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. 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.

  3. Human Health Effects, Task Force Assessment, Preliminary Report.

    Science.gov (United States)

    Aronow, Wilbert S.; And Others

    Presented in this preliminary report is one of seven assessments conducted by a special task force of Project Clean Air, the Human Health Effects Task Force. The reports summarize assessments of the state of knowledge on various air pollution problems, particularly in California, and make tentative recommendations as to what the University of…

  4. Editorial: Lead Risk Assessment and Health Effects.

    Science.gov (United States)

    Mielke, Howard W

    2016-06-14

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

  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. 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.

  10. Subgroup analyses of clinical effectiveness to support health technology assessments.

    Science.gov (United States)

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

    2011-01-01

    Subgroup analysis is an integral part of access and reimbursement dossiers, in particular health technology assessment (HTA), and their HTA recommendations are often limited to subpopulations. HTA recommendations for subpopulations are not always clear and without controversies. In this paper, we review several HTA guidelines regarding subgroup analyses. We describe good statistical principles for subgroup analyses of clinical effectiveness to support HTAs and include case examples where HTA recommendations were given to subpopulations only. Unlike regulatory submissions, pharmaceutical statisticians in most companies have had limited involvement in the planning, design and preparation of HTA/payers submissions. We hope to change this by highlighting how pharmaceutical statisticians should contribute to payers' submissions. This includes early engagement in reimbursement strategy discussions to influence the design, analysis and interpretation of phase III randomized clinical trials as well as meta-analyses/network meta-analyses. The focus on this paper is on subgroup analyses relating to clinical effectiveness as we believe this is the first key step of statistical involvement and influence in the preparation of HTA and reimbursement submissions.

  11. 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)

  12. 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)

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

    DEFF Research Database (Denmark)

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

    551,000 wood stoves and 48,000 wood boilers and the particle emission from these sources make up the most dominant source of particle emission in DK. It is estimated that this emission contributes to an annual increased PM2.5 level of 0.6 microgram/m³. From the dose-response relationships used......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...

  14. 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.

  15. 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.

  16. 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.

  17. Assessing potential health effects from municipal sludge incinerators: screening methodology

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

    1987-04-01

    This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

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

    DEFF Research Database (Denmark)

    Nielsen, Elsa

    2007-01-01

    organic hydrocarbons (VOC), and polycyclic aromatic hydrocarbons (PAH). Particulate matter is itself a complex mixture and can be fractionated as inorganic ash material, soot, and condensed organic material. The number of residential wood stoves has increased during the latest years. Due to the size...... smoke emissions in Denmark is currently being assessed for mortality, and for hospital admissions for respiratory and cardio-vascular diseases. The results will be presented in the poster. Copyright © 2007 Published by Elsevier Ireland Ltd....

  19. 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.

  20. 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.

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

    DEFF Research Database (Denmark)

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

    : Tools for the Assessment of Ecosystem Health, 2009-2011), which is part of the Baltic Sea BONUS+ Programme funded jointly by national funding agencies and FP7 ERA-NET+ of the European Commission. The BEAST project consists of three workpackages (WP) with the following main tasks: WP1- Field studies...... and experiments in selected sub-regions of the Baltic Sea, WP2 - Application and validation of methods in monitoring and assessment in the Baltic Sea, and WP3 - Developing tools for ecosystem health assessment in the Baltic Sea. BEAST research activities are focused in the sub-regions of Gulf of Bothnia, Gulf...... of Finland, Gulf of Riga, Gulf of Gdansk and the Belt Sea, most of which are characterised by scarce data on biological effects of hazardous substances. The data acquired will be combined with previous data (e.g. national monitoring activities, case studies, EU BEEP project) to reach the goals of WP2 and WP3...

  2. Assessing the effect of the 2001-06 Mexican health reform: an interim report card.

    Science.gov (United States)

    Gakidou, Emmanuela; Lozano, Rafael; González-Pier, Eduardo; Abbott-Klafter, Jesse; Barofsky, Jeremy T; Bryson-Cahn, Chloe; Feehan, Dennis M; Lee, Diana K; Hernández-Llamas, Hector; Murray, Christopher J L

    2006-11-25

    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 7 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, we used a wide range of datasets to assess the effect of this reform on different dimensions of the health system. 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 for uninsured people even though use of services has increased. We present some lessons for Mexico based on this interim evaluation and explore implications for other countries considering health reforms.

  3. [Assessing the effect of the 2001-06 Mexican health reform: an interim report card].

    Science.gov (United States)

    Gakidou, Emmanuela; Lozano, Rafael; González-Pier, Eduardo; Abbott-Klafter, Jesse; Barofsky, Jeremy T; Bryson-Cahn, Chloe; Feehan, Dennis M; Lee, Diana K; Hernández-Llamas, Héctor; Murray, Christopher J L

    2007-01-01

    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 affilates 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 for uninsured people even though use of services has increased. We present some lessons for Mexico based on this interim evaluation and explore implications for other countries considering health reforms.

  4. Root-cause analysis and health failure mode and effect analysis: two leading techniques in health care quality assessment.

    Science.gov (United States)

    Shaqdan, Khalid; Aran, Shima; Daftari Besheli, Laleh; Abujudeh, Hani

    2014-06-01

    In this review article, the authors provide a detailed series of guidelines for effectively performing root-cause analysis (RCA) and health failure mode and effect analysis (HFMEA). RCA is a retrospective approach used to ascertain the "root cause" of a problem that has already occurred, whereas HFMEA is a prospective risk assessment tool whose aim is to recognize risks to patient safety. RCA and HFMEA are used for the prevention of errors or recurring errors to create a safer workplace, maintain high standards in health care quality, and incorporate time-saving and cost-saving modifications to favorably affect the patient care environment. The principles and techniques provided here should allow reviewers to better understand the features of RCA and HFMEA and how to apply these processes appropriately. These principles include how to organize a team, identify root causes, seed out proximate causes, graphically describe the process, conduct a hazard analysis, and develop and implement potential action plans.

  5. A new air quality perception scale for global assessment of air pollution health effects.

    Science.gov (United States)

    Deguen, Séverine; Ségala, Claire; Pédrono, Gaëlle; Mesbah, Mounir

    2012-12-01

    Despite improvements in air quality in developed countries, air pollution remains a major public health issue. To fully assess the health impact, we must consider that air pollution exposure has both physical and psychological effects; this latter dimension, less documented, is more difficult to measure and subjective indicators constitute an appropriate alternative. In this context, this work presents the methodological development of a new scale to measure the perception of air quality, useful as an exposure or risk appraisal metric in public health contexts. On the basis of the responses from 2,522 subjects in eight French cities, psychometric methods are used to construct the scale from 22 items that assess risk perception (anxiety about health and quality of life) and the extent to which air pollution is a nuisance (sensorial perception and symptoms). The scale is robust, reproducible, and discriminates between subpopulations more susceptible to poor air pollution perception. The individual risk factors of poor air pollution perception are coherent with those findings in the risk perception literature. Perception of air pollution by the general public is a key issue in the development of comprehensive risk assessment studies as well as in air pollution risk management and policy. This study offers a useful new tool to measure such efforts and to help set priorities for air quality improvements in combination with air quality measurements.

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

    Science.gov (United States)

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

    2017-04-12

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

  7. Health Effects

    Science.gov (United States)

    ... CDC Policy Partners Climate Effects on Health Air Pollution Allergens Wildfires Temperature Extremes Precipitation Extremes Diseases Carried by Vectors Food and Waterborne Diarrheal Disease Food Security Mental Health and Stress-Related Disorders Climate-Ready States and ...

  8. Assessment of the aerosols distribution in the Bucharest metropolitan area in relation with health effects

    Science.gov (United States)

    Zoran, M. A.; Dida, M. R.

    2013-06-01

    MODIS Terra/Aqua time-series satellite images and in- situ monitoring of particle matter PM2.5 and PM10 have been used in an effort to qualitatively assess distribution of aerosols in the greater Bucharest area during 2010-2011 period. It was found that PM2.5 and PM10 aerosols exhibit their highest concentration mostly in the central part mainly due to road traffic as well as in the industrialized parts outside of city's centre. An epidemiological study examining the relationships between adverse health outcomes and exposure to air pollutants in metropolitan agglomeration of Bucharest used ambient air pollution measurements like as PM10 and PM2.5 levels as a proxy for personal exposure levels. The measurements of environmental concentrations of particulate matter air pollutants have been correlated with health effects on respiratory health status of school children in urban/periurban areas of Bucharest.

  9. 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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Nutritional effects from the ‘use stage’ of food items life cycle can have a substantial effect on human health; yet, they are often not considered in life cycle assessment (LCA). In our study we explore the case of increased fruit and vegetable consumption, a healthy dietary option – that could ...... for nutritional foods such as fruits and vegetables. This approach could be used for making recommendations about sustainable diets and food choices....... of disease that are based on epidemiological studies. Results and discussion: Adding one serving of fruits or vegetables to the current average diet in Europe may lead to substantial nutritional health benefits. These nutritional benefits are slightly increased when we consider substitution scenarios...

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

    Science.gov (United States)

    Wedemeyer, Gary A.; Yasutake, William T.

    1977-01-01

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

  12. 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

  13. 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)

  14. 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.

  15. Noncarcinogenic effects of chromium: Update to health-assessment document. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Victery, W.; Lee, S.D.; Mushak, P.; Piscator, M.

    1990-04-01

    The document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these oxidation states and amounts at submicrogram ambient air levels, the degree of human exposure to chromium in the environment, both short-term and long-term, in vivo reduction of Cr (VI) to Cr (III), and effects from environmentally relevant levels on pulmonary function and renal function. Trivalent chromium is chemically stable; Cr (VI) is readily reduced to Cr (III). Oxidation state of chromium in ambient air depends on proximity to sources emitting one form over the other. Reliable monitoring methods to speciate oxidation states at ambient air levels below 1 microgram/cu m are not available. Ambient levels of total chromium (obtained from EPA's National Air Data Branch) range from a high of 0.6 microgram/cu m to below the detection limit of 0.005 microgram/cu m. Reduction of hexavalent chromium in vivo occurs in several organ systems and therefore, small amounts of inhaled Cr (VI) will be reduced before systemic absorption can occur. Trivalent chromium is an essential trace metal which potentiates actions of insulin-mediated glucose transport.

  16. 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.

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

    DEFF Research Database (Denmark)

    McKone, T.E.; Fantke, Peter

    2016-01-01

    Fine particulate matter (PM2.5) pollution has been estimated to contribute more than 7% to the total global human disease burden from 1990 to 2013 (http://healthdata.org/gbd). Ambient (outdoor) and household indoor PM2.5 exposures are reported to account for 41% and 58% of this impact, respectively....... Model and parameters are tested in a case study on the production and rocessing of rice in three distinct scenarios covering urban China, rural India and U.S.-Europe. Recommendations are to use this coupled, generic framework whenever emission locations are unknown and to apply spatial models henever...... emission locations are known. Our study constitutes a first step towards providing guidance on how to include health effects from PM2.5 indoor air exposures in product-oriented impact assessments....

  18. 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.

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

    Science.gov (United States)

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

    2017-02-10

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Harris-Roxas, Ben, E-mail: ben@harrisroxashealth.com; Harris, Elizabeth, E-mail: e.harris@unsw.edu.au

    2013-09-15

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

  1. 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.

  2. 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.

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

    OpenAIRE

    Chiu, Weihsueh A.; Slob, Wout

    2015-01-01

    Background When chemical health hazards have been identified, probabilistic dose–response assessment (“hazard characterization”) quantifies uncertainty and/or variability in toxicity as a function of human exposure. Existing probabilistic approaches differ for different types of endpoints or modes-of-action, lacking a unifying framework. Objectives We developed a unified framework for probabilistic dose–response assessment. Methods We established a framework based on four principles: a) indiv...

  4. 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.

  5. 40 CFR 79.62 - Subchronic toxicity study with specific health effect assessments.

    Science.gov (United States)

    2010-07-01

    ... will provide screening information on target organ toxicities and on concentration levels useful for... through concentration range-finding trials prior to starting this study. This health effects screening... (if present); esophagus; stomach; duodenum; jejunum; ileum; cecum; colon; rectum; urinary...

  6. 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...

  7. 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.

  8. 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).

  9. 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

  10. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

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

  11. 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.

  12. 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).

  13. 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.

  14. 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.

  15. 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.

  16. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kathryn Lane

    2013-01-01

    Full Text Available 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.

  19. What is Health Impact Assessment?

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2010-12-01

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

  20. Health Economic Assessment: A Methodological Primer

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2009-11-01

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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Colkesen

    2011-02-01

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

  7. 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.

  8. 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.

  9. 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.

  10. Health effects for the population living near a cement plant: an epidemiological assessment.

    Science.gov (United States)

    Bertoldi, Martina; Borgini, Alessandro; Tittarelli, Andrea; Fattore, Elena; Cau, Alessandro; Fanelli, Roberto; Crosignani, Paolo

    2012-05-01

    Epidemiological studies have shown the association between the exposure to air pollution and several adverse health effects. To evaluate the possible acute health effects of air pollution due to the emissions of a cement plant in two small municipalities in Italy (Mazzano and Rezzato), a case-control study design was used. The risks of hospital admission for cardiovascular or respiratory diseases for increasing levels of exposure to cement plant emissions were estimated, separately for adults (age>34 years) and children (0-14 years). Odds ratios (OR) were estimated using unconditional regression models. Attributable risks were also calculated. Statistically significant risks were found mainly for respiratory diseases among children: OR 1.67 (95% CI 1.08-2.58) for the moderately exposed category (E1), OR 1.88 (95% CI 1.19-2.97) for the highly exposed category (E2), with an attributable risk of 38% of hospital admissions due to the exposure to cement plant exhausts. Adults had a weaker risk: OR 1.38 (95% CI 1.18-1.61) for group E1, OR 1.31 (95% CI 1.10-1.56) for group E2; the attributable risk was 23%. Risks were higher for females and for the age group 35-64. These results showed an association between the exposure to plant emissions and the risk of hospital admission for cardiovascular or respiratory causes; this association was particularly strong for children.

  11. 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.

  12. 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...

  13. Assessment of the effects of supplementation with vitamin E on health and production of feedlot cattle using meta-analysis.

    Science.gov (United States)

    Cusack, Paul; McMeniman, Neil; Rabiee, Ahmad; Lean, Ian

    2009-04-01

    Delivery of supplemental antioxidant vitamins to cattle placed in feedlots might be expected to improve health and performance outcomes by reducing the effects of oxidative stress to which these cattle are presumably exposed. Meta-analytic procedures were used in this study to assess published experiments on the effects of vitamin E supplementation in feedlot cattle. The health outcome of morbidity, and the production outcomes of average daily gain (ADG) and gain to feed ratio (G:F), were analysed. The currently available data do not support the use of supplemental vitamin E administered as an injection (morbidity risk ratio=1.17; P=0.17). The authors conclude that supplemental dietary vitamin E should be fed within the [NRC, 1996. National Research Council. Nutrient Requirements of Beef Cattle, 7th ed. Natl. Acad. Press, Washington, DC] recommended range.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    PURPOSE: The purpose of the study is to compare different approaches to the identification of confounders needed for analyzing observational data. Whereas standard analysis usually is conducted as if the confounders were known a priori, selection uncertainty also must be taken into account. METHODS......: Confounders were selected by using backward elimination (BE), change in estimate (CIE) method, Akaike information criterion, Bayesian information criterion (BIC), and an empirical approach using a priori information. A modified ridge regression estimator, which shrinks effects of confounders toward zero, also...... was considered. For each criterion, uncertainty in the estimated exposure effect was assessed by using bootstrap simulations for which confounders were selected in each sample. These methods were illustrated by using data for mercury neurotoxicity in Faroe Islands children. Point estimates and standard errors...

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Henny Rydberg

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

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

    Science.gov (United States)

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

    2014-01-01

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

  18. 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.

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

    Science.gov (United States)

    Sharma, S.K.; Puri, Rajesh; Jain, Ajay; Sharma, M.P.; Sharma, Anita; Bohra, Shravan; Gupta, Y.K.; Saraya, Anoop; Dwivedi, S.; Gupta, K.C.; Prasad, Mahadeo; Pandey, Janardhan; Dohroo, Netar Prakash; Tandon, Neeraj; Sesikeran, B.; Dorle, A.K.; Tandon, Nikhil; Handa, S.S.; Toteja, G.S.; Rao, Spriha; Satyanarayana, K.; Katoch, V.M.

    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 Research (ICMR), Ministry of Health & Family Welfare, Government of India in October 2010. The committee looked into the issues related to safety of consumption of bottle gourd juice, and this paper presents the findings. Methods: Information on cases of suspected toxicity due to consumption of bottle gourd juice was collected by internet search, advertising on website of ICMR and by writing to State and district health authorities as well as to medical colleges, hospitals and private nursing homes across the country. Results: Three deaths were reported, one from Delhi and two from Uttar Pradesh after consumption of extremely bitter bottle gourd juice. Three persons who died after consumption of freshly prepared bottle gourd juice or juice mixed with bitter gourd (karela) juice were over 59 years of age and had diabetes since last 20 years. This juice was reported to be extremely bitter by all three. Twenty six persons were admitted to various hospitals of the country on complaint of abdominal pain and vomiting following consumption of freshly prepared bottle gourd juice. Diarrhoea and vomiting of blood (haematemesis) was reported in 18 (69.2%) and 19 (73.1%) patients, respectively. Biochemical investigations revealed elevated levels of liver enzymes. More than 50 per cent patients had hypotension. Endoscopic findings showed profusely bleeding stomach with excessive ulceration seen in distal oesophagus, stomach and duodenum in most of the cases. All these patients recovered

  20. Lean systems approaches to health technology assessment: a patient-focused alternative to cost-effectiveness analysis.

    Science.gov (United States)

    Bridges, John F P

    2006-12-01

    Many countries now use health technology assessment (HTA) to review new and emerging technologies, especially with regard to reimbursement, pricing and/or clinical guidelines. One of the common, but not universal, features of these systems is the use of economic evaluation, normally cost-effectiveness analysis (CEA), to confirm that new technologies offer value for money. Many have criticised these systems as primarily being concerned with cost containment, rather than advancing the interests of patients or innovators. This paper calls into question the underlying principles of CEA by arguing that value in the healthcare system may in fact be unconstrained. It is suggested that 'lean management principles' can be used not only to trim waste from the health system, but as a method of creating real incentives for innovation and value creation. Following the lean paradigm, this value must be defined purely from the patients' perspective, and the entire health system needs to work towards the creation of such value. This paper offers as a practical example a lean approach to HTA, arguing that such an approach would lead to better incentives for innovation in health, as well as more patient-friendly outcomes in the long run.

  1. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-01-01

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

  3. 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...

  4. 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.

  5. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    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......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...... standardised scientific methods to characterise the probability and magnitude of harm caused by a hazard, preferably in a quantitative manner. In turn, HIA is a process to assess future impacts of recent proposals and is dominated by qualitative evaluation. It makes a projection for a future scenario rather...

  6. 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

  7. 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.

  8. Lessons from San Francisco: health impact assessments have advanced political conditions for improving population health.

    Science.gov (United States)

    Bhatia, Rajiv; Corburn, Jason

    2011-12-01

    Health impact assessment is a structured decision support tool used to systematically characterize the anticipated health effects, both adverse and beneficial, of societal decisions. In San Francisco, the use of health impact assessments has not only produced evidence to inform health policy decision making but has also contributed to the political conditions needed to achieve optimal population health. Health impact assessments have helped increase public awareness of the determinants of health, routine monitoring of these determinants, cooperation among institutions, health-protective laws and regulations, and organizational networks for health advocacy and accountability. Drawing on more than a decade of local experience, we identify the direct and indirect effects of the assessments on the politics of governance as well as on health. We demonstrate that health impact assessment is both an analytic tool and a process that helps build the social institutions that can improve health.

  9. Screening methodology for assessing potential health effects from municipal sludge incinerators

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.

