, socioeconomic factors, food intake patterns and levels of mycotoxins in food commodities which may vary considerably between countries.

  18. Health effects of energy development

    International Nuclear Information System (INIS)

    Our accumulated technology has added roughly 50 years to the average life span of a human being in North America. Most of this increase in life span has occurred within the last 100 years. Cheap and safe supplies of energy are required for the industrial prosperity that has made this possible. The best estimates available all indicate that nuclear power and natural gas are the safest forms of contemporary energy production. The largest potential radiation hazard to which we are currently exposed appears to derive from our houses; increased attention by public health authorities to the control of this particular hazard may be warranted. (Auth)

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Short-run Effects of Job Loss on Health Conditions, Health Insurance, and Health Care Utilization

    OpenAIRE

    Jessamyn Schaller; Ann Huff Stevens

    2014-01-01

    Job loss in the United States is associated with long-term reductions in income and long-term increases in mortality rates. This paper examines the short- to medium-term changes in health, health care access, and health care utilization after job loss that lead to these long-term effects. Using a sample with more than 9800 individual job losses and longitudinal data on a wide variety of health-related measures and outcomes, we show that job loss results in worse self-reported health, includin...

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

    Science.gov (United States)

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

    2003-01-01

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

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

    Science.gov (United States)

    Northridge, Mary E; Sclar, Elliott

    2003-01-01

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

  3. Refugee children: mental health and effective interventions.

    Science.gov (United States)

    Pacione, Laura; Measham, Toby; Rousseau, Cécile

    2013-02-01

    The mental health consequences of war and other forms of organized violence for children represent a serious global public health issue. Much of the research on the mental health of war-affected civilians has focused on refugees who have sought asylum in high-income countries and face the dual stress of a traumatic past and resettlement. This review will focus on the mental health of refugee children who have fled war as well as interventions to both prevent and treat adverse mental health outcomes. While war can have devastating mental health consequences, children raised in the midst of armed conflict also display resilience. Effective interventions for refugee children will be discussed both in terms of prevention and treatment of psychopathology, with a focus on recent developments in the field. PMID:23307563

  4. Effects of Smoking on Your Health

    Science.gov (United States)

    ... and Nicotine Smoked Tobacco Products Smokeless Tobacco Products Electronic Cigarettes New FDA Regulations HEALTH EFFECTS Nicotine Addiction ... Bronchus Esophagus Oral Cavity Lip Nasopharynx Nasal Cavity Larynx Stomach Bladder Pancreas Kidney Liver Uterine Cervix Colon ...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  6. 78 FR 15023 - Office of Health Assessment and Translation Webinar on the Assessment of Data Quality in Animal...

    Science.gov (United States)

    2013-03-08

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

  7. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Patel Vikram

    2010-10-01

    Full Text Available Abstract Background The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health around the world. Findings To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1 interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2 interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3 interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders. A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms for the following mobile electronic devices (MEDs and a range of compatible media: mobile phone; personal digital assistant (PDA; handheld computer (e.g. tablet PC; PDA phone (e.g. BlackBerry, Palm Pilot; Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player; handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will

  8. 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.

  9. [Vegetarian diets; effect on health].

    Science.gov (United States)

    de Luis Román, D; Aller, R; Castaño, O

    2007-03-01

    Vegetarian diets are those diets mainly based on the consumption of vegetable product, but that also permit consumption of eggs and milk. The American Dietetic Association made a declaration on these vegetarian diets in which they stated that vegetarian diet is healthy, nutritionally adequate and provides health benefits in the prevention and treatment of certain diseases>. Some studies have shown beneficial results in obesity, cancer, Parkinson disease, hypertension, type 2 diabetes mellitus and urinary stones, compared with the omnivorous. The possible theoretical benefits in some diseases has been seen in the medical practice (diabetes mellitus, obesity, cardiovascular risk). However more studies are needed in the case of Parkinson's disease and rheumatoid arthritis. PMID:17397638

  10. Health effects of vegan diets.

    Science.gov (United States)

    Craig, Winston J

    2009-05-01

    Recently, vegetarian diets have experienced an increase in popularity. A vegetarian diet is associated with many health benefits because of its higher content of fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemicals and a fat content that is more unsaturated. Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegan include vitamins B-12 and D, calcium, and long-chain n-3 (omega-3) fatty acids. Unless vegans regularly consume foods that are fortified with these nutrients, appropriate supplements should be consumed. In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals. PMID:19279075

  11. Health effects of vegan diets.

    Science.gov (United States)

    Craig, Winston J

    2009-05-01

    Recently, vegetarian diets have experienced an increase in popularity. A vegetarian diet is associated with many health benefits because of its higher content of fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemicals and a fat content that is more unsaturated. Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegan include vitamins B-12 and D, calcium, and long-chain n-3 (omega-3) fatty acids. Unless vegans regularly consume foods that are fortified with these nutrients, appropriate supplements should be consumed. In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals.

  12. 78 FR 12764 - Draft Office of Health Assessment and Translation Approach for Systematic Review and Evidence...

    Science.gov (United States)

    2013-02-25

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

  13. 某大型电子企业健康促进综合干预策略及效果评估%Intervention strategy and its assessment of effect on health promotion in a large electronic enterprise

    Institute of Scientific and Technical Information of China (English)

    张巧耘; 王建锋; 张恒东; 白莹; 许忠杰; 赵圆; 朱宝立

    2012-01-01

    status, physical exercise, body-weight control were 69.1% , 60. 3% , 59.9% , 59.1% respectively; over 62.5% of the employees reported that the health promotion measures have positive impact on spirit outlook, work status, job satisfaction, lifestyle improvement, health status advancing. Meanwhile, the awareness rates of "Occupational Disease Prevention Law" , of occupational preventive measures, and of chronic disease prevention information all rose to 74.21% , 93.00% and 53.52% from 51.70% , 33. 20% and 38.44% respectively; the attendance rate rose to 80. 32% from 78. 12% , two-week visiting rale decrease to 5. 76% . From 7.58% , the physical examination rate rise to 97% from 92% , and in 45 overall assessment indices, 39 completely qualified, 5 items were basically qualified, only one did not meet the requirement. Conclusion The results showed that developing workplace health promotion activities, can all-round enhance the management level of enterprise on occupational health, improve employees' health literacy, advance their health status, which also clearly suggests that this kind of comprehensive intervention measure is effective.

  14. Particulate Matter and Health Risk under a Changing Climate: Assessment for Portugal

    Directory of Open Access Journals (Sweden)

    Daniela Dias

    2012-01-01

    Full Text Available The potential impacts of climate-induced changes in air pollution levels and its impacts on population health were investigated. The IPCC scenario (SRES A2 was used to analyse the effects of climate on future PM10 concentrations over Portugal and their impact on short-term population exposure and mortality. The air quality modelling system has been applied with high spatial resolution looking on climate changes at regional scale. To quantify health impacts related to air pollution changes, the WHO methodology for health impact assessment was implemented. The results point to 8% increase of premature mortality attributed to future PM10 levels in Portugal. The pollution episodes with daily average PM10 concentration above the current legislated value (50 μg·m−3 would be responsible for 81% of attributable cases. The absolute number of deaths attributable to PM10 under future climate emphasizes the importance of indirect effects of climate change on human health.

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

    Science.gov (United States)

    Wemelsfelder, F; Mullan, S

    2014-04-01

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

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

    Science.gov (United States)

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

    2001-01-01

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

  17. Proceedings of the Hydrogen Sulfide Health Research and Risk Assessment Symposium October 31-November 2, 2000.

    Science.gov (United States)

    Woodall, George M; Smith, Roy L; Granville, Geoff C

    2005-10-01

    The Hydrogen Sulfide Health Research and Risk Assessment Symposium came about for several reasons: (1) increased interest by the U.S. Environmental Protection Agency (EPA) and several state agencies in regulating hydrogen sulfide (H2S); (2) uncertainty about ambient exposure to H2S; (3) confusion and disagreement in the literature about possible health effects at low-level exposures; and (4) presentation of results of a series of recent animal bioassays. The American Petroleum Institute (API) proposed this symposium and the EPA became an early co-sponsor, with the Chemical Industry Institute of Toxicology (CIIT) and the American Forest & Paper Association (AF&PA) contributing expertise and funding assistance. The topics covered in this symposium included Animal Research, Human Research, Mode-of-Action and Dosimetry Issues, Environmental Exposure and Monitoring, Assessment and Regulatory Issues, and closed with a panel discussion. The overall goals of the symposium were to: gather together experts in H2S health effects research and individuals from governmental agencies charged with protecting the public health, provide a venue for reporting of recent research findings, identify gaps in the current information, and outline new research directions and promote research collaboration. During the course of the symposium, presenters provided comprehensive reviews of the state of knowledge for each topic. Several new research proposals discussed at the symposium have subsequently been initiated. This report provides a summary of the talks, poster presentations, and panel discussions that occurred at the Hydrogen Sulfide Health and Risk Assessment Symposium. PMID:16033755