    1987-01-01

    This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

  10. Screening methodology for assessing potential health effects from municipal sludge incinerators

    Energy Technology Data Exchange (ETDEWEB)

    Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

    1987-04-01

    This paper describes a risk assessment of methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e. facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium. (Refs. 5).

  11. 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

  12. 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

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

    DEFF Research Database (Denmark)

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

    Exposure to fine particulate matter (PM2.5) pollution is a major contributor to human disease burden as continuously shown in the Global Burden of Disease study series. Exposures to PM2.5 concentration outdoors and indoors contribute almost equally to this burden. Despite the importance, health...... balance matrix that tracks the global fate of primary PM2.5 and secondary PM2.5 precursor emissions (both indoors and outdoors) as an embedded system of compartments including urban environments, rural environments, and indoor environments within urban and rural areas. After presenting the model structure...

  14. [Preliminary assessment of the effect of disinfectants on skin changes in health service workers].

    Science.gov (United States)

    Kieć-Swierczyńska, M

    1995-01-01

    During a five-year period (1 Jan. 1989 and 31 Oct. 1994) epidermal tests with disinfectants (formalin, sterinol, lysoformin, aldesan, septyl, chloramine, lysol, chlorhexidine) and their components (glutaraldehyd, phenol, hydroquinone) were performed on 322 health service workers examined at the Nofer Institute of Occupational Medicine due to suspected occupational dermatitis. It was found that 89 (27.6%) subjects examined were oversensitive, at least, to one disinfectant, mostly to formalin, sterinol (benzalkonium bromide), lysoformin and chloramine. Frequent occurrence of allergy to metals (nickel, cobalt, chromium, mercury) was observed in persons oversensitive to disinfectants.

  15. 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.

  16. 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

  17. The development of health technology assessment.

    Science.gov (United States)

    Banta, David

    2003-02-01

    The field of health technology assessment (HTA) is still relatively new, but it has shown remarkable growth over the last decade, having spread first from the United States to Europe, and now to the entire world. HTA seeks to couple evidence with decision-making, and thus has similarities to evidence-based health care and evidence-based policy-making. The early history of HTA, beginning around 1975, reveals a first period of synthesising available evidence-principally that dealing with efficacy and cost-effectiveness of health care interventions-so as to put it in a format helpful to health policy-makers, especially those in national governments. From 1985 or so, the focus of the second period was on seeking more effective links with these policy-makers, particularly in Europe. The most recent period, beginning in the late 1990s, has been increasingly devoted to more effective dissemination and implementation in order to influence administrators and clinicians. While early assessments tended to focus on large, expensive, machine-based technologies, the scope has gradually widened to include smaller technologies, 'softer' technologies (such as counselling), and health care needs. Actual assessments have also taken on broader issues, such as organisational, social, and ethical implications. In the Member States of the European Union (EU), HTA activities are increasingly visible, and almost all now have a national focus for HTA associated with the Ministry of Health or its equivalent. Central and Eastern European countries are also developing HTA activities. Most recently, HTA has been highlighted by health policy documents from the European Commission. It seems likely that HTA will in the future be institutionalised in some form as part of EU activities.

  18. 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

  19. 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...

  20. Health technology assessment and thyroid surgery.

    Science.gov (United States)

    Lucchini, R; Sanguinetti, A; Monacelli, M; Triola, R; Avenia, S; Conti, C; Santoprete, S; Avenia, N

    2013-01-01

    The growth of technological innovation, the request for assistance, the rising patient's expectations and the interest of the industry have led to a rise in the cost of health care systems. In this context the role of the National Health System is not to delay the development or adoption of new technologies, but rather to drive the development selecting priorities and promoting its use. Health Technology Assessment (HTA) is a multidisciplinary and multidimensional approach for analyzing the medical-clinical, social, organizational, economic, ethical and legal implications of a technology (devices, drugs, procedures) through the assessment of multiple parameters such as effectiveness, safety, costs of the social and organizational impact. A health technology assessment is a comprehensive, systematic evaluation of the prerequisites for estimating the consequences of using health technology. Main characteristic of HTA is that the problem is tackled using an approach focused on four main elements: - technology; - patient; - organization; - economy. The authors have applied the HTA method for the analysis of the ultrasonic focus dissector on thyroid surgery. They compared the cost of the surgical procedure using the ultrasonic dissector and without it in a case study of 440 patients who underwent thyroidectomy.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    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 for examining effects of coverage on health measures may not be suitable for effects on mortality. Thus, estimates may be misleading when these different outcomes are jointly modeled. We also present new survival analyses that suggest Medicare coverage significantly attenuated the rising risk of death for previously uninsured adults. PMID:20337735

  3. 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

    or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could......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...

  4. Assessing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Cuff, Patricia A.

    2014-01-01

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

  5. A critical assessment of shrinkage-based regression approaches for estimating the adverse health effects of multiple air pollutants

    Science.gov (United States)

    Roberts, Steven; Martin, Michael

    Most investigations of the adverse health effects of multiple air pollutants analyse the time series involved by simultaneously entering the multiple pollutants into a Poisson log-linear model. Concerns have been raised about this type of analysis, and it has been stated that new methodology or models should be developed for investigating the adverse health effects of multiple air pollutants. In this paper, we introduce the use of the lasso for this purpose and compare its statistical properties to those of ridge regression and the Poisson log-linear model. Ridge regression has been used in time series analyses on the adverse health effects of multiple air pollutants but its properties for this purpose have not been investigated. A series of simulation studies was used to compare the performance of the lasso, ridge regression, and the Poisson log-linear model. In these simulations, realistic mortality time series were generated with known air pollution mortality effects permitting the performance of the three models to be compared. Both the lasso and ridge regression produced more accurate estimates of the adverse health effects of the multiple air pollutants than those produced using the Poisson log-linear model. This increase in accuracy came at the expense of increased bias. Ridge regression produced more accurate estimates than the lasso, but the lasso produced more interpretable models. The lasso and ridge regression offer a flexible way of obtaining more accurate estimation of pollutant effects than that provided by the standard Poisson log-linear model.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Brit S. Schneider

    2012-01-01

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

  12. Assessing the Effect of Highly Cited Papers on the Impact Factor of Journals in the Field of Public Health

    Directory of Open Access Journals (Sweden)

    E Rezaei

    2012-12-01

    Full Text Available Background: The aim of this study was to appraisal the effect of highly cited papers in the field of public health and find out whether the unusual citations affect the ranking order of the journals in this field or not. A total number of 142 journals titles were listed in Journal Citation Report (ISI Thomson in the field of "Public, Environmental & Occupational Health". All but one of them had published papers at least for a year from 2009 to 2010. Journal title, number of citations and publication year of 45685 papers were collected from ISI web of knowledge database at December 25, 2011. About half of the papers (23226 had no citations and 89.4% (40835 had less than 6 citations. We concluded that the ranking of journals in the field of public health is not affected by the individual papers with unusual number of citations.

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

    Directory of Open Access Journals (Sweden)

    Changzheng Yuan

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

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

    Science.gov (United States)

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

    2014-01-15

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

  15. [Assessing forest ecosystem health I. Model, method, and index system].

    Science.gov (United States)

    Chen, Gao; Dai, Limin; Ji, Lanzhu; Deng, Hongbing; Hao, Zhanqing; Wang, Qingli

    2004-10-01

    Ecosystem health assessment is one of the main researches and urgent tasks of ecosystem science in 21st century. An operational definition on ecosystem health and an all-sided, simple, easy operational and standard index system, which are the foundation of assessment on ecosystem health, are necessary in obtaining a simple and applicable assessment theory and method of ecosystem health. Taking the Korean pine and broadleaved mixed forest ecosystem as an example, an originally creative idea on ecosystem health was put forward in this paper based on the idea of mode ecosystem set and the idea of forest ecosystem health, together with its assessment. This creative idea can help understand what ecosystem health is. Finally, a formula was deduced based on a new effective health assessment method--health distance (HD), which is the first time to be brought forward in China. At the same time, aiming at it's characteristics by status understanding and material health questions, a health index system of Korean pine and broadleaved mixed forest ecosystem was put forward in this paper, which is a compound ecosystem based on the compound properties of nature, economy and society. It is concrete enough to measure sub-index, so it is the foundation to assess ecosystem health of Korean pine and broadleaved mixed forest in next researches.

  16. Exploration Health Risks: Probabilistic Risk Assessment

    Science.gov (United States)

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

    2006-01-01

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

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

    DEFF Research Database (Denmark)

    Larsen, Klaus; Merlo, Juan

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zallaghi

    2014-10-01

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

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

    OpenAIRE

    Dawkins, LE; Soar, K; Papaioannou, G.

    2016-01-01

    Background: Intentional consumption of alcohol based hand gels has been reported especially amongst non-UK national, alcohol dependent, homeless individuals in London. Whilst alcohol misuse is known to be associated with impaired cognitive functioning and mental health problems, the effects of additional ingestion of alcohol gel are unknown. Objectives: To explore cognitive and psychological functioning in users who intentionally ingest alcohol gel compared with ethyl-alcohol only misusers an...

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

    Science.gov (United States)

    2016-09-01

    Health Effects Report to Congressional Committees September 2016 GAO-16-781 United States Government Accountability Office...United States Government Accountability Office Highlights of GAO-16-781, a report to congressional committees September 2016 WASTE MANAGEMENT...on the results of its review in March 2016. Section 313 also includes a provision for GAO to assess DOD’s report and its compliance with

  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.

    Science.gov (United States)

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

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation.

  2. 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.

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

    Science.gov (United States)

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

    2016-12-16

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

  4. 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.

  5. The Assessment of Diet Quality and Its Effects on Health Outcomes Pre-pregnancy and during Pregnancy.

    Science.gov (United States)

    Martin, Julie C; Zhou, Shao J; Flynn, Angela C; Malek, Lenka; Greco, Rebecca; Moran, Lisa

    2016-03-01

    Overweight and obesity pre pregnancy or during pregnancy is associated with an increased risk for maternal obstetric and fetal complications. Diet is one modifiable risk factor that women may be motivated to improve. General healthy eating guidelines, micronutrient sufficiency and macronutrient quantity and quality are important nutrition considerations pre and during pregnancy. With regards to specific nutrients, health authorities have recommendations for folate and/or iodine supplementation; but not consistently for iron and omega-3 despite evidence for their association with health outcomes. There are modest additional requirements for energy and protein, but not fat or carbohydrate, in mid-late pregnancy. Diet indices and dietary pattern analysis are additional tools or methodologies used to assess diet quality. These tools have been used to determine dietary intakes and patterns and their association with pregnancy complications and birth outcomes pre or during pregnancy. Women who may unnecessarily resist foods due to fear of food contamination from listeriosis and methylmercury may limit their diet quality and a balanced approached is required. Dietary intake may also vary according to certain population characteristics. Additional support for women who are younger, less educated, overweight and obese, from socially disadvantaged areas, smokers and those who unnecessarily avoid healthy foods, is required to achieve a higher quality diet and optimal lifestyle peri conception.

  6. Assessment factors for human health risk assessment: A discussion paper

    NARCIS (Netherlands)

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

    1999-01-01

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

  7. Mobile technology for mental health assessment.

    Science.gov (United States)

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

    2016-06-01

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

  8. 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.

  9. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine

    OpenAIRE

    Steuten, Lotte M.G.

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved “upstream” so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bri...

  10. 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.

  11. 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.

  12. [Assessing the effect of health belief, knowledge, and social support on compliance behaviors in chronic hemodialysis patients].

    Science.gov (United States)

    Lin, C C; Ko, N Y; Tsai, L C; Chen, C H

    1995-08-01

    The purposes of this study were to investigate the effects of hemodialysis patients' health belief, knowledge on uremia, and social support upon their compliance behavior. The convenience sample of 330 hemodialysis (HD) patients was obtained at HD centers in southern Taiwan. With the use of a questionnaire developed by the researcher, all subjects were interviewed during hemodialysis. Data analyses were processed by a personal computer with SPSS/PC. Pearson correlation, ANOVA, chi-square, multiple regression and factor analysis were selected as the analysis methods for this study. The results indicated: (1) The average overall rate of compliance was 72.1% by patient self report for fluid limit, diet restriction and taking PBM. (2) Two factors of subject's health belief were identified by factor analysis. (3) Those who had more positive motivation for compliance with therapeutic regiments, more knowledge on uremia and stronger social support were positively correlated with compliance behaviors. (4) The best predictive variables of compliance behaviors of HD patients included positive motivation, knowledge on uremia, educational level, current daily urine amount and age; these five variables explained 23% of variance in compliance behaviors. (5) The instruments with a satisfactory validity and reliability developed by the researcher could provide a valuable basis for relevant future research. Implications of these findings for nursing practice are also discussed.

  13. 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.

  14. 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.

  15. [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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. Nutrition and health technology assessment: when two worlds meet

    OpenAIRE

    Poley, Marten J.

    2015-01-01

    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 a...

  1. Mental health assessment of rape offenders.

    Science.gov (United States)

    Sarkar, Jaydip

    2013-07-01

    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 health issues are implicated, what mental health professionals can do to contribute to crime management, and why this is ethically right and proper.

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

    Science.gov (United States)

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

  3. Evaluate, assess, treat: development and evaluation of the EAT framework to increase effective communication regarding sensitive oral-systemic health issues.

    Science.gov (United States)

    DeBate, R D; Cragun, D; Gallentine, A A; Severson, H H; Shaw, T; Cantwell, C; Christiansen, S; Koerber, A; Hendricson, W; Tomar, S L; McCormack Brown, K; Tedesco, L A

    2012-11-01

    Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst 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 behaviours, patient approach and communication, patient-specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B-MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group-randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre- and post-intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre- to post-intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills-based knowledge, and self-efficacy (all P oral/systemic health issues. Because the EAT Framework was developed by translating B-MI principles and procedures, the framework can be easily adopted as a non-confrontational method for patient communication.

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

    Directory of Open Access Journals (Sweden)

    Livia Turco

    2007-09-01

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

  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. 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......-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...

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

    Science.gov (United States)

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

    2011-02-01

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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Currie Leanne M

    2011-08-01

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

  10. Health actions prompted by health assessments for people with intellectual disability exceed actions recorded in general practitioners' records.

    Science.gov (United States)

    Byrne, Jacqueline H; Ware, Robert S; Lennox, Nicholas G

    2015-01-01

    People with intellectual disability experience inadequate health care and have unmet health needs that can go unidentified or be poorly managed. Health assessments have been shown to significantly increase short-term clinical activity for people with intellectual disability. The aim of this study was to more accurately quantify the effect of health assessments for people with intellectual disability by comparing health actions recorded in health assessment booklets to actions recorded in general practitioners' (GPs) records in the 12-month period following the health assessment. Participants were people with intellectual disability who had received a Comprehensive Health Assessment Program (CHAP), living in the community. The CHAP is a health assessment that is demonstrated to significantly increase health actions, compared with usual care, for people with intellectual disability. Data collected from three randomised controlled trials conducted in South-East Queensland, Australia, from 2000 to 2010 were pooled and analysed. The health assessment booklet contained significantly more information on health actions than GPs' records. Notably, hearing tests (risk ratio (RR) = 5.9; 95% confidence interval (CI) = 4.7-7.4), breast checks (RR = 3.9; 95% CI = 2.7-5.7), and skin examinations (RR = 7.9; 95% CI = 5.9-10.7) were more likely to be recorded in the CHAP booklet. Health assessments increase health actions for people with intellectual disability to a significantly greater extent than previously demonstrated.

  11. 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

    Purpose Fine particulate matter (PM2.5) is considered to be one of the most important environmental factors contributing to the global human disease burden. However, due to the lack of broad consensus and harmonization in the life cycle assessment (LCA) community, there is no clear guidance on how...

  12. Assessment of Public Health Infrastructure to Determine Public Health Preparedness

    Science.gov (United States)

    2006-03-01

    62 Confirmed Positive 39 92 42 Residences Abated 40 92 43 Rabies and Zoonosis Control 2 Animal Bite Investigation3 1,280 … … Pets...Shops Inspected 9 9 100 Notes: 1 LHER: Local Health Evaluation Report 2 Zoonosis : Diseases transmitted from animals to humans 3 Number of...5,984 5,984 Childhood Lead Poisoning Risk assessments 2 466 932 Residences abated 8 40 320 Rabies and Zoonosis Control 2 Animal

  13. Health Technology Assessment: a field still maturing!

    Directory of Open Access Journals (Sweden)

    Renaldo N. Battista

    2005-06-01

    Full Text Available

    With this issue’s focus on Health Technology Assessment (HTA, the Italian Journal of Public Health has tackled an area of growing importance in today’s increasingly complex health care delivery systems.

    As the articles in this issue demonstrate, HTA has grown from a relatively narrow technical focus to a form of policy research underway in dozens of countries. Since its inception just over three decades ago,HTA has evolved through three distinct phases: the machine, the disease and the delivery mode, with the third of these still underway.

    As the focus has shifted from machines to disease conditions to service delivery approaches, HTA has drawn on research and modes of discourse from a growing variety of disciplines. Thus, despite the evolution that continues, HTA remains, at its core, both multidisciplinary and pragmatic, for the strengths of HTA arise from its integration of the efforts of actors in multiple, diverse disciplines with a view to producing knowledge that will assist decision-makers. The machine phase was marked by a focus on the technical performance of health technologies, often embodying innovative approaches to diagnosis or treatment of human illness.

    Given the newness and costliness of many technologies selected for assessment, a significant emphasis was placed on assessing the safety of these devices. Imaging technologies were the subject of assessment in many settings, perhaps in part because devices such as the CT scanner produced remarkable visual results that were heralded as affording breakthroughs in diagnosis and treatment. One need only look through the programs of early HTA conferences to see the emphasis on high cost, infrastructure-intensive health technologies that was the hallmark of the machine period.

  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. 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...

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

    Science.gov (United States)

    Lysdahl, Kristin Bakke; Hofmann, Bjørn

    2016-01-01

    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.

  17. Assessment of the impact of fibrates and diet on survival and their cost-effectiveness: evidence from randomized, controlled trials in coronary heart disease and health economic evaluations.

    Science.gov (United States)

    Montagne, O; Vedel, I; Durand-Zaleski, I

    1999-11-01

    The fibrates are one of several classes of lipid-reducing agents commonly prescribed to reduce hypercholesterolemia and prevent coronary heart disease. In today's evidence-based, cost-conscious health care environment, interventions promoted by policymakers must provide clear clinical benefits and economic value. We assessed the evidence regarding the impact of fibrates and diet on survival and the cost-effectiveness of these interventions. A literature search was conducted for randomized, controlled trials of diet, fibrates, and heart disease that were published after 1971; both primary and secondary prevention clinical trials were reviewed, and recent literature reviews and meta-analyses were searched. The evidence that diet alone improves survival is poor, although specifically increasing intake of polyunsaturated fatty acid (including n-3 fatty acids) relative to saturated fatty acid intake may provide some clinical benefit in the secondary prevention of coronary heart disease. The cost-effectiveness of dietary intervention is also questionable because compliance is extremely poor. There is no consistent evidence from primary or secondary prevention trials that fibrates improve survival; in fact, fibrates may increase the risk of death from noncoronary causes. No consistent data suggest that fibrates are a cost-effective therapy. Because diet and fibrates do not appear to improve survival or provide value, policymakers should promote the use of alternative drug interventions that have consistently been proved to reduce mortality and are cost-effective.

  18. A dynamic human health risk assessment system.

    Science.gov (United States)

    Prasad, Umesh; Singh, Gurmit; Pant, A B

    2012-05-01

    An online human health risk assessment system (OHHRAS) has been designed and developed in the form of a prototype database-driven system and made available for the population of India through a website - www.healthriskindia.in. OHHRAS provide the three utilities, that is, health survey, health status, and bio-calculators. The first utility health survey is functional on the basis of database being developed dynamically and gives the desired output to the user on the basis of input criteria entered into the system; the second utility health status is providing the output on the basis of dynamic questionnaire and ticked (selected) answers and generates the health status reports based on multiple matches set as per advise of medical experts and the third utility bio-calculators are very useful for the scientists/researchers as online statistical analysis tool that gives more accuracy and save the time of user. The whole system and database-driven website has been designed and developed by using the software (mainly are PHP, My-SQL, Deamweaver, C++ etc.) and made available publically through a database-driven website (www.healthriskindia.in), which are very useful for researchers, academia, students, and general masses of all sectors.