  18. Environmental Impacts of the U.S. Health Care System and Effects on Public Health

    Science.gov (United States)

    Eckelman, Matthew J.; Sherman, Jodi

    2016-01-01

    The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation’s pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003–2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1–2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000–98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety. PMID:27280706

  19. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Science.gov (United States)

    Eckelman, Matthew J; Sherman, Jodi

    2016-01-01

    The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety. PMID:27280706

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

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Assessment of Knowledge, Attitudes and Competencies of Health Professionals Attended an International Training Programme in Public Health

    Directory of Open Access Journals (Sweden)

    Despena Andrioti

    2013-01-01

    Full Text Available Background: Continuing education is a fundamental aspect of health personnel professional life. These enable health professionals improve patient-centred care, stay current and provide quality services.Objectives: To assess knowledge, attitudes and competencies from the interprofessional training programme in public health held in cooperation with WHO/EURO.Methods: A structured questioner for self-ratings on perceived seminar usefulness and implementation was placed on the internet followed by email notification to the 300 participants. We have received 128 completed questionnaires (42.5%.Programme effects were tested by categorical analysis using Pearson chi-Square or Fisher's exact test. Logistic regression was used to reveal correlation between implementation of competencies according to discipline and type of employer. All tests were considered to be significant at a 5% level. Analysis was carried out using SPSS 20.0. Findings: 85.9% (p = 0.021 <0.05 of the participants applied the knowledge they acquired in the seminar. The application of the competencies in public health services differed according to position (p<0.05. Supervisors achieved higher scores (81.4% in the administration and management than the officers (48.5%. Health professionals felt that their performance has been improved and consequently the quality of the services (75%. Conclusion: The international programme gave them confidence that the acquired knowledge and skills were equal to those of their European colleagues and that they are able to deal with public health issues and to provide the respective services.

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

    Directory of Open Access Journals (Sweden)

    Omalu ICJ

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Scotch Matthew

    2006-09-01

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

  5. Social class, marginality and self-assessed health: a cross-sectional analysis of the health gradient in Mexico

    Directory of Open Access Journals (Sweden)

    Valle Adolfo

    2009-02-01

    Full Text Available Abstract Background Examining the association between social inequality and health is not new. However, there is little empirical evidence of this association in the Latin American literature, much less from the Mexican scholars. Its research, including the one conducted in Mexico, has mostly followed a theoretical approach and has not been able to provide strong empirical evidence of their important theoretical and conceptual contributions, mainly because reliable, complete and valid data are unavailable. Methods To empirically examine the gradient effect of social class on self-rated health in Mexico, a secondary cross-sectional mixed-level analysis was designed. Using individual level data from the Second National Health Survey (ENSA II, social class categories were specified following a stratification approach according to the occupation and education indicators available from ENSA II. Two types of categories were made, one for t urban and one for the rural labor force. Two indicators of perceived health status were used as health outcomes: self-assessed health and reported morbidity. Furthermore, the marginality index, an indicator of relative deprivation was used to examine its contextual effect at the state and regional level. The analysis was conducted using logistic multivariate models. Results The cross-sectional analysis showed a gradient effect of social class for good assessed-health. Relative to the low urban class, the odds ratio (OR for a good perception of health for individuals belonging to the high urban class was 2.9 (95% confidence interval: 2.1–3.9. The OR for the middle high class was 2.8 (95% confidence interval: 2.4–3.4, while the OR for the middle low class was 1.8 (95% confidence interval: 1.6–2.1. However, for the rural labour force an OR of 1.5 was only significant between the high class who considered their health as good relative to the low class (95% confidence interval: 1.02–2.2. At the aggregate level

  6. Social class, marginality and self-assessed health: a cross-sectional analysis of the health gradient in Mexico

    Science.gov (United States)