  19. 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.

  20. 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

  1. 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.

  2. 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. PMID:26167479

  3. Health impact assessment of transport policies in Rotterdam

    DEFF Research Database (Denmark)

    Tobollik, Myriam; Keuken, Menno; Sabel, Clive E;

    2016-01-01

    BACKGROUND: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. METHOD: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle......: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well...

  4. Assessing Proposals for New Global Health Treaties: An Analytic Framework.

    Science.gov (United States)

    Hoffman, Steven J; Røttingen, John-Arne; Frenk, Julio

    2015-08-01

    We have presented an analytic framework and 4 criteria for assessing when global health treaties have reasonable prospects of yielding net positive effects. First, there must be a significant transnational dimension to the problem being addressed. Second, the goals should justify the coercive nature of treaties. Third, proposed global health treaties should have a reasonable chance of achieving benefits. Fourth, treaties should be the best commitment mechanism among the many competing alternatives. Applying this analytic framework to 9 recent calls for new global health treaties revealed that none fully meet the 4 criteria. Efforts aiming to better use or revise existing international instruments may be more productive than is advocating new treaties.

  5. 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.

  6. 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.

  7. Gap Junctional Intercellular Communication: A Functional Biomarker to Assess Adverse Effects of Toxicants and Toxins, and Health Benefits of Natural Products.

    Science.gov (United States)

    Upham, Brad L; Sovadinová, Iva; Babica, Pavel

    2016-12-25

    This protocol describes a scalpel loading-fluorescent dye transfer (SL-DT) technique that measures intercellular communication through gap junction channels, which is a major intercellular process by which tissue homeostasis is maintained. Interruption of gap junctional intercellular communication (GJIC) by toxicants, toxins, drugs, etc. has been linked to numerous adverse health effects. Many genetic-based human diseases have been linked to mutations in gap junction genes. The SL-DT technique is a simple functional assay for the simultaneous assessment of GJIC in a large population of cells. The assay involves pre-loading cells with a fluorescent dye by briefly perturbing the cell membrane with a scalpel blade through a population of cells. The fluorescent dye is then allowed to traverse through gap junction channels to neighboring cells for a designated time. The assay is then terminated by the addition of formalin to the cells. The spread of the fluorescent dye through a population of cells is assessed with an epifluorescence microscope and the images are analyzed with any number of morphometric software packages that are available, including free software packages found on the public domain. This assay has also been adapted for in vivo studies using tissue slices from various organs from treated animals. Overall, the SL-DT assay can serve a broad range of in vitro pharmacological and toxicological needs, and can be potentially adapted for high throughput set-up systems with automated fluorescence microscopy imaging and analysis to elucidate more samples in a shorter time.

  8. 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).

  9. Bringing in health technology assessment and cost-effectiveness considerations at an early stage of drug development.

    Science.gov (United States)

    Jönsson, Bengt

    2015-05-01

    This paper reviews the issues involved in undertaking HTA studies early in the development of new cancer therapies, and discusses the data and methods for estimating the cost-effectiveness of new diagnostics and treatments. The value for patients of new cancer therapies is based on access to the treatment and optimal use. Realising potential value depends on successful completion of a series of steps, from the initial economic evaluations based on clinical trial data, to the reimbursement decisions based on the evaluations and the implementation of these decisions in clinical practice. Considerable resources have been devoted to the study of the cost-effectiveness of new cancer drugs as a basis for decisions about payment and use. Such resources could be used much more effectively if industry and HTA agencies were to collaborate at an early stage in the development process. The traditional clinical trial approach of using progression-free survival and cross-overs has serious shortcomings, producing data that cannot be used to determine outcomes and, so, cost-effectiveness. A new standard is needed; both regulatory and HTA authorities should be involved in its development.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Proposal for a state health technology assessment program.

    Science.gov (United States)

    Colmenares, Phil

    2012-08-01

    Evidence suggests that a significant number of medical technologies are of little or no benefit to patients. Under current budgetary pressures, state health care programs cannot afford continued spending on unnecessary medical care without further cuts in enrollment. Limiting coverage of high-tech care only to indications supported by good clinical evidence would help save state health care dollars. However, there is currently no public process to formally evaluate new medical interventions in Wisconsin. In fact, new therapies often are introduced into clinical practice, and covered by state health insurance programs, even when there is weak or questionable evidence of clinical effectiveness. This article proposes the creation of a state Health Technology Assessment program in Wisconsin to systematically evaluate new tests or treatments, and to promote evidence-based coverage decisions. Such a program would help limit wasteful spending on unnecessary technologies, reinforce good clinical practice, and protect patients from the risks of interventions that have not been proven effective.

  17. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p clinical competence, while done in the mind of the student, can be practiced, learned and assessed.

  18. 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.

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

    Science.gov (United States)

    Titilayo, Odetola D; Okanlawon, F A

    2014-09-01

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

  20. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine.

    Science.gov (United States)

    Steuten, Lotte M G

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved "upstream" so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bridges between oral health and systems medicine since what happens in oral health affects systems pathophysiology, and vice versa. This article offers a synthesis of the latest trends and approaches in early phase HTA, with a view to near future applications in oral health, systems medicine, and biomarker-guided precision medicine. In brief, this review underscores that demonstrating health outcomes of biomarkers and next-generation diagnostics is particularly challenging because they do not always influence long-term outcomes directly, but rather impact subsequent care processes. Biomarker testing costs are typically less of a barrier to uptake in practice than the biomarker's impact on longer term health outcomes. As a single biomarker or next-generation diagnostic in oral health can inform decisions about numerous downstream diagnosis-treatment combinations, early stage "upstream" HTA is crucial in prioritizing the most valuable diagnostic applications to pursue first. For the vast array of oral health biomarkers currently developed, early HTA is necessary to timely and iteratively assess their comparative effectiveness and anticipate the inevitable questions about value for money from regulators and payers.

  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. 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...

  3. Developing public sociology through health impact assessment.

    Science.gov (United States)

    Elliott, Eva; Williams, Gareth

    2008-11-01

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

  4. Particulate matter in urban areas: health-based economic assessment.

    Science.gov (United States)

    El-Fadel, M; Massoud, M

    2000-08-10

    The interest in the association between human health and air pollution has grown substantially in recent years. Based on epidemiological studies in several countries, there is conclusive evidence of a link between particulate air pollution and adverse health effects. Considering that particulate matter may be the most serious pollutant in urban areas and that pollution-related illness results in financial and non-financial welfare losses, the main objective of this study is to assess the economic benefits of reducing particulate air pollution in Lebanese urban areas. Accordingly, the extent and value of health benefits due to decreasing levels of particulate in the air are predicted. Health impacts are expressed in both physical and monetary terms for saved statistical lives, and productivity due to different types of morbidity endpoints. Finally, the study concludes with a range of policy options available to mitigate particulate air pollution in urban areas.

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

  6. Assessment of time management attitudes among health managers.

    Science.gov (United States)

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

    2005-01-01

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

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

    OpenAIRE

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

    2016-01-01

    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 m...

  8. 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.

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Hosseinpoor

    2016-10-01

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

  12. The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications

    Directory of Open Access Journals (Sweden)

    Fries James F

    2003-06-01

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

  13. 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

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

    Science.gov (United States)

    Friedrich, Meik; Müller-Riemenschneider, Falk; Roll, Stephanie; Kulp, Werner; Vauth, Christoph; Greiner, Wolfgang; Willich, Stefan; von der Schulenburg, Johann-Matthias

    2008-01-01

    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

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

    OpenAIRE

    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 influenc...

  16. Conceptualising the effectiveness of impact assessment processes

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

  17. Health impact assessment of soil pollution

    Directory of Open Access Journals (Sweden)

    Koldo Cambra Contín

    2003-12-01

    Full Text Available The soil reflects every activity taking place on it, such as polluting industrial activities and waste disposal. Contaminated soils also may be the source of pollution of air (volatilization and suspension of particles, of surface and groundwater (leaching and running-off, and of vegetables grown there ( root and leaf absorption. The likelihood and extent of human exposure to soil contaminants depends on its accessibility to populations and, consequently, it can be altered dramatically when land use is changed at urban renewals.During the 90s health risk assessment was broadly used to evaluate the risk of contaminated soils and to set up maximum acceptable levels of pollutants in soil.

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

    Science.gov (United States)

    Yang, Bong-min

    2012-05-01

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

  19. 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

  20. 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.

  1. Assessment of exposure to hand-arm vibration and its related health effects in workers employed in stone cutting workshops of Hamadan city

    Directory of Open Access Journals (Sweden)

    Roya Bayat

    2016-06-01

    Full Text Available Introduction: The workers employed in stone cutting workplace are exposed to hand-arm vibration and its complications. The aim of this study was to evaluate the exposure to hand-arm vibration and its health effects on workers in the stone cutting workshops. Methods: In this descriptive-analytic study, 40 workers of Hamadan city stone cutting who worked with stone cutting machines were examined. Measuring exposure to hand-arm vibration was performed by standard methods ISO 5349. Symptoms related hand-arm vibration syndrome using a questionnaire construction was studied. Data were analyzed using SPSS software. Results: Results showed that 8-hour equivalent acceleration of hand-arm vibration exposure in stonecuttingworkers was exceeds the permissible exposure levels of country (Pv<0.05. Most average hand and arm vibration acceleration was measured in the Z axis. The average vibration acceleration hand-arm and cutting transverse and longitudinal cutting significant difference was observed (Pv<0.05. Conclusion: In regard to exposure level of stone cutting workers compared with the national exposure limit, the training of health care, non-smoking, and use of anti-vibration gloves, work rotations canthe effective in reducing the risk of health effects. Furthermore, it seems essential to track the health effects associated with human vibration by use of screening tests in the work place seem.

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

    Energy Technology Data Exchange (ETDEWEB)

    Oudinet, Jean-Paul [Centre de Biogeographie - Ecologie FRE 2545 CNRS, Maison de la recherche, Universite Paris - Sorbonne, Paris IV, 28 rue Serpente, 75006 Paris (France)]. E-mail: biogeo@paris4.sorbonne.fr; Meline, Julie [Centre de Biogeographie - Ecologie FRE 2545 CNRS, Maison de la recherche, Universite Paris - Sorbonne, Paris IV, 28 rue Serpente, 75006 Paris (France); Chelmicki, Wojciech [Institute of Geography and Spatial Management, Jagiellonian University, ul. Gronostajowa 7, 30-387 Cracow (Poland); Sanak, Marek [Molecular Biology Laboratory, Department of Internal Medicine, Jagiellonian University, ul. Skawinska 8, 31066 Cracow (Poland); Magdalena, Dutsch-Wicherek [Otolaryngology and Head and Neck Department, Jagiellonian University, ul. Sniadeckich 2, 31501 Cracow (Poland); Besancenot, Jean-Pierre [Climat et sante, Centre universitaire d' epidemiologie de population, Faculte de Medecine, BP 87900, 21079 Dijon Cedex (France); Wicherek, Stanislas [Centre de Biogeographie - Ecologie FRE 2545 CNRS, Maison de la recherche, Universite Paris - Sorbonne, Paris IV, 28 rue Serpente, 75006 Paris (France); Julien-Laferriere, Bertrand [Centre de Biogeographie - Ecologie FRE 2545 CNRS, Maison de la recherche, Universite Paris - Sorbonne, Paris IV, 28 rue Serpente, 75006 Paris (France); Gilg, Jean-Paul [Laboratoire Teleanalyse, Espace et Societe, Centre d' Analyse et de Mathematique Sociales, UMR 8557 CNRS - EHESS, 54, Boulevard Raspail, 75006 Paris (France); Geroyannis, Helene [Laboratoire Teleanalyse, Espace et Societe, Centre d' Analyse et de Mathematique Sociales, UMR 8557 CNRS - EHESS, 54, Boulevard Raspail, 75006 Paris (France); Szczeklik, Andrew [Molecular Biology Laboratory, Department of Internal Medicine, Jagiellonian University, ul. Skawinska 8, 31066 Cracow (Poland); Krzemien, Kazimierz [Institute of Geography and Spatial Management, Jagiellonian University, ul. Gronostajowa 7, 30-387 Cracow (Poland)

    2006-09-15

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

  3. 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.].

  4. Health impact assessment of quality wine production in Hungary.

    Science.gov (United States)

    Adám, Balázs; Molnár, Agnes; Bárdos, Helga; Adány, Róza

    2009-12-01

    Alcohol-related health outcomes show strikingly high incidence in Hungary. The effects of alcohol consumption are influenced not only by the quantity, but also the quality of drinks; therefore, wine production can have an important effect on public health outcomes. Nevertheless, the Hungarian wine sector faces several vital problems and challenges influenced by the country's accession to the European Union and by the need for restructuring. A comprehensive health impact assessment (HIA) based on the evaluation of the Hungarian legislation related to the wine sector has been carried out, aiming to assess the impact of the production of quality wine versus that of table wine, using a range of public health and epidemiological research methods and data as well as HIA guidelines. The study finds that the toxic effects of alcohol can be reduced with an increased supply of quality wine and with decreased overall consumption due to higher cost, although this might drive some people to seek illegal sources. Quality wine production allows for improved use of land, creates employment opportunities and increases the incomes of producers and local communities; however, capital-scarce producers unable to manage restructuring may lose their source of subsistence. The supply of quality wine can promote social relations, contribute to a healthy lifestyle and reduce criminality related to alcohol's influence and adulteration. In general, the production and supply of quality wine can have an overall positive impact on health. Nevertheless, because of the several possible negative effects expected without purposeful restructuring, recommendations for the maximization of favourable outcomes and suggestions for monitoring the success of the analysis have been provided.

  5. 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.

  6. 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.

  7. Using Community Health Assessment to Teach and Explore Health Status Disparities

    Science.gov (United States)

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  8. 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.

  9. 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…

  10. 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.

  11. 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…

  12. Health Technology Assessment (HTA in a changing social and health care context

    Directory of Open Access Journals (Sweden)

    Alìcia Granados

    2005-06-01

    Full Text Available

    Health Technology Assessment (HTA has been defined in different ways, nevertheless it can be described briefly as a multidisciplinary process of analysis dealing with evidence and context to inform decision making in health care.

    For decades HTA and related fields, aimed to produce and encourage the use of scientific evidence to inform decision making, at all levels of the health care system, from policy making and management to clinical decision making [1,2]. Scientific evidence involved in the HTA process may refer to efficacy, effectiveness, safety, needs, appropriateness, efficiency, equity, acceptability and some other issues related to the effect of the introduction, use and diffusion of medical technologies on health and health care. The evaluation, with formal rules, of the quality of available scientific information is an important step of the HTA process as are the skills required for literature searching.The source of scientific information should not be limited to clinical literature, but also exploit other areas of knowledge such as epidemiology, social sciences,economics,health services research among others [1].

    The best method to be used in the HTA analysis process obviously depends on the uncertainties to be assessed. It could range from the synthesis and/or integration of scientific information to production of primary data.

    The latter is the option of choice when there is insufficient existing evidence or its quality is poor. The assessments often require a multidisciplinary and multi-method approach, the former, of course, must be chosen after translating the uncertainty into sound research questions.

  13. Health Technology Assessment (HTA in a changing social and health care context

    Directory of Open Access Journals (Sweden)

    Alicia Granados

    2003-05-01

    Full Text Available

    Health Technology Assessment (HTA has been defined in different ways, nevertheless it can be described briefly as a multidisciplinary process of analysis dealing with evidence and context to inform decision making in health care. For decades HTA and related fields, aimed to produce and encourage the use of scientific evidence to inform decision making, at all levels of the health care system, from policy making and management to clinical decision making [1,2].

    Scientific evidence involved in the HTA process may refer to efficacy, effectiveness, safety, needs, appropriateness, efficiency, equity, acceptability and some other issues related to the effect of the introduction, use and diffusion of medical technologies on health and health care. The evaluation, with formal rules, of the quality of a

    vailable scientific information is an important step of the HTA process as are the skills required for literature searching. The source of scientific information should not be limited to clinical literature, but also exploit other areas of knowledge such as epidemiology, social sciences,economics,health services research among others [1].The best method to be used in the HTA analysis process obviously depends on the uncertainties to be assessed. It could range from the synthesis and/or integration of scientific information to production of primary data.The latter is the option of choice when there is insufficient existing evidence or its quality is poor.

    The assessments often require a multidisciplinary and multi-method approach, the former, of course,must be chosen after translating the uncertainty into sound research questions.

     

  14. [Assessment of the effects of age at start of puberty on mental health in pre-adolescence: results of a longitudinal study (1989-1991)].

    Science.gov (United States)

    Bolognini, M; Plancherel, B; Nuñez, R; Bettschart, W

    1993-01-01

    The transition from childhood to adolescence is widely believed to be a stressful period in which the child faces multiple changes: physical changes, school choices, development of new social roles, and changes in the relation with his or her parents and friends. We investigated the effects of the timing of puberty on mental health, studied in a population of 219 young adolescents who were followed during three years (mean age at the beginning of the study was 12.5 years). The changes in the perception of the individual's body associated with puberty depended on the child's gender. Significant events during puberty had a negative effect on mental health. Although puberty remains a critical period of temporary unstable and fragile transition, most of the young adolescents coped relatively well with the physiological, psychological and social changes they faced.

  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. Assessment of exposure to hand-arm vibration and its related health effects in workers employed in stone cutting workshops of Hamadan city

    OpenAIRE

    Roya Bayat; Mohsen Aliabadi; Rostam Golmohamadi; Masoud Shafiee Motlagh

    2016-01-01

    Introduction: The workers employed in stone cutting workplace are exposed to hand-arm vibration and its complications. The aim of this study was to evaluate the exposure to hand-arm vibration and its health effects on workers in the stone cutting workshops. Methods: In this descriptive-analytic study, 40 workers of Hamadan city stone cutting who worked with stone cutting machines were examined. Measuring exposure to hand-arm vibration was performed by standard methods ISO 5349. Symptoms r...

  17. Alcohol gel ingestion amongst homeless Eastern and Central Europeans in\\ud London: assessing the effects on cognitive functioning and psychological health

    OpenAIRE

    Soar, Kirstie; Papaioannou, G.; Dawkins, Lynne

    2016-01-01

    Background: Intentional consumption of alcohol based hand gels has been reported\\ud especially amongst non-UK national, alcohol dependent, homeless individuals in\\ud London. Whilst alcohol misuse is known to be associated with impaired cognitive\\ud functioning and mental health problems, the effects of additional ingestion of alcohol gel\\ud are unknown. Objectives: To explore cognitive and psychological functioning in users\\ud who intentionally ingest alcohol gel compared with ethyl-alcohol o...

  18. Climate Change Effects on Heat- and Cold-Related Mortality in the Netherlands: A Scenario-Based Integrated Environmental Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Maud M. T. E. Huynen

    2015-10-01

    Full Text Available Although people will most likely adjust to warmer temperatures, it is still difficult to assess what this adaptation will look like. This scenario-based integrated health impacts assessment explores baseline (1981–2010 and future (2050 population attributable fractions (PAF of mortality due to heat (PAFheat and cold (PAFcold, by combining observed temperature–mortality relationships with the Dutch KNMI’14 climate scenarios and three adaptation scenarios. The 2050 model results without adaptation reveal a decrease in PAFcold (8.90% at baseline; 6.56%–7.85% in 2050 that outweighs the increase in PAFheat (1.15% at baseline; 1.66%–2.52% in 2050. When the 2050 model runs applying the different adaptation scenarios are considered as well, however, the PAFheat ranges between 0.94% and 2.52% and the PAFcold between 6.56% and 9.85%. Hence, PAFheat and PAFcold can decrease as well as increase in view of climate change (depending on the adaptation scenario. The associated annual mortality burdens in 2050—accounting for both the increasing temperatures and mortality trend—show that heat-related deaths will range between 1879 and 5061 (1511 at baseline and cold-related deaths between 13,149 and 19,753 (11,727 at baseline. Our results clearly illustrate that model outcomes are not only highly dependent on climate scenarios, but also on adaptation assumptions. Hence, a better understanding of (the impact of various plausible adaptation scenarios is required to advance future integrated health impact assessments.

  19. Climate Change Effects on Heat- and Cold-Related Mortality in the Netherlands: A Scenario-Based Integrated Environmental Health Impact Assessment

    Science.gov (United States)

    Huynen, Maud M. T. E.; Martens, Pim

    2015-01-01

    Although people will most likely adjust to warmer temperatures, it is still difficult to assess what this adaptation will look like. This scenario-based integrated health impacts assessment explores baseline (1981–2010) and future (2050) population attributable fractions (PAF) of mortality due to heat (PAFheat) and cold (PAFcold), by combining observed temperature–mortality relationships with the Dutch KNMI’14 climate scenarios and three adaptation scenarios. The 2050 model results without adaptation reveal a decrease in PAFcold (8.90% at baseline; 6.56%–7.85% in 2050) that outweighs the increase in PAFheat (1.15% at baseline; 1.66%–2.52% in 2050). When the 2050 model runs applying the different adaptation scenarios are considered as well, however, the PAFheat ranges between 0.94% and 2.52% and the PAFcold between 6.56% and 9.85%. Hence, PAFheat and PAFcold can decrease as well as increase in view of climate change (depending on the adaptation scenario). The associated annual mortality burdens in 2050—accounting for both the increasing temperatures and mortality trend—show that heat-related deaths will range between 1879 and 5061 (1511 at baseline) and cold-related deaths between 13,149 and 19,753 (11,727 at baseline). Our results clearly illustrate that model outcomes are not only highly dependent on climate scenarios, but also on adaptation assumptions. Hence, a better understanding of (the impact of various) plausible adaptation scenarios is required to advance future integrated health impact assessments. PMID:26512680

  20. Health Security Intelligence: Assessing the Nascent Public Health Capability

    Science.gov (United States)

    2012-03-01

    Information Sharing System MOU Memorandum of Understanding NBIC National Biosurveillance Integration Center NCMI National Center for...definition, have come to the fore in the literature, biosurveillance and health security. Biosurveillance , as a term, is too limited to provide the...purposes. The Government Accountability Office (GAO) in a 2006 report on public health infrastructure described biosurveillance as, “…automated

  1. The Development of a Secondary School Health Assessment Model

    Science.gov (United States)

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

    The objective of this research was to: 1) involved a survey of information relating to secondary school health, 2) involved the construction of a model of health assessment and a handbook for using the model in secondary school, 3) develop an assessment model for secondary school. The research included 3 phases. (1) involved a survey of…

  2. Effectiveness of oral health education among primary health care workers at the primary health center in Nellore district, Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    Muthyala Pavana Sandhya

    2014-01-01

    Full Text Available Background: Primary dental care can be a way of achieving good oral health for the community. This can be achieved by integration of oral health care with the existing primary health care activities through training of primary health care workers on aspects of oral health. Objective: To assess the effectiveness of oral health education among primary health care workers at the primary health center (PHC in Nellore district, Andhra Pradesh. Materials and Methods: Descriptive longitudinal study was conducted from June 2010 to August 2010 at a PHC. Knowledge about oral health among primary health care workers was pretested using a self-administered questionnaire prepared in local language (Telugu. Later after a month health education was provided to the health workers, and pamphlets with information on oral health were distributed. Posttest assessment was done 1-month after providing health education using the same questionnaire. Statistical analysis was performed using the SPSS 12.0 software, Student′s t-test was used to compare knowledge scores between pre and posttests. Results: A total of 118 Primary Health Care Workers with the majority in the 20-30 years age group participated in the study. Posttest assessment showed a change in knowledge level with an overall increase in knowledge level of primary health care workers with a mean difference of 12.56 ± 3.23, which was highly significant (P < 0.001. Conclusion: The knowledge about oral health was poor, and it improved after providing health education to primary health care workers. Change in knowledge was appreciable and may play a key role in oral health promotion of the vast majority of the rural population.

  3. Healthy public policy--is health impact assessment the cornerstone?

    Science.gov (United States)

    Metcalfe, O; Higgins, C

    2009-04-01

    The 8th International Health Impact Assessment Conference, entitled 'Healthy public policy--is health impact assessment the cornerstone?', was hosted by the Institute of Public Health in Ireland (IPH). At the event, IPH sponsored a keynote speech to set the context of the conference and outline the importance of healthy public policy. This article presents an overview of healthy public policy and the barriers to its adoption in policy-making. Health impact assessment is one such tool to overcome the barriers, and the authors recommend the methodology as the cornerstone to healthy public policy.

  4. 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.

  5. 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.

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

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-03

    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.

  7. A Health Impact Assessment Framework for Assessing Vulnerability and Adaptation Planning for Climate Change

    Directory of Open Access Journals (Sweden)

    Helen Brown

    2014-12-01

    Full Text Available This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  8. A health impact assessment framework for assessing vulnerability and adaptation planning for climate change.

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-12-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  9. Assessing ozone-related health impacts under a changing climate.

    Science.gov (United States)

    Knowlton, Kim; Rosenthal, Joyce E; Hogrefe, Christian; Lynn, Barry; Gaffin, Stuart; Goldberg, Richard; Rosenzweig, Cynthia; Civerolo, Kevin; Ku, Jia-Yeong; Kinney, Patrick L

    2004-11-01

    Climate change may increase the frequency and intensity of ozone episodes in future summers in the United States. However, only recently have models become available that can assess the impact of climate change on O3 concentrations and health effects at regional and local scales that are relevant to adaptive planning. We developed and applied an integrated modeling framework to assess potential O3-related health impacts in future decades under a changing climate. The National Aeronautics and Space Administration-Goddard Institute for Space Studies global climate model at 4 degrees x 5 degrees resolution was linked to the Penn State/National Center for Atmospheric Research Mesoscale Model 5 and the Community Multiscale Air Quality atmospheric chemistry model at 36 km horizontal grid resolution to simulate hourly regional meteorology and O3 in five summers of the 2050s decade across the 31-county New York metropolitan region. We assessed changes in O3-related impacts on summer mortality resulting from climate change alone and with climate change superimposed on changes in O3 precursor emissions and population growth. Considering climate change alone, there was a median 4.5% increase in O3-related acute mortality across the 31 counties. Incorporating O3 precursor emission increases along with climate change yielded similar results. When population growth was factored into the projections, absolute impacts increased substantially. Counties with the highest percent increases in projected O3 mortality spread beyond the urban core into less densely populated suburban counties. This modeling framework provides a potentially useful new tool for assessing the health risks of climate change.

  10. Hygienic environmental assessment and health of children in Penza

    Directory of Open Access Journals (Sweden)

    Yu.V. Korochkina

    2015-09-01

    Full Text Available Assessment of the carcinogenic risk from air pollution, the chemical composition of the drinking water and the content of contaminants in food showed that the total cancer risk for both inhalation and oral routes of administering priority pollutants and contaminants into the body of Penza children and adolescents complies with the maximum permissible level. The greatest risk of non-carcinogenic impact associated with air pollution is generated in respect of the respiratory system, eyes and immune system. The maximum hazard indices associated with the consumption of drinking water, are set for blood, hormone system and kidneys. The risk of negative impacts associated with the receipt of food contaminants is observed in respect of the hematopoietic and cardiovascular systems. Application of risk assessment methodology to study the effects of chemicals polluting the environment on health has allowed to justify preventive measures aimed at reducing the risk to the health of children and adolescents, as well as increased monitoring researches of environmental objects to isolate areas of high risk to children's health.

  11. Longitudinal health effects of disasters.

    NARCIS (Netherlands)

    Yzermans, C.J.

    2004-01-01

    Background: We carry out prospective, longitudinal studies on the possible health effects of two disasters in the Netherlands: the explosion of fireworks depot in a residential area (Enschede) and a fire in discotheque in Volendam. Learning from the chaotic aftermath previous disasters, the Dutch g

  12. Longitudinal health effects of disasters.

    NARCIS (Netherlands)

    IJzermans, C.J.; Donker, G.

    2003-01-01

    Background and Aim: We are involved in research on the possible health effects of three disasters in the Netherlands: a plane crash in an Amsterdam neighbourhood, the explosion of a firework factory in the city of Enschede and a fire in a discotheque in Volendam. Which methodologies were used and wh

  13. Health Effects of Air Pollution.

    Science.gov (United States)

    Environmental Education Report and Newsletter, 1985

    1985-01-01

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

  14. Health Effects of Climate Change

    Science.gov (United States)

    ... resulting health effects. Extreme weather events due to climate change may cause people to experience geographic displacement, damage to their property, loss of loved ones, and chronic stress—all of which can negatively affect ... change may be associated with staple food shortages, malnutrition, ...

  15. 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...... health. Assessment took place with the help of professional interpreters and was, during each interview, performed by two medical doctors using double-blind techniques. Based on a number of highly significant (P

  16. Health literacy and its importance for effective communication. Part 2.

    Science.gov (United States)

    Lambert, Veronica; Keogh, Deborah

    2014-05-01

    This is the second of two articles exploring the concept of health literacy, an often hidden barrier to effective healthcare communication. Part 1 was published in April ( Lambert and Keogh 2014 ). This article explains how to detect low levels of health literacy among parents and children, and outlines the challenges to assessing health literacy levels, including the stigma and discrimination some people experience. Some basic healthcare communication strategies for supporting health literacy in practice are suggested.

  17. 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.

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

    Science.gov (United States)

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

    2010-04-01

    We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996-2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus 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 influenza.

  19. Learning about health: The pupils' and the school health nurses assessment of the health dialogue

    DEFF Research Database (Denmark)

    Borup, Ina K.

    Public health, health promotion, empowerment, experiential learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialouge, school health nurse......Public health, health promotion, empowerment, experiential learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialouge, school health nurse...

  20. Learning about health: The pupils' and the school health nurses assessment of the health dialogue

    DEFF Research Database (Denmark)

    Borup, Ina K.

    Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse......Public health, health promotion, empowerment, experiental learning, HBSC, health survey, qualitative interviews, grounded theory, school children, adolescents, health dialogue, school health nurse...

  1. [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

  2. 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

    2017-01-01

    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...... 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...

  3. 2011 Behavioral Health Risk Assessment Data Report (BH-RADR)

    Science.gov (United States)

    2015-09-01

    Approved for public release, distribution unlimited General Medicine: 500A, Public Health Data 2011 Behavioral Health Risk Assessment Data...REPORT DATE 30 SEP 2015 2. REPORT TYPE Annual 3. DATES COVERED 01 JAN 2011 - 31 DEC 2011 4. TITLE AND SUBTITLE 2011 Behavioral Health Risk...ABSTRACT This publication describes characteristics of Soldiers who completed a behavioral health (BH) screening at the two post-deployment Touch Points

  4. 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

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

    Science.gov (United States)

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

    2009-01-01

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

  6. The Health Assessment Longitudinal File imperative: foundation for improving the health of the force.

    Science.gov (United States)

    Kemper, Judith A; Donahue, Donald A; Harris, Judith S

    2003-08-01

    A smaller active duty force and an increased operational tempo have made the Reserve components (RC) essential elements in the accomplishment of the mission of the U.S. Army. One critical factor in meeting mission is maintaining the optimal health of each soldier. Baseline health data about the RC is currently not being collected, even though increasing numbers of reserve soldiers are being activated. The Annual Health Certification and Survey is being developed as a way to meet the RCs' statutory requirement for annual certification of health while at the same time generating and tracking baseline data on each reservist in a longitudinal health file, the Health Assessment Longitudinal File. This article discusses the Annual Health Certification Questionnaire/Health Assessment Longitudinal File, which will greatly enhance the Army's ability to accurately certify the health status of the RC and track health in relation to training, mission activities, and deployment.

  7. Assessing the effect of Measurement-Based Care depression treatment on HIV medication adherence and health outcomes: rationale and design of the SLAM DUNC Study.

    Science.gov (United States)

    Pence, Brian W; Gaynes, Bradley N; Williams, Quinn; Modi, Riddhi; Adams, Julie; Quinlivan, E Byrd; Heine, Amy; Thielman, Nathan; Mugavero, Michael J

    2012-07-01

    Depression affects 20-30% of people living with HIV/AIDS (PLWHA) in the U.S. and predicts greater sexual risk behaviors, lower antiretroviral (ARV) medication adherence, and worse clinical outcomes. Yet little experimental evidence addresses the critical clinical question of whether depression treatment improves ARV adherence and clinical outcomes in PLWHA with depression. The Strategies to Link Antidepressant and Antiretroviral Management at Duke, UAB, and UNC (SLAM DUNC) Study is a randomized clinical effectiveness trial funded by the National Institute for Mental Health. The objective of SLAM DUNC is to test whether a depression treatment program integrated into routine HIV clinical care affects ARV adherence. PLWHA with depression (n=390) are randomized to enhanced usual care or a depression treatment model called Measurement-Based Care (MBC). MBC deploys a clinically supervised Depression Care Manager (DCM) to provide evidence-based antidepressant treatment recommendations to a non-psychiatric prescribing provider, guided by systematic and ongoing measures of depressive symptoms and side effects. MBC has limited time requirements and the DCM role can be effectively filled by a range of personnel given appropriate training and supervision, enhancing replicability. In SLAM DUNC, MBC is integrated into HIV care to support HIV providers in antidepressant prescription and management. The primary endpoint is ARV adherence measured by unannounced telephone-based pill counts at 6 months with follow-up to 12 months and secondary endpoints including viral load, health care utilization, and depressive severity. Important outcomes of this study will be evidence of the effectiveness of MBC in treating depression in PLWHA and improving HIV-related outcomes.

  8. Questioning reliability assessments of health information on social media.

    Science.gov (United States)

    Dalmer, Nicole K

    2017-01-01

    This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media's increasing role in health information consumption is recognized, studies are dominated by investigations of traditional (i.e., non-social media) sites. To more richly assess constructions of reliability when using social media for health information, future research must focus on health consumers' unique contexts, virtual relationships, and degrees of trust within their social networks.

  9. Questioning reliability assessments of health information on social media

    Science.gov (United States)

    Dalmer, Nicole K.

    2017-01-01

    This narrative review examines assessments of the reliability of online health information retrieved through social media to ascertain whether health information accessed or disseminated through social media should be evaluated differently than other online health information. Several medical, library and information science, and interdisciplinary databases were searched using terms relating to social media, reliability, and health information. While social media’s increasing role in health information consumption is recognized, studies are dominated by investigations of traditional (i.e., non-social media) sites. To more richly assess constructions of reliability when using social media for health information, future research must focus on health consumers’ unique contexts, virtual relationships, and degrees of trust within their social networks. PMID:28096748

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal in an ...... a practical example of applying quantification in an HIA, thereby promoting its incorporation into political decision making.......BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...

  11. Effects of Indoor Air Pollution on Human Health

    DEFF Research Database (Denmark)

    Berglund, B.; Brunekreef, B.; Knöppel, H.

    1992-01-01

    This article contains a summary discussion of human health effects linked to indoor air pollution (UP) in homes and other non-industrial environments. Rather than discussing the health effects of the many different pollutants which can be found in indoor air, the approach has been to group broad...... categories of adverse health effects in separate chapters, and describe the relevant indoor exposures which may give rise to these health effects. The following groups of effects have been comdered: effects on the respiratory system; allergy and other effects on the immune system; cancer and effects...... the principal agents and sources, evidence linking IAP to the effects, susceptible groups, the public health relevance, methods for assessment, and major research needs are briefly discussed. For some groups of effects, clear relationships with exposure to IAP have been reported in the world literature. Among...

  12. 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

  13. 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.

  14. History of the international societies in health technology assessment: International Society for Technology Assessment in Health Care and Health Technology Assessment International.

    Science.gov (United States)

    Banta, David; Jonsson, Egon; Childs, Paul

    2009-07-01

    The International Society for Technology Assessment in Health Care (ISTAHC) was formed in 1985. It grew out of the increasing awareness of the international dimensions of health technology assessment (HTA) and the need for new communication methods at the international level. The main function of ISTAHC was to present an annual conference, which gradually grew in size, and also to generally improve in quality from to year. ISTAHC overextended itself financially early in the first decade of the 2000s and had to cease its existence. A new society, Health Technology Assessment international (HTAi), based on many of the same ideas and people, grew up beginning in the year 2003. The two societies have played a large role in making the field of HTA visible to people around the world and providing a forum for discussion on the methods and role of HTA.

  15. The impact of inclusion criteria in health economic assessments.

    Science.gov (United States)

    Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

    2011-05-01

    The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive

  16. Quality of care in a low-income consumer-driven health plan: assessment of healthcare effectiveness data information set (HEDIS) scores for secondary prevention.

    Science.gov (United States)

    Westover, Chad; Arredondo, Patricia H; Chapa, Griselda; Cole, Evan; Campbell, Claudia R

    2014-01-01

    The passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) may create an estimated 16 million new Medicaid enrollees. This underscores the need to develop innovative strategies to provide efficient care to this population without compromising quality. To address concerns that consumer-driven health plans (CDHPs) and cost sharing discourage individuals from seeking needed care, we examined the Healthcare Effectiveness Data Information Set (HEDIS) measures of secondary prevention for a CDHP offered to uninsured, non-Medicaid eligible adults with incomes under 200% of the federal poverty level and compared them to the National Committee for Quality Assurance (NCQA) benchmarks achieved by national Medicaid and commercially insured health plans. Results suggest that the cost-sharing component in the CDHP plan did not deter these low-income enrollees from pursuing or receiving appropriate care when compared to either Medicaid or commercially insured populations. As these results are only descriptive and not statistical measures, further research is needed with comparable populations and more detailed data for hypothesis testing.

  17. 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.

  18. TO ASSESS EFFECTIVENESS OF PLAN TEACHING PROGRAMME ON NATIONAL ACCREDITATION BOARD FOR HOSPITALS AND HEALTH CARE PROVIDERS (NABH GUIDELINES AMONG NEWLY RECRUITED STAFF NURSES AT KRISHNA HOSPITAL, KARAD

    Directory of Open Access Journals (Sweden)

    Kavita Sanjay

    2015-12-01

    Full Text Available The continual improvement of service quality in healthcare units has become a prime consideration to ensure patient satisfaction across the world in the modern economic scenario. In India, health sector is one of the largest and fastest growing sector in which both the private and government care providers and hospitals put much emphasis on quality improvement and patient satisfaction. National Accreditation Board of Hospitals and Healthcare Providers (NABH along with Quality Council of India provided the criteria based on which quality standard of hospitals is determined. The study was conducted on 51 newly recruited staff nurses at Krishna Hospital, Karad. An evaluator survey approach was considered. Study design was used one group pre-test, post-test design. Purposive sampling technique was used. RESULTS The study was conducted on 51 newly recruited staff nurses at Krishna Hospital, Karad. An evaluator survey approach was considered. Study design was used one group pre-test, post-test design. Purposive sampling technique was used. CONCLUSION Study concludes majority of newly recruited nursing staff having 19.38% average knowledge and 17.85% having average practice towards NABH guidelines. Knowledge and practice score of newly recruited nursing staff between the pre-test and post-test was highly significant. OBJECTIVES 1 To assess newly recruited staff nurses knowledge and practice towards NABH guidelines. 2 To find an association of knowledge and practice between pre-test and post-test of PTP programme on NABH guidelines.

  19. 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.

  20. Learning about health: The pupils' and the school health nurses' assessment of the health dialogue

    DEFF Research Database (Denmark)

    Borup, Ina K.

    Public health, health promotion, empowerment, experiential learning, health behaviour in school-aged children (HBSC), health survey, qualitative interviews, grounded theory, school children......Public health, health promotion, empowerment, experiential learning, health behaviour in school-aged children (HBSC), health survey, qualitative interviews, grounded theory, school children...

  1. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    Science.gov (United States)

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  2. 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 ...