    Valle, Adolfo Martinez

    2009-01-01

    Background Examining the association between social inequality and health is not new. However, there is little empirical evidence of this association in the Latin American literature, much less from the Mexican scholars. Its research, including the one conducted in Mexico, has mostly followed a theoretical approach and has not been able to provide strong empirical evidence of their important theoretical and conceptual contributions, mainly because reliable, complete and valid data are unavailable. Methods To empirically examine the gradient effect of social class on self-rated health in Mexico, a secondary cross-sectional mixed-level analysis was designed. Using individual level data from the Second National Health Survey (ENSA II), social class categories were specified following a stratification approach according to the occupation and education indicators available from ENSA II. Two types of categories were made, one for t urban and one for the rural labor force. Two indicators of perceived health status were used as health outcomes: self-assessed health and reported morbidity. Furthermore, the marginality index, an indicator of relative deprivation was used to examine its contextual effect at the state and regional level. The analysis was conducted using logistic multivariate models. Results The cross-sectional analysis showed a gradient effect of social class for good assessed-health. Relative to the low urban class, the odds ratio (OR) for a good perception of health for individuals belonging to the high urban class was 2.9 (95% confidence interval: 2.1–3.9). The OR for the middle high class was 2.8 (95% confidence interval: 2.4–3.4), while the OR for the middle low class was 1.8 (95% confidence interval: 1.6–2.1). However, for the rural labour force an OR of 1.5 was only significant between the high class who considered their health as good relative to the low class (95% confidence interval: 1.02–2.2). At the aggregate level, the results also showed

  7. Timing effects in health valuations.

    Science.gov (United States)

    Leiter, Andrea M; Pruckner, Gerald J

    2014-06-01

    This paper analyzes the impact of external sources of information, conveyed by the frequency of risky events that vary across time, on the individual willingness to pay (WTP) for a reduction of mortality risk. We collected data from a contingent valuation (CV) exercise conducted in two waves (fall and winter) to examine whether individual WTP varied across periods that differed in the predominance of fatal accidents. Risk valuations were based on fatal snow avalanche accidents, that is, a type of risk with seasonal differences in occurrence. We found slightly lower but statistically significant mean WTP figures in the winter than in the fall sample because of time-varying individual risk attitudes and, therefore, recommend controlling for these factors in risk assessment CV surveys.

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

    Science.gov (United States)

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

    2006-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Jonathan Heller

    2014-10-01

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

  10. Evaluación del impacto de la Reforma Mexicana de salud 2001-2006: un informe inicial Assessing the effect of the 2001-06 Mexican health reform: an interim report card

    Directory of Open Access Journals (Sweden)

    Emmanuela Gakidou

    2007-01-01

    deciles de ingresos; los gastos catastróficos para los afiliados al Seguro Popular son más bajos que los de los no asegurados, a pesar de que se haya incrementado su utilización en México. Este trabajo presenta algunas lecciones para México con base en esta evaluación provisional, así como algunas implicaciones potenciales para otros países que consideran desarrollar reformas en materia de salud.Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform. A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over seven years to uninsured people, nearly half the total population at the start of 2001. The reform included five actions: legislation of entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% of gross domestic product; creation of explicit benefits packages; allocation of monies to decentralised state ministries of health in proportion to number of families affiliated; division of federal resources flowing to states into separate funds for personal and non-personal health services; and creation of a fund to protect families against catastrophic health expenditures. Using the WHO health-systems framework, a wide range of datasets to assess the effect of this reform on different dimensions of the health system was used. Key findings include: affiliation is preferentially reaching the poor and the marginalised communities; federal non-social security expenditure in real per-head terms increased by 38% from 2000 to 2005; equity of public-health expenditure across states improved; Seguro Popular affiliates used more inpatient and outpatient services than uninsured people; effective coverage of 11 interventions has improved between 2000 and 2005-06; inequalities in effective coverage across states and wealth deciles has decreased over this period; catastrophic expenditures for Seguro Popular affiliates are lower than

  11. Health and environmental effects document for batteries: 1980

    Energy Technology Data Exchange (ETDEWEB)

    1980-11-01

    An evaluation is presented of the ecological and health effects of the near-term electric storage batteries (lead/acid, nickel/zinc, and nickel/iron) as related to electric and hybrid vehicle applications. The storage battery technology is considered in its totality, and emissions are estimated for the complete cycle. For estimating quantities of various emissions, the market penetration is assumed to be 3 x 10/sup 6/ Pb/acid battery-powered vehicles and 8 x 10/sup 6/ each of the Ni/Zn and Ni/Fe battery-powered vehicles on the road by the year 2000. Ecological effects are assessed using the Estimated Permissible Concentration (EPC) approach. Pb, S, Cu, Ni, Cd, Zn, and Sb appear to be the most hazardous emission constituents and exceed EPC values for protection of ecology in one or more of the battery-related industries. More definitive, quantitative estimates of damage to the biota and to the ecosystem are not feasible because of paucity of relevant information. Health effects as a result of increased levels of lead, arsenic, and cadmium in the environment and risks of exposure to arsine, stibine, and antimony trioxide released during charging are assessed. Health effects among the occupationally exposed are also assessed using the toxicological models. Acute and chronic effects of exposure to stibine, arsine, and antimony trioxide are described.