  3. 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

  4. HEALTH ASSESSMENT OF 1,3-BUTADIENE | Science ...

    Science.gov (United States)

    This assessment was conducted to review the new information that has become available since EPA's 1985 health assessment of 1,3-butadiene.1,3-Butadiene is a gas used commercially in the production of styrene-butadiene rubber, plastics, and thermoplastic resins. The major environmental source of 1,3-butadiene is the incomplete combustion of fuels from mobile sources (e.g., automobile exhaust). Tobacco smoke can be a significant source of 1,3-butadiene in indoor air.This assessment concludes that 1,3-butadiene is carcinogenic to humans by inhalation, based on the total weight of evidence. The specific mechanisms of 1,3-butadiene-induced carcinogenesis are unknown; however, it is virtually certain that the carcinogenic effects are mediated by genotoxic metabolites of 1,3-butadiene.Animal data suggest that females may be more sensitive than males for cancer effects; nevertheless, there are insufficient data from which to draw any conclusions on potentially sensitive subpopulations.The human incremental lifetime unit cancer (incidence) risk estimate is based on extrapolation from leukemias observed in an occupational epidemiologic study. A twofold adjustment to the epidemiologic-based unit cancer risk is then applied to reflect evidence from the rodent bioassays suggesting that the epidemiologic-based estimate may underestimate total cancer risk from 1,3-butadiene exposure in the general population. 1,3-Butadiene also causes a variety of reproductive and develop

  5. Assessing Your Weight and Health Risk

    Science.gov (United States)

    ... 0–29.9 Obesity 30.0 and Above Waist Circumference Measuring waist circumference helps screen for possible health risks that come ... Risks of Obesity-Associated Diseases by BMI and Waist Circumference provides you with an idea of whether your ...

  6. 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

  7. Metrics for assessing improvements in primary health care.

    Science.gov (United States)

    Stange, Kurt C; Etz, Rebecca S; Gullett, Heidi; Sweeney, Sarah A; Miller, William L; Jaén, Carlos Roberto; Crabtree, Benjamin F; Nutting, Paul A; Glasgow, Russell E

    2014-01-01

    Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences.

  8. 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.

  9. [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.

  10. The Effects of State Terrorism and Exile on Indigenous Guatemalan Refugee Children: A Mental Health Assessment and an Analysis of Children's Narratives.

    Science.gov (United States)

    Miller, Kenneth E.

    1996-01-01

    Examined the mental health and psychosocial development of 58 Guatemalan Mayan children living in 2 refugee camps in the Mexican state of Chiapas. Found only minimal evidence of psychological trauma among the children and a positive relationship between children's mental health and the health status (physical and mental) of their mothers. (MDM)

  11. "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…

  12. Nutrition and health technology assessment: When two worlds meet

    NARCIS (Netherlands)

    M.J. Poley (Marten)

    2015-01-01

    textabstractThere 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

  13. 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

  14. Health Impact Assessment Schiphol airport. Overview of results until 1999

    NARCIS (Netherlands)

    Franssen EAM; Lebret E; Staatsen BAM; LBM

    1999-01-01

    This report provides an English overview of the current results of the Health Impact Assessment Schiphol (HIAS) research programme. This programme consists of a series of studies with different designs. Results are rather described for each separate health end-point than by the separate studies: an

  15. Methodology of constructive technology assessment in health care

    NARCIS (Netherlands)

    Douma, Kirsten F.L.; Karsenberg, Kim; Hummel, Marjan J.M.; Bueno-de-Mesquita, Jolien M.; Harten, van Wim H.

    2007-01-01

    Objectives: Technologies in health care are evolving quickly, with new findings in the area of biotechnological and genetic research being published regularly. A health technology assessment (HTA) is often used to answer the question of whether the new technology should be implemented into clinical

  16. 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 ...

  17. 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.

  18. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

    or proven by past experiences but in general there appears to be no rational or systematic approach for assessing the value of SHM systems a-priory to their implementation. The present paper addresses the assessment of the value of SHM with basis in structural risk assessments and the Bayesian pre......-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...... of the uncertainty associated with the performance of SHM on the value of SHM. Moreover, in order to illustrate the potential of the application of approach for monitoring of structural systems an optimal strategy for SHM is determined for a system comprised of three welded details. © 2013 Taylor & Francis Group...

  19. 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.

  20. Comparison of the effects of using the Crowe Critical Appraisal Tool versus informal appraisal in assessing health research: a randomised trial.

    Science.gov (United States)

    Crowe, Michael; Sheppard, Lorraine; Campbell, Alistair

    2011-12-01

    In systematic reviews, evidence-based practice and journal clubs critical appraisal tools are used to rate research papers. However, little evidence exists on whether the critical appraisal tool, subject matter knowledge or research design knowledge affect the appraisal of research papers. A match paired randomised trial was conducted in August/September 2010 in the Faculty of Medicine, Health and Molecular Science, James Cook University, Australia. Ten participants in total were randomly assigned to two groups using either an informal appraisal of research (IA group) or the Crowe Critical Appraisal Tool (CCAT group), a general critical appraisal tool. Participant independently appraised five research papers, where each paper had a different research design. The scores allocated to the papers by each group were analysed. The intraclass correlation coefficient for absolute agreement was 0.76 for the informal appraisal group and 0.88 for the Crowe Critical Appraisal Tool group. The G study showed that in the informal appraisal group 24% of variance in scores was attributable to either the rater or paper × rater interactions, whereas this was 12% in the Crowe Critical Appraisal Tool group. Analysis of covariance showed that there were statistically significant results in the informal appraisal group for subject matter knowledge (F(1,18) = 7.03, P Crowe Critical Appraisal Tool was more reliable than an informal appraisal of the research papers. In the informal appraisal group, there were significant effects for rater and subject matter knowledge, whereas the Crowe Critical Appraisal Tool almost eliminated the rater effect, and no subject matter knowledge effect was apparent. There was no research design knowledge effect in either group. The Crowe Critical Appraisal Tool provided much better score reliability and should help readers with different levels and types of knowledge to reach similar conclusions about a research paper.

  1. [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).

  2. 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.

  3. 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 Inst...

  4. Frameworks to assess health systems governance: a systematic review.

    Science.gov (United States)

    Pyone, Thidar; Smith, Helen; van den Broek, Nynke

    2017-03-03

    Governance of the health system is a relatively new concept and there are gaps in understanding what health system governance is and how it could be assessed. We conducted a systematic review of the literature to describe the concept of governance and the theories underpinning as applied to health systems; and to identify which frameworks are available and have been applied to assess health systems governance. Frameworks were reviewed to understand how the principles of governance might be operationalized at different levels of a health system. Electronic databases and web portals of international institutions concerned with governance were searched for publications in English for the period January 1994 to February 2016. Sixteen frameworks developed to assess governance in the health system were identified and are described. Of these, six frameworks were developed based on theories from new institutional economics; three are primarily informed by political science and public management disciplines; three arise from the development literature and four use multidisciplinary approaches. Only five of the identified frameworks have been applied. These used the principal-agent theory, theory of common pool resources, North's institutional analysis and the cybernetics theory. Governance is a practice, dependent on arrangements set at political or national level, but which needs to be operationalized by individuals at lower levels in the health system; multi-level frameworks acknowledge this. Three frameworks were used to assess governance at all levels of the health system. Health system governance is complex and difficult to assess; the concept of governance originates from different disciplines and is multidimensional. There is a need to validate and apply existing frameworks and share lessons learnt regarding which frameworks work well in which settings. A comprehensive assessment of governance could enable policy makers to prioritize solutions for problems identified

  5. Health promotion: An effective tool for global health

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar

    2012-01-01

    Full Text Available Health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectoral action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration. Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectoral partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes.

  6. 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.

  7. 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.

  8. 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.

  9. 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...

  10. Models and Methods for Assessing Refugee Mental Health Needs.

    Science.gov (United States)

    Deinard, Amos S.; And Others

    This background paper on refugee needs assessment discusses the assumptions, goals, objectives, strategies, models, and methods that the state refugee programs can consider in designing their strategies for assessing the mental health needs of refugees. It begins with a set of background assumptions about the ethnic profile of recent refugee…

  11. 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,…

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. A consumer involvement model for health technology assessment in Canada.

    Science.gov (United States)

    Pivik, Jayne; Rode, Elisabeth; Ward, Christopher

    2004-08-01

    Similar to other health policy initiatives, there is a growing movement to involve consumers in decisions affecting their treatment options. Access to treatments can be impacted by decisions made during a health technology assessment (HTA), i.e., the rigorous assessment of medical interventions such as drugs, vaccines, devices, materials, medical and surgical procedures and systems. The purpose of this paper was to empirically assess the interest and potential mechanisms for consumer involvement in HTA by identifying what health consumer organizations consider meaningful involvement, examining current practices internationally and developing a model for involvement based on identified priorities and needs. Canadian health consumer groups representing the largest disease or illness conditions reported a desire for involvement in HTA and provided feedback on mechanisms for facilitating their involvement.

  17. 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.

  18. 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 ...

  19. 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.

  20. 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

  1. Air quality monitoring in NIS (SERBIA) and health impact assessment.

    Science.gov (United States)

    Nikic, Dragana; Bogdanovic, Dragan; Nikolic, Maja; Stankovic, Aleksandra; Zivkovic, Nenad; Djordjevic, Amelija

    2009-11-01

    The aim of this study is to indicate the significance of air quality monitoring and to determine the air quality fields for the assessment of air pollution health effects, with special attention to risk population. Radial basis function network was used for air quality index mapping. Between 1991 and 2005, on the territory of Nis, several epidemiological studies were performed on risk groups (pre-school children, school children, pregnant women and persons older than 65). The total number of subjects was 5837. The exposed group comprised individuals living in the areas with unhealthy AQI, while the control group comprised individuals living in city areas with good or moderate AQI. It was determined that even relatively low levels of air pollution had impact on respiratory system and the occurrence of anaemia, allergy and skin symptoms.

  2. [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.

  3. 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.

  4. 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

  5. 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.

  6. Health technology assessment in Australia: a role for clinical registries?

    Science.gov (United States)

    Scott, Anna Mae

    2016-03-31

    Objective Health technology assessment (HTA) is a process of assessing evidence to inform policy decisions about public subsidy of new drugs and medical procedures. Where evidence is uncertain but the technology itself is promising, funders may recommend funding on an interim basis. It is unknown whether evidence from clinical registries is used to resolve uncertainties identified in interim-funded decisions made by Australian HTA bodies. Therefore, the present study evaluated the role of evidence from clinical registries in resolving evidence uncertainties identified by the Medical Services Advisory Committee (MSAC).Methods All HTAs considered by MSAC between 1998 and 2015 were reviewed and assessments that recommended interim funding were identified. The MSAC website was searched to identify reassessments of these recommendations and sources of evidence used to resolve the uncertainties were identified.Results Of 173 HTA reports considered by MSAC, 17 (10%) contained an interim funding recommendation. Eight recommendations cited uncertainty around safety, 15 cited uncertainty around clinical effectiveness and 13 cited uncertainty around economics (cost-effectiveness and/or budget impact). Of the 17 interim funding recommendations, 11 (65%) have been reassessed. Only two reassessments relied on clinical registry evidence to resolve evidence gaps identified at the time of the interim funding recommendation.Conclusions Clinical registries are underused as a source of evidence for resolving uncertainties around promising new health technologies in Australia. An open dialogue between stakeholders on the role of registries in this context is needed.What is known about the topic? HTA is a process of assessing the evidence to inform policy decisions about public subsidy of new health technologies (e.g. pharmaceuticals, diagnostic tests, medical procedures). Where evidence is uncertain but the technology under evaluation is promising, funders may recommend the funding of

  7. Case Report Form for oral health assessments: methodological considerations

    Directory of Open Access Journals (Sweden)

    Joana Christina Carvalho

    2012-01-01

    Full Text Available Information on the oral health condition of the target population is required to enable the development of policy strategies for oral health promotion. This information needs to be substantiated by reliable data obtained through regular oral health assessments. Countries around the world have set up oral health data-registration systems that monitor the oral health of the population. These systems are either integrated in the public oral health care service or in national surveys conducted on a regular basis. This paper describes the conception and development of a Case Report Form for oral health assessments and introduces a recently developed electronic data-registration system for data capture in oral health surveys. The conception and development of a Case Report Form poses a number of challenges to be overcome. In addition to ensuring the scientific quality of its contents, several requirements need to be met. In the framework of national oral health surveys, handwritten data capture has proven accurate, but entails an important workload related to the printing and transporting of the forms, data transfer and storage of the forms, as well as the time required to perform these tasks. On the other hand, electronic data capture enables time saving and better performance. However, the advantages of this system may not be fully acknowledged by general practitioners, and their motivation to employ information and communication technologies may need to be encouraged. In the long term, the inclusion of electronic data registration in university training is probably the best strategy to achieve this.

  8. Some insights on grassland health assessment based on remote sensing.

    Science.gov (United States)

    Xu, Dandan; Guo, Xulin

    2015-01-29

    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.

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

    Directory of Open Access Journals (Sweden)

    Dandan Xu

    2015-01-01

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

  10. Rapid assessment of infrastructure of primary health care facilities – a relevant instrument for health care systems management

    OpenAIRE

    2015-01-01

    Background Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health informatio...

  11. Assessing health literacy in rural settings: a pilot study in rural areas of Cluj County, Romania.

    Science.gov (United States)

    Pop, Oana M; Brînzaniuc, Alexandra; Sirlincan, Emanuela O; Baba, Catalin O; Chereches, Razvan M

    2013-12-01

    Health literacy improves knowledge and builds skills to help individuals make appropriate decisions regarding their health. Over the past 20 years, several studies have described associations between health literacy and health outcomes. With respect to Romania, evidence is scarce on the level of health literacy, as well as on its determinants. Thus, the objectives of this study were to briefly screen functional health literacy levels in a sample of rural inhabitants, to assess the relationship between health literacy and reported health status, as well as to explore health literacy determinants within this population. Data were collected between September-November 2010, in four villages in Cluj County, Romania, using a cross-sectional survey. The mean age of respondents in the sample was 56 years, with roughly half of respondents being retired. The brief screening of health literacy suggested inadequate to marginal levels within the sample. Significant associations were observed between health literacy score and education, and self-perceived health status, whereas the relationship between health literacy and gender, and the presence of a chronic disease was not statistically significant. Limited health literacy has been shown to be common in people who rated their health as poor, those who attended only middle school, and individuals lacking basic information about their body. In order to minimize the adverse effects of low health literacy on health and health outcomes, efforts should be invested in identifying and addressing the health needs of adults with low and marginal health literacy, especially in underserved areas such as rural and remote settings, where access to health-related information is limited.

  12. Health effects of dietary phospholipids

    Directory of Open Access Journals (Sweden)

    Küllenberg Daniela

    2012-01-01

    Full Text Available Abstract Beneficial effects of dietary phospholipids (PLs have been mentioned since the early 1900's in relation to different illnesses and symptoms, e.g. coronary heart disease, inflammation or cancer. This article gives a summary of the most common therapeutic uses of dietary PLs to provide an overview of their approved and proposed benefits; and to identify further investigational needs. From the majority of the studies it became evident that dietary PLs have a positive impact in several diseases, apparently without severe side effects. Furthermore, they were shown to reduce side effects of some drugs. Both effects can partially be explained by the fact that PL are highly effective in delivering their fatty acid (FA residues for incorporation into the membranes of cells involved in different diseases, e.g. immune or cancer cells. The altered membrane composition is assumed to have effects on the activity of membrane proteins (e.g. receptors by affecting the microstructure of membranes and, therefore, the characteristics of the cellular membrane, e.g. of lipid rafts, or by influencing the biosynthesis of FA derived lipid second messengers. However, since the FAs originally bound to the applied PLs are increased in the cellular membrane after their consumption or supplementation, the FA composition of the PL and thus the type of PL is crucial for its effect. Here, we have reviewed the effects of PL from soy, egg yolk, milk and marine sources. Most studies have been performed in vitro or in animals and only limited evidence is available for the benefit of PL supplementation in humans. More research is needed to understand the impact of PL supplementation and confirm its health benefits.

  13. 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

  14. 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.

  15. 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.

  16. Cost-Effectiveness of a New Nordic Diet as a Strategy for Health Promotion

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Saxe, Henrik; Denver, Sigrid

    2015-01-01

    . This study assesses whether a large-scale introduction of NND is a cost-effective health promotion strategy by combining an economic model for estimating the utility-maximizing composition of NND, a life cycle assessment model to assess environmental effects of the dietary change, and a health impact model...

  17. "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…

  18. 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…

  19. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    Science.gov (United States)

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  20. 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.

  1. Assessment and treatment of dizzy patients in primary health care.

    OpenAIRE

    Ekvall-Hansson, Eva

    2006-01-01

    Dizziness is a common reason for visits to primary health care, especially among elderly patients. From a physiotherapeutic perspective, this thesis aims to study the assessment and treatment of dizzy patients in primary health care. Interventions in papers I, III and IV comprised a vestibular rehabilitation programme. In paper I, patients with multisensory dizziness were randomized to intervention group or control group. At follow-up after six weeks and three months, the intervention ...

  2. Assessing health centre systems for guiding improvement in diabetes care

    Directory of Open Access Journals (Sweden)

    Robinson Gary

    2005-08-01

    Full Text Available Abstract Background Aboriginal people in Australia experience the highest prevalence of diabetes in the country, an excess of preventable complications and early death. There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to assess the status of systems for chronic illness care in Aboriginal community health centres, and to explore whether more developed systems were associated with better quality of diabetes care. Methods This cross-sectional study was conducted in 12 Aboriginal community health centres in the Northern Territory of Australia. Assessment of Chronic Illness Care scale was adapted to measure system development in health centres, and administered by interview with health centre staff and managers. Based on a random sample of 295 clinical records from attending clients with diagnosed type 2 diabetes, processes of diabetes care were measured by rating of health service delivery against best-practice guidelines. Intermediate outcomes included the control of HbA1c, blood pressure, and total cholesterol. Results Health centre systems were in the low to mid-range of development and had distinct areas of strength and weakness. Four of the six system components were independently associated with quality of diabetes care: an increase of 1 unit of score for organisational influence, community linkages, and clinical information systems, respectively, was associated with 4.3%, 3.8%, and 4.5% improvement in adherence to process standards; likewise, organisational influence, delivery system design and clinical information systems were related to control of HbA1c, blood pressure, and total cholesterol. Conclusion The state of development of health centre systems is reflected in quality of care outcome measures for patients. The health centre systems assessment tool should be useful in assessing and guiding development of systems for improvement of

  3. 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.

  4. Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform.

    Science.gov (United States)

    Puertas, B; Schlesser, M

    2001-04-01

    Health reform is an important movement in countries throughout the region of the Americas, which could profoundly influence how basic health services are provided and who receives them. Goals of health sector reform include to improve quality, correct inefficiencies, and reduce inequities in current systems. The latter may be especially important in countries with indigenous populations, which are thought to suffer from excess mortality and morbidity related to poverty. The purpose of this paper is to report the results of a community health assessment conducted in 26 indigenous communities in the Province of Cotopaxi in rural Ecuador. It is hoped that this information will inform the health reform movement by adding to the current understanding of the health and socioeconomic situation of indigenous populations in the region while emphasizing a participatory approach toward understanding the social forces impacting upon health. This approach may serve as a model for empowering people through collective action. Recommended health reform strategies include: 1) Develop a comprehensive plan for health improvement in conjunction with stakeholders in the general population, including representatives of minority groups; 2) Conduct research on the appropriate mix between traditional medicine, primary health care strategies, and high technology medical services in relation to the needs of the general population; 3) Train local health personnel and traditional healers in primary health care techniques; 4) Improve access to secondary and tertiary health services for indigenous populations in times of emergency; and 5) Advocate for intersectoral collaboration among government institutions as well as non-governmental organizations and the private sector.

  5. 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......-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...

  6. 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.

  7. 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.

  8. 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.

  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. 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.

  11. 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.