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Yueze Liu; Jianwen Cao; Zuxun Lu

    2004-01-01

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

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

    Science.gov (United States)

    Pliakos, Ioannis; Kefaliakos, Antonios; Diomidous, Marianna

    2016-01-01

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

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

    Science.gov (United States)

    Pliakos, Ioannis; Kefaliakos, Antonios; Diomidous, Marianna

    2016-01-01

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

  16. Assessment of mental health in adults of the northern part of the city of Kosovska Mitrovica

    Directory of Open Access Journals (Sweden)

    Mirković Momčilo

    2012-01-01

    Full Text Available Background/Aim. Mental health disorders lead to disorder of effective functioning of people and deterioration of quality of life. Early detection of individuals at risk of mental health disorders is extremely important from the aspect of mental health disorders prevention. The aim of the research was to determine the frequency of mental health problems among adult residents of northern Kosovska Mitrovica and to examine the association between frequency of mental health problems and socio-demographic and other characteristics of the population obtained by the questionnaire. Methods. The cross-sectional study on the representative sample of adult residents of northern Kosovska Mitrovica was performed in October 2009. To obtain information about the characteristics of mental health the Goldberg’s General Health Questionnaire (GHQ-28 was used. For performing survey at site the method of rapid epidemiological assessment was chosen. Statistical analysis included the methods of descriptive statistics, multivariate regression analysis and calculation of the Cronbach’s alpha coefficient of internal consistency of the questionnaire. Results. Mental health problems (total score were present in almost half of the respondents (49.2%. Psychosomatic problems were present in more than half of the respondents (55.4%, while anxiety and insomnia were present in almost half of the respondents (49.2%. Social dysfunction had more than three fifths of the respondents (63.1% and depression more than a quarter of the respondents (28.5%. More positive responses in the questionnaire were statistically significantly associated with older age, poor financial situation, abuse and assessing of the current political-security situation as high risk. The value of Cronbach’s alpha coefficient was 0.705. Conclusions. Almost half of the respondents (49.2% of North Kosovska Mitrovica had mental health problems. Mental health problems were associated with older age, poor

  17. Assessing Community Health Risks: Proactive Vs Reactive Sampling

    Directory of Open Access Journals (Sweden)

    Sarah Taylor

    2009-01-01

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

  18. Health effects of coal technologies: research needs

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    In this 1977 Environmental Message, President Carter directed the establishment of a joint program to identify the health and environmental problems associated with advanced energy technologies and to review the adequacy of present research programs. In response to the President's directive, representatives of three agencies formed the Federal Interagency Committee on the Health and Environmental Effects of Energy Technologies. This report was prepared by the Health Effects Working Group on Coal Technologies for the Committee. In this report, the major health-related problems associated with conventional coal mining, storage, transportation, and combustion, and with chemical coal cleaning, in situ gasification, fluidized bed combustion, magnetohydrodynamic combustion, cocombustion of coal-oil mixtures, and cocombustion of coal with municipal solid waste are identified. The report also contains recommended research required to address the identified problems.

  19. Children, adolescents, and the media: health effects.

    Science.gov (United States)

    Strasburger, Victor C; Jordan, Amy B; Donnerstein, Ed

    2012-06-01

    The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media. PMID:22643165

  20. Children, adolescents, and the media: health effects.

    Science.gov (United States)

    Strasburger, Victor C; Jordan, Amy B; Donnerstein, Ed

    2012-06-01

    The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.

  1. Effective Structural Health Monitoring with Additive Manufacturing

    OpenAIRE

    De Baere, Dieter; Strantza, Maria; Hinderdael, Michaël; Devesse, Wim; Guillaume, Patrick

    2014-01-01

    The current remaining challenges for structural health monitoring (SHM) systems prevented the introduction of SHM systems on a large scale within industrial applications. An effective SHM system is required for the reduction of the direct operation costs, improvement of the life-safety and the introduction of additive manufactured components for critical structures. In this paper, a new structural health monitoring methodology will be presented for components that can be processed by additive...

  2. Racism, Other Discriminations and Effects on Health

    OpenAIRE

    Gil González, Diana; Vives Cases, Carmen; Borrell, Carme; Andrés A. Agudelo Suárez; Davó Blanes, María del Carmen; Miralles Bueno, Juan José; Álvarez-Dardet Díaz, Carlos

    2014-01-01

    We study the probability of perceived racism/other forms of discrimination on immigrant and Spanish populations within different public spheres and show their effect on the health of immigrants using a cross-sectional design (ENS-06). Variables: perceived racism/other forms of discrimination (exposure), socio-demographic (explicative), health indicators (dependent). Frequencies, prevalences, and bivariate/multivariate analysis were conducted separately for men (M) and women (W). We estimated ...

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Holtzman, S.; Meinhold, A.F.; Morris, S.C.; Rowe, M.D. [Brookhaven National Lab., Upton, NY (United States); Daniels, J.I.; Layton, D.W.; Anspaugh, L.R. [Lawrence Livermore National Lab., CA (United States)

    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.

  5. Assessment of the Effect of Oral Health Education Program On Improvement of the Oral Health Knowledge and Behavior%口腔健康教育对改善医学专科院校新生口腔健康知识及行为的效果评价

    Institute of Scientific and Technical Information of China (English)

    倪成励; 周孟平; 柴梅

    2014-01-01

    Objective:To assess the effect of three kinds of oral health education programs on the improvement of the fresh-men′s oral health awareness,oral health behaviors and oral health in the medical college. Methods:1 022 medical college fresh-men with caries and periodontal disease from different specialties in physical examination were randomly divided into 4 groups and received the same content of oral health education,but with different teaching methods. The first group was given the oral lecture (lecture group). The second group watched education video(video group). The third group studied the relevant content by them-selves(self - learning group). The fourth group was taken as the normal control group. Questionnaires were given to all the freshmen from the four groups before the performance of health education program and two months after it to observe the changes in their health knowledge awareness and health behaviors and to assess the comparison of dental plaque index. Results:Com-pared with that before the performance of health education,there was significant improvement in health knowledge awareness and health behaviours of the most freshmen(P ﹤ 0. 05);plaque index in the lecture group and the video group significantly descen-ded compared with that before the intervention(P ﹤ 0. 05);there was no change in self - learning group and and the control group(P ﹥ 0. 05). Compared with that in the video and the lecture group,the improvement was most significant in the lecture group(P ﹤ 0. 05),with the most freshmen willing to take the lecture as their way of having oral health education. Conclusion:Oral health education can produce a positive effect on the improvement of freshmen′s oral health condition ,oral health awareness and oral health behaviors in medical college.%目的:评价3种口腔健康教育形式对改善医学专科院校新生口腔健康意识、行为及口腔卫生的效果。方法:选取医学专科院校新生1022

  6. Assessing Skills and Capacity for Informatics: Activities Most Commonly Performed by or for Local Health Departments

    Science.gov (United States)

    McKeown, Lisa; Shah, Gulzar H.

    2016-01-01

    Objective: To describe the informatics activities performed by and for local health departments. Design: Analysis of data from the 2015 Informatics Capacity and Needs Assessment Survey of local health departments conducted by the Jiann-Ping Hsu College of Public Health at Georgia Southern University in collaboration with the National Association of County & City Health Officials. Participants: 324 local health departments. Main Outcome Measure(s): Informatics activities performed at or for local health departments in use and analysis of data, system design, and routine use of information systems. Results: A majority of local health departments extract data from information systems (69.5%) and use and interpret quantitative (66.4%) and qualitative (55.1%) data. Almost half use geographic information systems (45.0%) or statistical or other analytical software (39.7%). Local health departments were less likely to perform project management (35.8%), business process analysis and redesign (24.0%), and developing requirements for informatics system development (19.7%). Local health departments were most likely to maintain or modify content of a Web site (72.1%). A third of local health departments (35.8%) reported acting as “super users” for their information systems. A significantly higher proportion of local health departments serving larger jurisdictions (500 000+) and those with shared governance reported conducting informatics activities. Conclusion: Most local health department informatics activities are completed by local health department staff within each department or a central department, but many state health departments also contribute to informatics at the local level. Larger local health departments and those with shared governance were more likely to perform informatics activities. Local health departments need effective leadership, a skilled workforce, strong partnerships, and policies that foster implementation of health information systems to