  12. 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…

  13. Health assessment of toluene in California drinking water

    Energy Technology Data Exchange (ETDEWEB)

    Reed, N.; Reed, W.; Beltran, L.; Li, R.; Encomienda, I.

    1989-03-08

    This report reviews existing literature pertinent to the health risk posed by the use of toluene-contaminated drinking water. Also included in the study is an estimate of the toluene exposure of California residents based on the most recent data on toluene concentrations in California drinking water supplies. The concentration of toluene in drinking water that may cause adverse health effects is delineated.

  14. Health risk assessment for chemical exposures of military interest

    NARCIS (Netherlands)

    Langenberg, J.P.; Polhuijs, M.; Sijbranda, T.

    2016-01-01

    Participation in military operations is accompanied by health hazards resulting from exposure to chemical substances from natural and anthropogenic sources. Historically, focus on toxicological risks has been on the health effects of exposure to chemical warfare agents (CW A). In recent years the aw

  15. Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance.

    Science.gov (United States)

    Doiron, Denise; Jones, Glenn; Savage, Elizabeth

    2008-03-01

    Both adverse selection and moral hazard models predict a positive relationship between risk and insurance; yet the most common finding in empirical studies of insurance is that of a negative correlation. In this paper, we investigate the relationship between ex ante risk and private health insurance using Australian data. The institutional features of the Australian system make the effects of asymmetric information more readily identifiable than in most other countries. We find a strong positive association between self-assessed health and private health cover. By applying the Lokshin and Ravallion (J. Econ. Behav. Organ 2005; 56:141-172) technique we identify the factors responsible for this result and recover the conventional negative relationship predicted by adverse selection when using more objective indicators of health. Our results also provide support for the hypothesis that self-assessed health captures individual traits not necessarily related to risk of health expenditures, in particular, attitudes towards risk. Specifically, we find that those persons who engage in risk-taking behaviours are simultaneously less likely to be in good health and less likely to buy insurance.

  16. Reproductive Health Needs Assessment of Girl and Boy Teenagers

    Directory of Open Access Journals (Sweden)

    M Shakour

    2016-11-01

    Full Text Available Background & aim: Reproductive health of puberty is very important in the cycle of Life. Adolescence is a very important period of time in cycle of life and it is followed by physical, psychological and social changes. Therefore the aim of this study was needs assessment of reproductive health for adolescence as a first and principal step in curriculum planning for health services. Methods: This study was qualitative like the most needs assessments and the method was content analysis. Data gathering was done by semi structured interview. We used two focus groups (7and 10persons for needs assessment of reproductive health between girls, and personal interview with 10 boys. We did content analysis and then extracted the main themes and sub themes. Results: Adolescent girls had diverse needs in four groups: experiences related to menstruation and hygiene, social needs, sexual needs and psychological needs. Also adolescent boys had three groups of needs like physical changes, psychological and sexual needs. In physical needs group they had some needs like no knowledge of symptoms of adolescence, no knowledge of hygiene related to puberty. In psychological needs group they had some needs like feeling depression and in sexual needs group they had some needs like tendency to make contacts with girls, no knowledge of communication with people with different sex. Conclusion: Education and the systematic planning in reproductive health matters are necessary for parents, teachers and adolescents, and they are known as the prior needs.

  17. 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

  18. 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

  19. 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

  20. Assessing Health Literacy in Deaf American Sign Language Users.

    Science.gov (United States)

    McKee, Michael M; Paasche-Orlow, Michael K; Winters, Paul C; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, health care messages, and health care communication, which, when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version (ASL-NVS). We found that 48% of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research.

  1. 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.

  2. Medical health care professionals' assessments of oral health needs in children with disabilities: a qualitative study.

    Science.gov (United States)

    Hallberg, Ulrika; Klingberg, Gunilla

    2005-10-01

    Good collaboration between medical and dental care is essential to provide not only good oral health care, but also more holistic care for children with disabilities. The aim was to explore and describe medical health care professionals' assessments and considerations of orofacial problems and treatment needs in children with disabilities and in their families. In-depth interviews focusing on orofacial function were carried out with 17 medical health care employees. Interviews were transcribed verbatim and analysed in open and focused (selective) coding processes according to grounded theory. A core category was identified and named focusing on basic needs, showing that oral health care assessment was not on the agenda of medical health care professionals, but was instead viewed as a responsibility of parents or dentists. This study shows that oral health issues are not fully integrated in the medical care of children with disabilities. The omission of oral health issues from the medical agenda implies a risk of oral health problems in children with disabilities. To put the oral cavity and oral health on the medical agenda, dentists need to influence the undergraduate training of medical professionals and to initiate co-operation with the medical care system.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Health Assessment of School Children II -- Screening Tests

    Science.gov (United States)

    Eisner, Victor; Oglesby, Allan

    1971-01-01

    The article concludes that adequate screening, and the use of expensive diagnostic procedures (such as medical referral) only for children who have failed a screening test, will result in the most effective use of school health time and funds. (Author)

  8. Thoracic and respirable particle definitions for human health risk assessment

    Science.gov (United States)

    Provides estimates of the thoracic and respirable fractions, for adults and children during typical activities during both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of evidence of health effects.

  9. Assessing health consumerism on the Web: a demographic profile of information-seeking behaviors.

    Science.gov (United States)

    Lorence, Daniel P; Park, Heeyoung; Fox, Susannah

    2006-08-01

    The growing diversity of the online health information community is increasingly cited as a limiting factor related to the potential of the Internet as an effective health communication channel and information resource. Public-access Internet portals and decreasing costs of personal computers have created a consensus that unequal access to information, or a "Digital Divide," presents a like problem specific to health care consumers. Access to information, however, is an essential part of the consumer-centric framework outlined in the recently proposed U.S. National Health Information Infrastructure (NHII) and Health Architecture initiatives. To date little research has been done to differentiate the types of health information sought on the Web by different subgroups, linking user characteristics and health-seeking behaviors. Data from a study of consumer Web search activity in a post-intervention era serves as a natural experiment, and can identify whether a "digitally underserved group" persists in the United States. Such an environment would serve to exclude traditionally underserved groups from the benefits of the planned national heath information infrastructure. This exploratory technology assessment study seeks to differentiate and delineate specific behaviors, or lack of desired behaviors, across targeted health care subgroups. Doing so allows the design of more effective strategies to promote the use of the Web as a health education and health promotion tool, under the envisioned shared decision-making, consumer-centric health information model.

  10. Testing a health impact assessment tool by assessing community opinion about a public park.

    Science.gov (United States)

    Hengpraprom, Sarunya; Bualert, Surat; Sithisarankul, Pornchai

    2012-01-01

    The purpose of this study was to assess a health impact assessment (HIA) tool to determine the perceived health impact by the public of a public park. The authors conducted a cross-sectional study from March to April, 2011, using this HIA questionnaire to collect data and through focus group discussions. We also assessed community concerns about the park and obtained recommendations of how to mitigate possible negative aspects of the parks. Four aspects were listed as possible benefits of the park: physical, mental, social, and spiritual health. The negative aspects mentioned by participants were that a park could be a potential place of assembly for teenagers, a place for theft and crime and accidents among children. The HIA tool used for this research seemed appropriate. The next challenge is to use this tool to assess a more controversial project.

  11. Health Effects and Energy Choices

    Science.gov (United States)

    Newill, Vaun A.

    1975-01-01

    The United States will continue to have a high energy demand to maintain our present life style. The development of a national health policy statement that would serve to coordinate federal programs for research and regulation of environmental health is suggested. (BT)

  12. Oxidant pollution - Effects on health

    Energy Technology Data Exchange (ETDEWEB)

    Bignon, J.

    Oxidizing pollution consists of air-borne gaseous, liquid and particle pollutants acting like reducing agents that can react with oxygen to produce toxic derivatives: superoxide anion, hydrogen peroxide, hydroxyl radicles and other free radicles. The major oxidizing gaseous pollutants are NO/sub x,/ particularly NO/sub 2/, ozone and photo-oxidizing agents as derivatives. Epidemiological studies have generally failed to show any significant relation between NO/sub 2/ concentration and respiratory disorders. Correlations are better with SO/sub 2/ and total suspended particles. In certain very sunny areas with high ozone levels, there is a link between O/sub 3/ concentration and respiratory disorders. Controlled trials comparing healthy and asthmatic volunteers have given variable results with highly raised bronchoreactivity at concentrations of 0.1 to 0.2 ppm NO/sub 2/ and 0.25 ppm O/sub 3/ for 1 to 2 hours in about half the studies. Using this data, the World Health Organisation (WHO) has established maximum exposure levels. Numerous investigations on exposure of animals to NO/sub 2/ and ozone have been performed using rodents, the dog, the cat and the primate. At concentrations close to peak urban air pollution levels various biochemical and cellular changes in the respiratory apparatus are generally observed. The areas most affected by NO/sub 2/ and ozone are the peripheral airways with distal stenosal bronchiolitis. NO/sub 2/ led to emphysematous lesions and O/sub 3/ to fibrosal hyperplasic lesions in alveolar tissue. Short bursts at high levels were generally more toxic than long exposure at low levels. There is an additive effect between NO/sub 2/ and ozone and with other pollutants. Exposure to nitrogen dioxide and ozone is conducive to bacterial and viral infection. Results for genitotoxicity and carcinogenic effects produced by NO/sub 2/ and ozone have hitherto been inconclusive.

  13. Implementation of health impact assessment in Danish municipal context

    DEFF Research Database (Denmark)

    Kraemer, Stella R. J.; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-01-01

    Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health...... and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance....... Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level....

  14. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

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

    2016-08-01

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

  15. 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

  16. 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.

  17. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND 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...

  18. 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.

  19. Who comes to a workplace health risk assessment?

    Science.gov (United States)

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

    1998-01-01

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

  20. 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

  1. 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

  2. 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

  3. Can migration health assessments become a mechanism for global public health good?

    Science.gov (United States)

    Wickramage, Kolitha; Mosca, Davide

    2014-09-26

    Migrant health assessments (HAs) consist of a medical examination to assess a migrant's health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and migrant HA processors at the country level are needed to shift these from being limited as an instrument of determining non-admissibility for purposes of visa issuance, to a process that may enhance public health. The importance of providing appropriate care and follow-up of migrants who "fail" their HA and the need for global efforts to enable data-collection and research on HAs are also highlighted.

  4. A review of data quality assessment methods for public health information systems.

    Science.gov (United States)

    Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

    2014-05-14

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

  5. Acquired and Participatory Competencies in Health Professions Education: Definition and Assessment in Global Health.

    Science.gov (United States)

    Eichbaum, Quentin

    2016-09-06

    Many health professions education programs in high-income countries (HICs) have adopted a competency-based approach to learning. Although global health programs have followed this trend, defining and assessing competencies has proven problematic, particularly in resource-constrained settings of low- and middle-income countries (LMICs) where HIC students and trainees perform elective work. In part, this is due to programs failing to take sufficient account of local learning, cultural, and health contexts.A major divide between HIC and LMIC settings is that the learning contexts of HICs are predominantly individualist, whereas those of LMICs are generally collectivist. Individualist cultures view learning as something that the individual acquires independent of context and can possess; collectivist cultures view learning as arising dynamically from specific contexts through group participation.To bridge the individualist-collectivist learning divide, the author proposes that competencies be classified as either acquired or participatory. Acquired competencies can be transferred across contexts and assessed using traditional psychometric approaches; participatory competencies are linked to contexts and require alternative assessment approaches. The author proposes assessing participatory competencies through the approach of self-directed assessment seeking, which includes multiple members of the health care team as assessors.The proposed classification of competencies as acquired or participatory may apply across health professions. The author suggests advancing participatory competencies through mental models of sharing. In global health education, the author recommends developing three new competency domains rooted in participatory learning, collectivism, and sharing: resourceful learning; transprofessionalism and transformative learning; and social justice and health equity.

  6. 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.

  7. 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.

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

    Science.gov (United States)

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

    2012-01-01

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

  9. Developing a tool for assessing public health law in countries.

    Science.gov (United States)

    Kim, So Yoon; Lee, Yuri; Sohn, Myongsei; Hahm, Ki-Hyun

    2012-09-01

    At present, the World Health Organization (WHO) is in the process of developing a tool designed to assess the status of public health legislation in a given country. An Expert Consultation on Public Health Law was convened in Manila, Philippines, in May 2011. The participants agreed that the tool could serve as a guide for a regional approach to assist Member States in assessing the scope, completeness, and adequacy of their public health law. Given the broad definition of "public health" and the laws that affect health, directly or indirectly, the participants further agreed to narrow the field to 4 areas based on significant WHO works/policies, each organized into an independent module: (1) International Digest on Health Law, (2) Primary Health Care, (3) International Health Regulations 2005, and (4) Framework Convention on Tobacco Control. The tool would be drafted in a questionnaire format that asks the respondent to determine whether primary and/or subsidiary legislation exists in the country on a specific topic and, if so, to cite the relevant law, describe the pertinent points, and attach and/or link to the full text where available. The participants agreed that the respondents should include government officials and/or academics with legal competency. Version 1 of the tool was piloted in the Philippines, the Republic of Korea, Samoa, and Vanuatu. At a 2nd Expert Consultation on Public Health Law, convened in Incheon, Republic of Korea, in October 2011, in conjunction with the 43rd Conference of the Asia-Pacific Academic Consortium on Public Health, the participants determined that the tool was generally usable, certain concerns notwithstanding, such as the risk of standardizing compliance with WHO policies. The agreed next step is to finalize the analysis tool by August 2012, marking the end of stage I in the development process. Stage II will consist of team building and networking of responsible officers and/or professionals in the countries. The tool

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Integration of health and environment through health impact assessment: cases from three continents.

    Science.gov (United States)

    Negev, Maya; Levine, Hagai; Davidovitch, Nadav; Bhatia, Rajiv; Mindell, Jennifer

    2012-04-01

    Despite the strong linkage between environment and health, institutions responsible for these fields operate in largely fragmented ways with limited interaction. As illustrated in the recent engagement between health and urban planning institutions, inter-institutional cooperation could support more effective and politically acceptable solutions for both local and global problems. Analysis of three case-studies, from three different continents, shows that HIA might serve to promote synergies among health and environmental disciplines in different local contexts, and could lead to institutional and procedural changes that promote health. Case examples provided supportive evidence for these effects, despite differences in approaches to HIA and governance levels. Obstacles to the use of HIA for inter-institutional integration also differed between countries. Lessons learned could support cooperation in other common interests of health and environment disciplines such as research, training and preparedness, and mitigation of public health emergencies related to the environment.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Farin Fatemi

    2013-09-01

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

  17. Enriching Mental Health Mobile Assessment and Intervention with Situation Awareness

    Directory of Open Access Journals (Sweden)

    Ariel Soares Teles

    2017-01-01

    Full Text Available Current mobile devices allow the execution of sophisticated applications with the capacity for identifying the user situation, which can be helpful in treatments of mental disorders. In this paper, we present SituMan, a solution that provides situation awareness to MoodBuster, an ecological momentary assessment and intervention mobile application used to request self-assessments from patients in depression treatments. SituMan has a fuzzy inference engine to identify patient situations using context data gathered from the sensors embedded in mobile devices. Situations are specified jointly by the patient and mental health professional, and they can represent the patient’s daily routine (e.g., “studying”, “at work”, “working out”. MoodBuster requests mental status self-assessments from patients at adequate moments using situation awareness. In addition, SituMan saves and displays patient situations in a summary, delivering them for consultation by mental health professionals. A first experimental evaluation was performed to assess the user satisfaction with the approaches to define and identify situations. This experiment showed that SituMan was well evaluated in both criteria. A second experiment was performed to assess the accuracy of the fuzzy engine to infer situations. Results from the second experiment showed that the fuzzy inference engine has a good accuracy to identify situations.

  18. Aluminium: Food-related health risk assessment of the consumers

    Directory of Open Access Journals (Sweden)

    О.V. Bagryantseva

    2016-03-01

    Full Text Available Aluminum is the most abundant metal in the lithosphere, constituting 8 % of the earth's crust. Aluminum enters the food from the various objects of environment such as water, food contact materials (packaging materials, cooking vessels, aluminum-containing food additives. In raw food products the content of aluminum is less than 5.7 mg/kg of the product. Normally, aluminum is not practically found in a human body. However, within the last decade various toxic effects of aluminum on human body have been revealed, and they are able to cause the risk of various diseases. The analysis of the available data has demonstrated that the excessive entry of aluminum in human body with food items is associated first of all with the content of aluminum-containing food additives, as well as with the use of materials and products made of aluminum and its alloys intended for contact with food. High level of aluminum consumption has been also detected among children of all ages. At the same time, today, theprovisional tolerable weekly intake (PTWI of aluminum for children is not established. To reduce negative effect of aluminum on human body it is necessary to: * exclude from the list of Annex 2 of the Technical Regulations of the Customs Union "Requirements for Food Additives, Flavorings and Technological Aids” (TR TS 029/2012 the following food additives – potassium aluminum silicate (E555, bentonite (E558, sodium aluminum silicate (E554, potassium aluminum silicate (E555, calcium aluminum silicate (E556, aluminum silicate (kaolin (E559; * to develop requirements for the aluminum content in food products intended for children nutrition; * to obtain data on aluminum content in food items sold on the domestic market and to assess health risks to consumers.

  19. Qualia: A Prescription for Developing a Quality Health Threat Assessment

    Science.gov (United States)

    2008-12-01

    Figure 10. Health Threat Assessment Strategy Canvas . (From: Kim and Mauborgne, 2005, p. 29...cost (p. 13). The development of a blue ocean strategy canvas includes consideration of four factors. These factors answer the questions, “What...is that of a starfish as opposed to that of a spider . The starfish organization represents a network of nodes that will continue to thrive if a leg

  20. 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...

  1. Complexity theory and geographies of health: a critical assessment.

    Science.gov (United States)

    Gatrell, Anthony C

    2005-06-01

    The interest of social scientists in complexity theory has developed rapidly in recent years. Here, I consider briefly the primary characteristics of complexity theory, with particular emphasis given to relations and networks, non-linearity, emergence, and hybrids. I assess the 'added value' compared with other, existing perspectives that emphasise relationality and connectedness. I also consider the philosophical underpinnings of complexity theory and its reliance on metaphor. As a vehicle for moving away from reductionist accounts, complexity theory potentially has much to say to those interested in research on health inequalities, spatial diffusion, emerging and resurgent infections, and risk. These and other applications in health geography that have invoked complexity theory are examined in the paper. Finally, I consider some of the missing elements in complexity theory and argue that while it is refreshing to see a fruitful line of theoretical debate in health geography, we need good empirical work to illuminate it.

  2. Molecular biomarkers to assess health risks due to environmental contaminants exposure.

    Science.gov (United States)

    Poblete-Naredo, Irais; Albores, Arnulfo

    2016-06-03

    Biomarkers, or bioindicators, are metric tools that, when compared with reference values, allow specialists to perform risk assessments and provide objective information to decision makers to design effective strategies to solve health or environmental problems by efficiently using the resources assigned. Health risk assessment is a multidisciplinary exercise, and molecular biology is a discipline that greatly contributes to these evaluations because the genome, transcriptome, proteome and metabolome could be affected by xenobiotics causing measurable changes that might be useful biomarkers. Such changes may greatly depend on individual genetic background; therefore, the polymorphic distribution of exposed populations becomes an essential feature for adequate data interpretation. The aim of this paper is to offer an up-to-date review of the role of different molecular biomarkers in health risk assessments.

  3. 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.

  4. Fuzzy assessment of health information system users' security awareness.

    Science.gov (United States)

    Aydın, Özlem Müge; Chouseinoglou, Oumout

    2013-12-01

    Health information systems (HIS) are a specific area of information systems (IS), where critical patient data is stored and quality health service is only realized with the correct use and efficient dissemination of this data to health workers. Therefore, a balance needs to be established between the levels of security and flow of information on HIS. Instead of implementing higher levels and further mechanisms of control to increase the security of HIS, it is preferable to deal with the arguably weakest link on HIS chain with respect to security: HIS users. In order to provide solutions and approaches for transforming users to the first line of defense in HIS but also to employ capable and appropriate candidates from the pool of newly graduated students, it is important to assess and evaluate the security awareness levels and characteristics of these existing and future users. This study aims to provide a new perspective to understand the phenomenon of security awareness of HIS users with the use of fuzzy analysis, and to assess the present situation of current and future HIS users of a leading medical and educational institution of Turkey, with respect to their security characteristics based on four different security scales. The results of the fuzzy analysis, the guide on how to implement this fuzzy analysis to any health institution and how to read and interpret these results, together with the possible implications of these results to the organization are provided.