  7. Effective Classroom Assessment for Children's Learning

    Institute of Scientific and Technical Information of China (English)

    黄志红

    2004-01-01

    Formative assessment is a new concept introduced to the English teachers in China by the National English Curriculum (NEC). Its main feature is to provide quick feedback to promote learning and improve teaching, compared with summative assessment. Mostly, formative assessment is implemented during teaching practice. It should be a part of teaching and learning process. So far as it is concerned, teachers play a very important role. They should be able to decide or select what to be assessed and how to assess in classroom teaching. Thus, the focus of this article is to show them the practical ways to reach the goal, i.e. how to implement formative assessment more effectively.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-04-14

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

  9. Environment, Safety and Health Self-Assessment Report Fiscal Year 2010

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Scott

    2011-03-23

    The Lawrence Berkeley National Laboratory (LBNL) Environment, Safety, and Health (ES&H) Self-Assessment Program was established to ensure that Integrated Safety Management (ISM) is implemented institutionally and by all divisions. The ES&H Self-Assessment Program, managed by the Office of Contractor Assurance (OCA), provides for an internal evaluation of all ES&H programs and systems at LBNL. The primary objective of the program is to ensure that work is conducted safely and with minimal negative impact to workers, the public, and the environment. Self-assessment follows the five core functions and guiding principles of ISM. Self-assessment is the mechanism used to promote the continuous improvement of the Laboratory's ES&H programs. The process is described in the Environment, Safety, and Health Assurance Plan (PUB-5344) and is composed of three types of self-assessments: Division ES&H Self-Assessment, ES&H Technical Assurance Program Assessment, and Division ES&H Peer Review. The Division ES&H Self-Assessment Manual (PUB-3105) provides the framework by which divisions conduct formal ES&H self-assessments to systematically identify program deficiencies. Issue-specific assessments are designed and implemented by the divisions and focus on areas of interest to division management. They may be conducted by teams and involve advance planning to ensure that appropriate resources are available. The ES&H Technical Assurance Program Manual (PUB-913E) provides the framework for systematic reviews of ES&H programs and processes. The ES&H Technical Assurance Program Assessment is designed to evaluate whether ES&H programs and processes are compliant with guiding regulations, are effective, and are properly implemented by LBNL divisions. The Division ES&H Peer Review Manual provides the framework by which division ISM systems are evaluated and improved. Peer Reviews are conducted by teams under the direction of senior division management and focus on higher

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

    Science.gov (United States)

    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.

  11. The importance of health co-benefits in macroeconomic assessments of UK Greenhouse Gas emission reduction strategies

    OpenAIRE

    Jensen, Henning Tarp; Keogh-Brown, Marcus R; Richard D. Smith; Chalabi, Zaid; Dangour, Alan D.; Davies, Mike,; Edwards, Phil; Garnett, Tara; Givoni, Moshe; Griffiths, Ulla; Hamilton, Ian; Jarrett, James; Roberts, Ian; Wilkinson, Paul; Woodcock, James

    2013-01-01

    We employ a single-country dynamically-recursive Computable General Equilibrium model to make health-focussed macroeconomic assessments of three contingent UK Greenhouse Gas (GHG) mitigation strategies, designed to achieve 2030 emission targets as suggested by the UK Committee on Climate Change. In contrast to previous assessment studies, our main focus is on health co-benefits additional to those from reduced local air pollution. We employ a conservative cost-effectiveness methodology with a...

  12. Comparative Health Impact Assessment of Local and Regional Particulate Air Pollutants in Scandinavia

    Energy Technology Data Exchange (ETDEWEB)

    Forsberg, Bertil; Jaervholm, Bengt [Umeaa Univ. (Sweden). Dept. of Public Health and Clinical Medicine; Hansson, Hans-Christen; Johansson, Christer; Areskoug, Hans [Stockholm Univ. (Sweden). Dept. of Applied Environmental Science; Persson, Karin [Swedish Environmental Research Institute, Goeteborg (Sweden)

    2005-02-01

    The ongoing program Clean Air for Europe (CAFE) is an initiative from the EU Commission to establish a coordinated effort to reach better air quality in the EU. The focus is on particulate matter as it has been shown to have large impact on human health. CAFE requested that WHO make a review of the latest findings on air pollutants and health to facilitate assessments of the different air pollutants and their health effects. The WHO review project on health aspects of air pollution in Europe confirmed that exposure to particulate matter (PM), despite the lower levels we face today, still poses a significant risk to human health. Using the recommended uniform risk coefficients for health impact assessment of PM, regardless of sources, premature mortality related to long-range transported anthropogenic particles has been estimated to be about 3,500 deaths per year for the Swedish population, corresponding to a reduction in life expectancy of up to about seven months. The influence of local sources is more difficult to estimate due to large uncertainties when linking available risk coefficients to exposure data, but the estimates indicate about 1,800 deaths brought forward each year with a life expectancy reduction of about 2-3 months. However, some sectors of the population are exposed to quite high locally induced concentrations and are likely to suffer excessive reductions in life expectancy. Since the literature increasingly supports assumptions that combustion related particles are associated with higher relative risks, further studies may shift the focus for abatement strategies. CAFE sets out to establish a general cost effective abatement strategy for atmospheric particles. Our results, based on studies of background exposure, show that long-range transported sulfate rich particles dominate the health effects of PM in Sweden. The same results would be found for the whole of Scandinavia and many countries influenced by transboundary air pollution. However

  13. Environment, Safety and Health Progress Assessment of the Argonne Illinois Site

    International Nuclear Information System (INIS)

    This report documents the results of the US Department of Energy (DOE) Environment, Safety and Health (ES ampersand H) Progress Assessment of the Argonne Illinois Site (AIS), near Chicago, Illinois, conducted from October 25 through November 9, 1993. During the Progress Assessment, activities included a selective review of the ES ampersand H management systems and programs with principal focus on the DOE Office of Energy Research (ER); CH, which includes the Argonne Area Office; the University of Chicago; and the contractor's organization responsible for operation of Argonne National Laboratory (ANL). The ES ampersand H Progress Assessments are part of DOE's continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the AIS ES ampersand H Progress Assessment was to provide the Secretary of Energy, senior DOE managers, and contractor management with concise independent information on the following: change in culture and attitude related to ES ampersand H activities; progress and effectiveness of the ES ampersand H corrective actions resulting from the previous Tiger Team Assessment; adequacy and effectiveness of the ES ampersand H self-assessment process of the DOE line organizations, the site management, and the operating contractor; and effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES ampersand H problems and new ES ampersand H initiatives

  14. Environment, Safety and Health Progress Assessment of the Argonne Illinois Site

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    This report documents the results of the US Department of Energy (DOE) Environment, Safety and Health (ES&H) Progress Assessment of the Argonne Illinois Site (AIS), near Chicago, Illinois, conducted from October 25 through November 9, 1993. During the Progress Assessment, activities included a selective review of the ES&H management systems and programs with principal focus on the DOE Office of Energy Research (ER); CH, which includes the Argonne Area Office; the University of Chicago; and the contractor`s organization responsible for operation of Argonne National Laboratory (ANL). The ES&H Progress Assessments are part of DOE`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. The purpose of the AIS ES&H Progress Assessment was to provide the Secretary of Energy, senior DOE managers, and contractor management with concise independent information on the following: change in culture and attitude related to ES&H activities; progress and effectiveness of the ES&H corrective actions resulting from the previous Tiger Team Assessment; adequacy and effectiveness of the ES&H self-assessment process of the DOE line organizations, the site management, and the operating contractor; and effectiveness of DOE and contractor management structures, resources, and systems to effectively address ES&H problems and new ES&H initiatives.

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

    Science.gov (United States)

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

    2001-01-01

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

  16. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    Source of ionizing radiations have innumerable applications in the work place. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not manifestly harmful. This Module explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit it if forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

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

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

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

  18. Health assessment for Agrico Chemical Company, Pensacola, Florida, Region 4. CERCLIS No. FLD980221857. Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    1990-05-31

    The site of the former Agrico Chemical Company covers an area of approximately 30 acres. Based on the available information, it has been concluded this site is of potential public health concern because of the risk to human health from exposure to hazardous substances at concentrations that may result in adverse health effects. As noted in the Environmental Contamination and Physical Hazards sections, human exposure to arsenic, chromium, fluoride, nitrate, and benzene may occur through contact with contaminated ground water; human exposure to fluoride may occur through contact with sediments and surface water in on-site impoundments. Air and edible plant and animal exposure pathways were not addressed in the information reviewed for this Preliminary Health Assessment.