  5. Optical methodology for the health assessment of power transformers

    Science.gov (United States)

    Palmer, John A.; Wang, Xianghui; Shoureshi, Rahmat A.; Mander, Arthur A.; Torgerson, Duane

    2000-06-01

    Among the most critical components in the electric power system is the power transformer. As such, a significant body of research has been put forward to attempt to anticipate the needs for maintenance to be performed. Traditional health assessment has required sampling of oil for submission to a laboratory for analysis, but this has been deemed undesirable in light of budgetary constraints on maintenance staffing, and new predictive maintenance philosophies for substation equipment. A number of processes have been developed in recent years for online health assessment of transformers, most of which have focused on dissolved gas analysis. This paper describes a novel optical methodology for on-line transformer health assessment that utilizes an ultraviolet absorption measurement to identify the degradation of the transformer oil. An optical system was selected because of its immunity to the electromagnetic noise typical of substations, and because of the minimal impact that non-conducting materials have on the insulation system design of the transformer. The system is designed to identify deterioration and premature aging resulting from overheating, low level arcing or excessive exposure to atmospheric air. The system consists of a light source, filter, guide and detection components, and a very simple computational requirement. The measurements performed with the prototype system are validated with a high precision spectrophotometry measurement and an independent oil-testing laboratory.

  6. 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.

  7. The Health Technology Assessment of companion diagnostics: experience of NICE.

    Science.gov (United States)

    Byron, Sarah K; Crabb, Nick; George, Elisabeth; Marlow, Mirella; Newland, Adrian

    2014-03-15

    Companion diagnostics are used to aid clinical decision making to identify patients who are most likely to respond to treatment. They are becoming increasingly important as more new pharmaceuticals receive licensed indications that require the use of a companion diagnostic to identify the appropriate patient subgroup for treatment. These pharmaceuticals have proven benefit in the treatment of some cancers and other diseases, and also have potential to precisely tailor treatments to the individual in the future. However, the increasing use of companion diagnostics could place a substantial burden on health system resources to provide potentially high volumes of testing. This situation, in part, has led policy makers and Health Technology Assessment (HTA) bodies to review the policies and methods used to make reimbursement decisions for pharmaceuticals requiring companion diagnostics. The assessment of a pharmaceutical alongside the companion diagnostic used in the clinical trials may be relatively straightforward, although there are a number of challenges associated with assessing pharmaceuticals where a range of alternative companion diagnostics are available for use in routine clinical practice. The UK HTA body, the National Institute for Health and Care Excellence (NICE), has developed policy for considering companion diagnostics using its Technology Appraisal and Diagnostics Assessment Programs. Some HTA bodies in other countries have also adapted their policies and methods to accommodate the assessment of companion diagnostics. Here, we provide insight into the HTA of companion diagnostics for reimbursement decisions and how the associated challenges are being addressed, in particular by NICE. See all articles in this CCR Focus section, "The Precision Medicine Conundrum: Approaches to Companion Diagnostic Co-development."

  8. 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…

  9. Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

    Science.gov (United States)

    Cookson, Richard; Mirelman, Andrew J; Griffin, Susan; Asaria, Miqdad; Dawkins, Bryony; Norheim, Ole Frithjof; Verguet, Stéphane; J Culyer, Anthony

    2017-02-01

    This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and-crucially-who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs.

  10. [Evaluation of the effectiveness of health care].

    Science.gov (United States)

    Strnad, L

    1990-01-01

    health workers and community as a whole. Besides the needful enlargement of sources, these complicated questions are resolvable in observing unity of medical, organizational and economical rationality on all levels of health service management and in all health institutions. This is also the way how to improve the efficiency of health care. The term of efficiency in relation to the health services. In economics, the efficiency is the ratio between the achieved result (effect) and the expenditure of a specified amount of resources. Mathematically, this ratio is expressed as follows: efficiency = end-result/costs Linked to the Health care, the efficiency may be understood also differently from its economic term.(ABSTRACT TRUNCATED AT 400 WORDS)

  11. 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

  12. 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.

  13. Effects of lifetime stress exposure on mental and physical health in young adulthood: How stress degrades and forgiveness protects health.

    Science.gov (United States)

    Toussaint, Loren; Shields, Grant S; Dorn, Gabriel; Slavich, George M

    2016-06-01

    To examine risk and resilience factors that affect health, lifetime stress exposure histories, dispositional forgiveness levels, and mental and physical health were assessed in 148 young adults. Greater lifetime stress severity and lower levels of forgiveness each uniquely predicted worse mental and physical health. Analyses also revealed a graded Stress × Forgiveness interaction effect, wherein associations between stress and mental health were weaker for persons exhibiting more forgiveness. These data are the first to elucidate the interactive effects of cumulative stress severity and forgiveness on health, and suggest that developing a more forgiving coping style may help minimize stress-related disorders.

  14. 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. 

  15. 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…

  16. An overview of health effects on noise

    Science.gov (United States)

    Osada, Y.

    1988-12-01

    Although noise can damage the inner ear and cause other pathological changes, its most common negative effects are non-somatic, such as a perception of noisiness and disturbance of daily activities. According to the definition of health by WHO, this should be considered as a health hazard. These health effects of noise can be classified into the following three categories: (I) hearing loss, perception of noisiness and masking are produced along the auditory pathway and are thus direct and specific effects of noise; (II) interference with performance, rest and sleep, a feeling of discomfort and some physiological effects are produced as indirect and non-specific effects via reticular formation of the midbrain; (III) annoyance is not merely a feeling of unpleasantness but the feeling of being bothered or troubled, and includes the development of a particular attitude toward the noise source. Individual or group behavioral responses will be evoked when annoyance develops. Annoyance and behavioral response are integrated and composite effects. The health effects of noise are modified by many factors related to both the noise and the individual. Noise level, frequency spectrum, duration and impulsiveness modify the effects. Sex, age, health status and mental character also have an influence on the effects. Direct effects of noise are most dependent on the physical nature of the noise and least dependent on human factors. Indirect effects are more dependent, and integrated effects most dependent, on human factors.

  17. 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.

  18. 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.

  19. Health technology assessment demonstrates efficient health promotion bu Transcendental Meditation (TM)

    DEFF Research Database (Denmark)

    Larsen, Torben

    2002-01-01

    -practitioners and controls without specific health promotion. The TM-group has a relative high level of education. TM is organized as a private, standardised dissemination of the original, Indoeuropean mantrameditation. This standardisation creates economies-of-scale 1) using local instructors with a short education, 2......BACKGROUND/OBJECTIVES: Health Technology Assessment of mantrameditation implemented as Transcendental Meditation (TM) METHODS: MEDLINE contains October 2001 335 titles on 'Transcendental Meditation' including various metaanalyses and a series of randomised, controlled trials: In summary......-actualisation; (3) Independence of stimulantia including tobacco and alcohol; (4) Cardiologic health. RESULTS: This health promotion is explained by a cybernetic model based on 'The Limbic System'. A sample of records collected by the Internet shows significant compliance between the self-reports of TM...

  20. The problems related to confidentiality and effectiveness of health care.

    Science.gov (United States)

    Scherrer, J R

    1983-08-01

    The problem of the impact of confidentiality on health effectiveness is discussed along five points: (1) Communication facilities between health departments are main features of health information systems. (2) Efforts, costs, limits of data protection. The privacy violation risks have to be related to the data protection costs. (3) Paradox of the fundamental rights to confidentiality regarding privacy of the individual and the preponderant interest of the State. (4) Facing the increasing health costs, the need for medical and hospital control systems is assessed. (5) New benefits in medicine and in the quality of care are partly the results of more or less extensive studies in epidemiology at national levels. The general conclusion is concerned with the risks that the computer could become an instrumental substitute for human reason with the progressive drop out of responsibility of health officers.

  1. Bridging the gap between policy and science in assessing the health status of marine ecosystems

    Directory of Open Access Journals (Sweden)

    Angel Borja

    2016-09-01

    Full Text Available Human activities, both established and emerging, increasingly affect the provision of marine ecosystem services that deliver societal and economic benefits. Monitoring the status of marine ecosystems and determining how human activities change their capacity to sustain benefits for society requires an evidence-based Integrated Ecosystem Assessment approach that incorporates knowledge of ecosystem functioning and services. Although there are diverse methods to assess the status of individual ecosystem components, none assesses the health of marine ecosystems holistically, integrating information from multiple ecosystem components. Similarly, while acknowledging the availability of several methods to measure single pressures and assess their impacts, evaluation of cumulative effects of multiple pressures remains scarce. Therefore, an integrative assessment requires us to first understand the response of marine ecosystems to human activities and their pressures and then develop innovative, cost-effective monitoring tools that enable collection of data to assess the health status of large marine areas. Conceptually, combining this knowledge of effective monitoring methods with cost-benefit analyses will help identify appropriate management measures to improve environmental status economically and efficiently. The European project DEVOTES (DEVelopment Of innovative Tools for understanding marine biodiversity and assessing good Environmental Status specifically addressed these topics in order to support policy makers and managers in implementing the European Marine Strategy Framework Directive. Here, we synthesize our main innovative findings, placing these within the context of recent wider research, and identifying gaps and the major future challenges.

  2. 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

  3. Physical Health Effects of Intimate Partner Abuse

    Science.gov (United States)

    Sillito, Carrie LeFevre

    2012-01-01

    Although intimate partner violence has been recognized as both a social problem and health issue, the extent to which it is a health issue for both males and females in the general population is largely unknown. This longitudinal research uses data from the National Survey of Family and Households (1987-2003). Random effects logistic regression…

  4. 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...

  5. 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.

  6. Mental health learning needs assessment: competency-based instrument for best practice.

    Science.gov (United States)

    McKnight, Sylvia E

    2013-06-01

    A learning needs assessment focused on psychiatric/mental health nursing competency development is a central component of nursing education in specialty mental health nursing practice. The provision of education for mental health nursing relies on the underlying assumption that the learning needs of experienced mental health nurses have been assessed and educational programs implemented to address educational needs for competency in professional practice. Few professional learning needs assessments have been developed to identify learning needs in mental health nursing practice. The majority of available professional learning needs assessments focus on medical nursing practice applications rather than the psychosocial aspects of a mental health assessment. The mental health field addresses very different assessment criteria such as knowledge of suicide assessment and therapeutic interventions. The purpose of this article is to present and describe the process of developing a learning needs assessment focused on competency development for the specialty practice of mental health nursing that addresses and resolves complex learning needs.

  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. 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.

  9. 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.

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

    Science.gov (United States)

    Duarte, C; Ruperto, N; Goycochea, M V; Maldonado, R; Beristain, R; De Inocencio, J; Burgos-Vargas, R

    2001-01-01

    We report herein the results of the cross-cultural adaptation and validation into the Mexican 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 Mexican CHAQ was already published and therefore it was revalidated while the Mexican CHQ was derived from the European Spanish version with changing of the few words whose use is different in the 2 countries. A total of 182 subjects were enrolled: 89 patients with JIA (26% systemic onset, 47% polyarticular onset, 13.5% extended oligoarticular subtype, and 13.5% persistent oligoarticular subtype) and 93 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, and polyarticular onset 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, and polyarticular onset having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Mexican version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Tiago Ricardo Moreira

    2016-01-01

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

  16. [An assessment of fiscal space for public health in Peru].

    Science.gov (United States)

    Matus-López, Mauricio; Toledo, Lorena Prieto; Pedraza, Camilo Cid

    2016-08-01

    Objective To assess the fiscal space for public health in Peru so as to attain the goal of raising health spending to 6% of gross domestic product, as agreed upon by member countries of the Pan American Health Organization in 2014. Methods The main sources of fiscal space were identified by means of a thorough literature review. Technical feasibility was determined from statistics and national and international surveys and by reviewing various documents and official reports. Political feasibility was ascertained by studying policy guidelines. Results The sources showing the greatest technical and political feasibility are economic growth, a broadening of the personal income tax base, and an increase in tobacco-specific taxes. Decreasing informality in the job market and increasing contributory coverage are considered to be less politically feasible, but there is ample technical space for these measures. Conclusions There is enough fiscal space to allow for an increase in public health spending. Nevertheless, the 6% target will be reached only if the timeline is extended, tax revenues are increased, and informality in the job market is reduced.

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. Application of ecological momentary assessment in workplace health evaluation.

    Science.gov (United States)

    Engelen, Lina; Chau, Josephine Y; Burks-Young, Sarah; Bauman, Adrian

    2016-08-31

    Issue addressed: Ecological momentary assessment (EMA) involves repeated sampling of current behaviours and experiences in real-time at random intervals. EMA is an innovative measurement method for program evaluation, using mobile technology (e.g. smartphones) to collect valid contextual health promotion data with good compliance. The present study examined the feasibility of using EMA for measuring workplace health outcomes.Methods: Twenty-two office-based adults were prompted at four random times per work-day during a 5-day period to respond to a short survey via a smartphone application. The prompting stopped when participants had either responded 12 times or the 5-day period had ended. The questions pertained to posture, task currently being undertaken, social interactions, musculoskeletal issues, mood, and perceptions of engagement and creativity.Results: In total 156 responses were collected. Nine participants completed all 12 surveys; the average completion rate was 58% (7/12). The average completion time was initially 50s and reduced to 24s during the later surveys. On average the participants were sitting and standing in 79% and 14% of survey instances, respectively. The participants reported they were working alone at their desks in 68% of instances. Reported productivity and stress were on average 6 and 3 out of 10, respectively, but varied up to 6-8 points within one person, hence the method appears sensitive to temporal variations in perceptions and mood.Conclusion: Given the rich real-time data, minimal participant burden and use of readily available technology, EMA has substantial potential in workplace health promotion evaluation through the measurement of participants' well being, activities, and behaviour change.So what?: An in-the-moment method using readily available mobile technology to assess participants' perceptions, mood and activity that provides rich information with minimal participant burden is a promising way to evaluate future health

  2. 78 FR 12764 - Draft Office of Health Assessment and Translation Approach for Systematic Review and Evidence...

    Science.gov (United States)

    2013-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Draft Office of Health Assessment and Translation Approach... comments on the Draft Office of Health Assessment and Translation (OHAT) Approach for Systematic Review...

  3. 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.

  4. 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.

  5. Health Risk Assessment for Cyanobacterial Toxins in Seafood

    Directory of Open Access Journals (Sweden)

    Andrew Humpage

    2012-03-01

    Full Text Available Cyanobacteria (blue-green algae are abundant in fresh, brackish and marine waters worldwide. When toxins produced by cyanobacteria are present in the aquatic environment, seafood harvested from these waters may present a health hazard to consumers. Toxicity hazards from seafood have been internationally recognised when the source is from marine algae (dinoflagellates and diatoms, but to date few risk assessments for cyanobacterial toxins in seafood have been presented. This paper estimates risk from seafood contaminated by cyanobacterial toxins, and provides guidelines for safe human consumption.

  6. Assessing framing assumptions in quantitative health impact assessments: a housing intervention example.

    Science.gov (United States)

    Mesa-Frias, Marco; Chalabi, Zaid; Foss, Anna M

    2013-09-01

    Health impact assessment (HIA) is often used to determine ex ante the health impact of an environmental policy or an environmental intervention. Underpinning any HIA is the framing assumption, which defines the causal pathways mapping environmental exposures to health outcomes. The sensitivity of the HIA to the framing assumptions is often ignored. A novel method based on fuzzy cognitive map (FCM) is developed to quantify the framing assumptions in the assessment stage of a HIA, and is then applied to a housing intervention (tightening insulation) as a case-study. Framing assumptions of the case-study were identified through a literature search of Ovid Medline (1948-2011). The FCM approach was used to identify the key variables that have the most influence in a HIA. Changes in air-tightness, ventilation, indoor air quality and mould/humidity have been identified as having the most influence on health. The FCM approach is widely applicable and can be used to inform the formulation of the framing assumptions in any quantitative HIA of environmental interventions. We argue that it is necessary to explore and quantify framing assumptions prior to conducting a detailed quantitative HIA during the assessment stage.

  7. 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.

  8. Patients' perspectives in health technology assessment: a route to robust evidence and fair deliberation.

    Science.gov (United States)

    Facey, Karen; Boivin, Antoine; Gracia, Javier; Hansen, Helle Ploug; Lo Scalzo, Alessandra; Mossman, Jean; Single, Ann

    2010-07-01

    There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients' views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients' perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients' perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients' perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.

  9. Should mental health assessments be integral to domestic violence research?

    Science.gov (United States)

    Satyanarayana, Veena A; Chandra, Prabha S

    2009-01-01

    Research on sensitive issues such as abuse and violence in vulnerable populations poses several ethical dilemmas. An important aspect is the impact of such enquiries on one's mental health. This paper discusses specific ethical issues related to mental health based on violence research conducted and reviewed by the authors. Research on violence among women includes the possibility that some revelations are occurring for the first time and are likely to be emotionally charged. Further, the very act of disclosure may involve emotional risks for the respondent. Psychological distress may be present prior to, during, or following the study. Hence assessing mental health parameters becomes essential and integral to research of this nature. Several issues in methodology are also important in mitigating the level of distress. Research on sensitive issues should either use measures developed in the same culture or those with adequate adaptation. The order of questions, language and method of termination of the interview may often make a difference to its psychological impact. While focus group discussions and semi structured interview schedules are most suited, questionnaires with a less structured and rigid approach may also be used. Preludes may be introduced to facilitate transition between different sections of an interview schedule and to provide a rationale for further enquiry. Obtaining informed consent in violence research should be a process rather than a one-time formality. Reports of adverse events are likely in violence research and hence such studies must include mental health intervention, ongoing follow up, documentation and appropriate referral services. Finally, since the researcher and the subject of the research are both affected in a study of this nature, adequate sensitisation, ongoing training and supervision of research staff are essential. Based on findings from ongoing research on violence and from review of other studies done in India, the paper

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. NTP monograph on health effects of low-level lead.

    Science.gov (United States)

    2012-06-01

    Although reductions in lead (Pb) exposure for the U.S. population have resulted in lower blood Pb levels over time, epidemiological studies continue to provide evidence of health effects at lower and lower blood Pb levels. Low-level Pb was selected for evaluation by the National Toxicology Program (NTP) because of (1) the availability of a large number of epidemiological studies of Pb, (2) a nomination by the National Institute for Occupational Safety and Health for an assessment of Pb at lower levels of exposure, and (3) public concern for effects of Pb in children and adults. This evaluation summarizes the evidence in humans and presents conclusions on health effects in children and adults associated with low-level Pb exposure as indicated by less than 10 micrograms of Pb per deciliter of blood (Monograph on Health Effects of Low-Level Lead. The document and appendices are available at http://ntp.niehs.nih.gov/go/evals. This document provides background on Pb exposure and includes a review of the primary epidemiological literature for evidence that low-level Pb is associated with neurological, immunological, cardiovascular, renal, and/or reproductive and developmental effects. The NTP Monograph presents specific conclusions for each health effect area. Overall, the NTP concludes that there is sufficient evidence that blood Pb levels Monograph on November 17-18, 2011 (http://ntp.niehs.nih.gov/go/37090.

  15. Effect of fasting on mental health in the general population of Kermanshah, Iran.

    OpenAIRE

    Seyed Ali Mousavi; Mansour Rezaei; Sahar Amiri Baghni; Maryam Seifi

    2014-01-01

    Objectives: Multiple studies have noted the positive effect of fasting on mental health improvement. The present study was conducted to determine the effect of fasting on mental health in the general population of Kermanshah, Iran. Methods: In this analytical research, one-group pretest-posttest design was used for the evaluation of 110 residents of Kermanshah city. General Health Questionnaire (GHQ) with four subscales was utilized in order to assess the subjects’ mental health. Data were an...

  16. Mapping cumulative environmental effects, social vulnerability, and health in the San Joaquin Valley, California.

    Science.gov (United States)

    Huang, Ganlin; London, Jonathan

    2012-05-01

    To understand the social distribution of environmental hazards, methods to assess cumulative effects and their health implications are needed. We developed a cumulative environmental hazard index integrating environmental data on pollution sites, air quality, and pesticide use; a social vulnerability index to measure residents' resources to prevent or mitigate health effects; and a health index. We found that communities in California's San Joaquin Valley with high social vulnerability face more environmental burdens and have worse health conditions.

  17. 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.

  18. Advanced korean industrial safety and health policy with risk assessment.

    Science.gov (United States)

    Kwon, Hyuckmyun; Cho, Jae Hyun; Moon, Il; Choi, Jaewook; Park, Dooyong; Lee, Youngsoon

    2010-09-01

    This article describes a systematic roadmap master plan for advanced industrial safety and health policy in Korea, with an emphasis on. Since Korean industries had first emergence of industrial safety and health policy in 1953, enormous efforts have been made on upgrading the relevant laws in order to reflect real situation of industrial work environment in accordance with rapid changes of Korean and global business over three decades. Nevertheless, current policy has major defects; too much techniques-based articles, diverged contents in less organization, combined enforcement and punishments and finally enforcing regulations full of commands and control. These deficiencies have make it difficult to accommodate changes of social, industrial and employment environment in customized fashion. The approach to the solution must be generic at the level of paradigm-shift rather than local modifications and enhancement. The basic idea is to establish a new system integrated with a risk assessment scheme, which encourages employers to apply to their work environment under comprehensive responsibility. The risk assessment scheme is designed to enable to inspect employers' compliances afterwards. A project comprises four yearly phases based on applying zones; initially designating and operating a specified risk zone, gradually expanding the special zones during a period of 3 years (2010-2012) and the final zone expanded to entire nation. In each phase, the intermediate version of the system is updated through a process of precise and unbiased validation in terms of its operability, feasibility and sustainability with building relevant infrastructures as needed.

  19. 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

  20. 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.

  1. 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

  2. Why ethics should be part of health technology assessment.

    Science.gov (United States)

    Hofmann, Bjørn Morten

    2008-01-01

    From the heydays of HTA in the 1970s, it has been argued that ethics should be a part of HTA. Despite more than 30 years with repeated intentions, only few HTA reports include ethical analysis, and there is little agreement on methods for integrating ethics. This poses the question of why it is so important to integrate ethics in HTA? The article analyzes ten arguments for making ethics part of HTA. The validity of the arguments depend on what we mean by "integrating," "ethics," and "HTA." Some of the counterarguments explain why it has taken so long to integrate ethics in HTA and why there are so many ethical approaches. Nevertheless, some of the arguments for making ethics part of HTA appear to be compelling. Health care is a moral endeavor, and the vast potential of technology poses complex moral challenges. A thorough assessment of technology would include reflection on these moral aspects. Ethics provides such a moral reflection. Health technology is a way to improve the life of human individuals. This involves questions of what "the good life" is, and hence ethical issues. Trying to ignore such questions may inflict with the moral foundation of health care: to help people. Additionally, HTA is an evaluation, and as such also a reflection on values. Hence, there is a profound affinity between HTA and ethics. Accordingly, ethics cannot be "integrated" in HTA as ethics is already a constitutive part of HTA. However, ethics can be acknowledged and emphasized.

  3. 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.

  4. [Citizen participation in the context of health technology assessment].

    Science.gov (United States)

    Freile-Gutiérrez, Berenice

    2014-01-01

    Citizen participation is important in all economic sectors of the democratic world, as it is also in the field of health. This is due to the significant value of life and therefore enjoying this in a healthy condition. This paper seeks to provide an overview of public participation in the context of Health Technology Assessments (HTA), covering from conceptualization to practical experiences. Within the existing literature, the definitions and methodological aspects of the topic discussed are reviewed, as well as how citizen participation in HTA agencies is manifested, presenting barriers as well as enablers for public involvement. In the Chilean case, where there are no public participation experiences in the context of HTA, a review of these initiatives in the health care sector is performed. In light with the studies examined, it is concluded that there is much to advance in the concreteness of citizen participation in HTA's agencies; efforts at institutional level as well as from community organizations are needed. This review can be useful as an antecedent for countries that are considering incorporating HTA in the future.

  5. Public health genomics Relevance of genomics for individual health information management, health policy development and effective health services.

    Directory of Open Access Journals (Sweden)

    Angela Brand

    2006-12-01

    Full Text Available Healthcare delivery systems are facing fundamental challenges. New ways of organising theses systems based on the different needs of stakeholders’ are required to meet these challenges. While medicine is currently undergoing remarkable developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, the discussion about the relevance of genome-based information and technologies for the health care system as a whole and especially for public health is still in its infancy. The following article discusses the relevance of genome-based information and technologies for individual health information management, health policy development and effective health services.

  6. Health Workforce Development: A Needs Assessment Study in French Speaking African Countries

    Science.gov (United States)

    Chastonay, Philippe; Moretti, Roberto; Zesiger, Veronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

    2013-01-01

    In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential…

  7. Teaching Community Health Assessment Skills in a Problem-based Format.

    Science.gov (United States)

    Sass, Pamela; Edelsack, Pyser

    2001-01-01

    Describes a four-week rotation at the State University of New York Health Science Center in Brooklyn in which medical residents are taught community health assessment using a problem-based format. They use demographic and health data to create rates they believe will help to illuminate the health status and health issues of their assigned…

  8. Considerations in applying the general equilibrium approach to environmental health assessment.

    Science.gov (United States)

    Wan, Yue; Yang, Hong-Wei; Masui, Toshihiko

    2005-10-01

    There are currently two commonly used approaches to assessing economic impacts of health damage resulting from environmental pollution: human capital approach (HCA) and willingness-to-pay (WTP). WTP can be further divided into averted expenditure approach (AEA), hedonic wage approach (HWA), contingent valuation approach (CVA) and hedonic price approach (HPA). A general review of the principles behind these approaches by the authors indicates that these methods are incapable of unveiling the mechanism of health impact from the point of view of national economy. On a basis of economic system, the shocks brought about by health effects of environmental pollution change the labor supply and medical expenditure, which in turn affects the level of production activity in each sector and the total final consumption pattern of the society. The general equilibrium approach within the framework of macroeconomic theory is able to estimate the health impact on national economy comprehensively and objectively. Its mechanism and applicability are discussed in detail by the authors.

  9. Considerations in Applying the General Equilibrium Approach to Environmental Health Assessment

    Institute of Scientific and Technical Information of China (English)

    YUE WAN; HONG-WEI YANG; TOSHIHIKO MASUI

    2005-01-01

    There are currently two commonly used approaches to assessing economic impacts of health damage resulting from environmental pollution: human capital approach (HCA) and willingness-to-pay (WTP). WTP can be further divided into averted expenditure approach (AEA), hedonic wage approach (HWA), contingent valuation approach (CVA) and hedonic price approach (HPA). A general review of the principles behind these approaches by the authors indicates that these methods are incapable of unveiling the mechanism of health impact from the point of view of national economy. On a basis of economic system, the shocks brought about by health effects of environmental pollution change the labor supply and medical expenditure, which in turn affects the level of production activity in each sector and the total final consumption pattern of the society. The general equilibrium approach within the framework of macroeconomic theory is able to estimate the health impact on national economy comprehensively and objectively. Its mechanism and applicability are discussed in detail by the authors.

  10. 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.

  11. A Systematic Methodology for Gearbox Health Assessment and Fault Classification

    Directory of Open Access Journals (Sweden)

    Jay Lee

    2011-01-01

    Full Text Available A systematic methodology for gearbox health assessment and fault classification is developed and evaluated for 560 data sets of gearbox vibration data provided by the Prognostics and Health Management Society for the 2009 data challenge competition. A comprehensive set of signal processing and feature extraction methods are used to extract over 200 features, including features extracted from the raw time signal, time synchronous signal, wavelet decomposition signal, frequency domain spectrum, envelope spectrum, among others. A regime segmentation approach using the tachometer signal, a spectrum similarity metric, and gear mesh frequency peak information are used to segment the data by gear type, input shaft speed, and braking torque load. A health assessment method that finds the minimum feature vector sum in each regime is used to classify and find the 80 baseline healthy data sets. A fault diagnosis method based on a distance calculation from normal along with specific features correlated to different fault signatures is used to diagnosis specific faults. The fault diagnosis method is evaluated for the diagnosis of a gear tooth breakage, input shaft imbalance, bent shaft, bearing inner race defect, and bad key, and the method could be further extended for other faults as long as a set of features can be correlated with a known fault signature. Future work looks to further refine the distance calculation algorithm for fault diagnosis, as well as further evaluate other signal processing method such as the empirical mode decomposition to see if an improved set of features can be used to improve the fault diagnosis accuracy.

  12. 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.

  13. 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

  14. Assessing the Physical Activity of Health Volunteers Based on the Pender’s Health Promotion Model

    Directory of Open Access Journals (Sweden)

    Rahimian M.* MSc,

    2015-12-01

    Full Text Available Aims Physical inactivity has been identified as the 4th leading risk factor for global mortality causing an estimated of 3.2million deaths per year. This study aimed to assess the physical activity of health volunteers with Pender’s Health Promotion Model. Instrument & Methods This cross-sectional analytical study was performed on 80 health volunteers in Torbat-e-Jam City, Iran, in 2015. A researcher-made questionnaire with the following sections was used to gather data; perceived benefits, perceived barriers, selfefficacy, interpersonal influences, positive emotion, commitment, modeling and competing preferences. SPSS 16 sofware was used to analyze data by independent T, Pearson’s correlation coefficient and linear regression tests. Findings There was no significant difference between the scores according to educational levels, age groups, BMI score, marital status, habitat and experience as a health volunteer duration. Physical activity had positive correlation with perceived benefits, self-efficacy, commitment, positive emotion and situational influences and a negative correlation with perceived barriers. Situational influences, as the strongest predictor of the physical activity, predicted 35.1% of it and then positive emotions predicted 34.7% and self-efficacy predicted 23.4% of physical activity. Conclusion The level of physical activity in health volunteers of Torbat-e-Jam City, Iran, is not appropriate and is less than moderate.

  15. 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.

  16. 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.

  17. Why and how should we assess occupational health impacts in integrated product policy

    Energy Technology Data Exchange (ETDEWEB)

    Hofstetter, P.; Norris, G.A. [US EPA, Cincinnati, OH (USA). National Risk Management Research Laboratory

    2003-05-15

    Integrated product policy (IPP) and life cycle assessment (LCA) focus traditionally on environmental impacts. The authors investigated whether occupational health impacts should be included in LCA and IPP. using data from 491 industry sectors including supply chain impacts, occupational health impacts being measured in disability adjusted life years (DALYs) per dollars output. Environmental health impact intensities were high for coal mining, electric service (utilities), iron and steel making and non ferrous metals manufacturing. A comparison suggests that United States occupational health impacts are about 10 times smaller than environmental health impacts and are, relatively speaking, important only for sectors with hazardous working environments but low environmental impacts. A consequential rather than attributional view suggests that a method to assess true consequences on long-term health impacts by product policies needs to be able to predict effects from present-day work place exposure and to account for likely changes in the labor market, including changes in unemployment rates and other substitution mechanisms. 70 refs., 2 figs., 4 tabs.

  18. Assessing Heat Health Risk for Sustainability in Beijing’s Urban Heat Island

    Directory of Open Access Journals (Sweden)

    Weihua Dong

    2014-10-01

    Full Text Available This research is motivated by the increasing threat of urban heat waves that are likely worsened by pervasive global warming and urbanization. Different regions of the city including urban, borderland and rural area will experience different levels of heat health risk. In this paper, we propose an improved approach to quantitatively assess Beijing’s heat health risk based on three factors from hazard, vulnerability and especially environment which is considered as an independent factor because different land use/cover types have different influence on ambient air temperatures under the Urban Heat Island effect. The results show that the heat health risk of Beijing demonstrates a spatial-temporal pattern with higher risk in the urban area, lower risk in the borderland between urban and rural area, and lowest risk in the rural area, and the total risk fluctuated dramatically during 2008–2011. To be more specific, the heat health risk was clearly higher in 2009 and 2010 than in 2008 and 2011. Further analysis with the urban area at sub-district level signifies that the impervious surface (urban area such as buildings, roads, et al. ratio is of high correlation with the heat health risk. The validation results show that the proposed method improved the accuracy of heat health risk assessment. We recommend that policy makers should develop efficient urban planning to accomplish Beijing’s sustainable development.

  19. Nigeria's National Health Act: An assessment of health professionals' knowledge and perception

    Directory of Open Access Journals (Sweden)

    Osahon Enabulele

    2016-01-01

    Full Text Available Background: Nigeria's National Health Act 2014 (NHA 2014 was signed into law on October 31, 2014. It provides a legal framework for the regulation, development, and management of Nigeria's Health System. This study assessed the knowledge and perception of the NHA 2014 by health professionals. Materials and Methods: This was a descriptive, cross-sectional, questionnaire-based study conducted in December 2015, in Ota, Ogun State, Nigeria. Data entry and analysis were done using the Statistical Package for the Social Sciences version 16 (IBM SPSS, Chicago, IL, USA statistical software, with Pearson's Chi-square, which is used to determine the associations between variables. Statistical significance was set at a P < 0.05. Results: The study population comprised 130 health professionals (medical doctors/dentists, nurses, pharmacists, laboratory scientists, and other health-related professionals in attendance at a medical conference. The respondents' age ranged from 21 to 75 years with a mean age of 44.53 ± 12.46 years. Medical practitioners accounted for 82.3% of the respondents. Although most (79.2% respondents had a good perception of the NHA 2014 with majority (86.2% claiming they were aware of the act, majority (73.8% exhibited poor knowledge of the act. A little more than half (53.1% of the respondents believed that the NHA 2014 will help to reduce strike actions in the health sector. Conclusion: Although health professionals in Nigeria have good awareness and perception of the NHA 2014, their knowledge of the Act is poor.

  20. Nanomaterials safety assessment: contribution from the Portuguese National Institute of Health (INSA) research

    OpenAIRE

    2015-01-01

    The National Health Institute Doutor Ricardo Jorge (INSA) is a public organization of the Portuguese Ministry of Health, which develops a triple role as State Laboratory in the health sector, National Reference Laboratory and National Health Observatory. All operative units composing the departments develop multidisciplinary programs in problem areas of Public Health, namely performing R&D, health monitoring, training, laboratory external quality assessment and general health services. INS...

  1. Pesticide assessment: Protecting public health on the home turf.

    Science.gov (United States)

    Sears, Meg; Walker, C Robin; van der Jagt, Richard Hc; Claman, Paul

    2006-04-01

    Pesticide regulation is examined in the context of Health Canada's Pest Management Regulatory Agency's assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec's Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.

  2. [Assessing the impact of the environment on human health].

    Science.gov (United States)

    Locatelli, Marine

    2016-05-01

    In public health, nurses are concerned with the global health of populations. A recently qualified nurse, interested in this area of health, enhanced her skills with a master's degree specialising in the links between the environment and health.

  3. Obstetrician-assessed maternal health at pregnancy predicts offspring future health.

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    Full Text Available BACKGROUND: We aimed to examine the association between obstetrician assessment of maternal physical health at the time of pregnancy and offspring cardiovascular disease risk. METHODS AND PRINCIPAL FINDINGS: We examined this association in a birth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariable regression models in which we adjusted for a range of indicators of socioeconomic position and we explored the specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5 hazard ratio comparing those described as having poor or very poor health at the time of pregnancy to those with good or very good health was 1.55 (95%CI: 1.05, 2.28 for coronary heart disease, 1.91 (95%CI: 0.99, 3.67 for stroke and 1.57 (95%CI: 1.13, 2.18 for either coronary heart disease or stroke. However, this association was not specific. There were strong associations for other outcomes that are known to be related to socioeconomic position (3.61 (95%CI: 1.04, 12.55 for lung cancer and 1.28 (95%CI:1.03, 1.58 for unintentional injury, but not for breast cancer (1.10 (95%CI:0.48, 2.53. CONCLUSIONS AND SIGNIFICANCE: These findings demonstrate that a simple assessment of physical health (based on the appearance of eyes, skin, hair and teeth of mothers at the time of pregnancy is a strong indicator of the future health risk of their offspring for common conditions that are associated with poor socioeconomic position and unhealthy behaviours. They do not support a specific biological link between maternal health across her life course and

  4. Quantitative Assessment of Soil Health Under Different Planting Patterns and Soil Types

    Institute of Scientific and Technical Information of China (English)

    BI Chun-Juan; CHEN Zhen-Lou; WANG Jun; ZHOU Dong

    2013-01-01

    Soil health assessment is an important step toward understanding the potential effects of agricultural practices on crop yield,quality and human health.The objectives of this study were to select a minimum data set for soil health evaluation from the physical,chemical and biological properties and environmental pollution characteristics of agricultural soil and to develop a soil health diagnosis model for determining the soil health status under different planting patterns and soil types in Chongming Island of Shanghai,China.The results showed that the majority of the farmland soils in Chongming Island were in poor soil health condition,accounting for 48.9% of the survey samples,followed by the medium healthy soil,accounting for 32.2% of the survey samples and mainly distributed in the central and mid-eastern regions of the island.The indicators of pH,total organic carbon,microbial biomass carbon and Cd exerted less influence on soil health,while the soil salinization and nitrate accumulation under a greenhouse cropping pattern and phosphate fertilizer shortage in the paddy field had limited the development of soil health.Dichlorodiphenyltrichloroethanes,hexachlorocyclohexanes and Hg contributed less to soil health index (SHI) and showed no significant difference among paddy field,greenhouse and open-air vegetable/watermelon fields.The difference of the SHI of the three soil types was significant at P=0.05.The paddy soil had the highest SHI values,followed by the gray alluvial soil,and the coastal saline soil was in a poor soil health condition,indicating a need to plant some salt-tolerant crops to effectively improve soil quality.

  5. The potential role of health impact assessment in tackling the complexity of climate change adaptation for health.

    Science.gov (United States)

    Brown, Helen L; Proust, Katrina; Spickett, Jeffery; Capon, Anthony

    2011-12-01

    Managing an issue of the magnitude, scope and complexity of climate change is a daunting prospect, yet one which nations around the world must face. Climate change is an issue without boundaries--impacts will cut across administrative and geographical borders and be felt by every sector of society. Responses to climate change will need to employ system approaches that take into account the relationships that cross organisational and sectoral boundaries. Solutions designed in isolation from these interdependencies will be unlikely to succeed, squandering opportunities for long-term effective adaptation. Health Impact Assessment (HIA) provides a structural approach to identify, evaluate and manage health impacts of climate change that is inclusive of a wide range of stakeholders. Climate change will affect decision-making across every government level and sector and the health implications of these decisions can also be addressed with HIA. Given the nature of the issue, HIA of climate change will identify a large number of variables that influence the type and extent of health impacts and the management of these impacts. In order to implement the most effective adaptation measures, it is critica that an understanding of the interactions between these variables is developed. The outcome of HIA of climate change can therefore be strengthened by the introduction of system dynamics tools, such as causal loop diagrams, that are designed to examine interactions between variables and the resulting behaviour of complex systems.

  6. Short-Term Health Impact Assessment of Urban PM10 in Bejaia City (Algeria

    Directory of Open Access Journals (Sweden)

    Fatima Benaissa

    2016-01-01

    Full Text Available We used Health Impact Assessment (HIA to analyze the impact on a given population’s health outcomes in terms of all-causes mortality and respiratory and cardiovascular hospitalizations attributable to short-term exposure to particulate matter less than 10 μm diameter (PM10 in Bejaia city, for which health effects of air pollution have never been investigated. Two scenarios of PM10 reduction were considered: first, a scenario where the PM10 annual mean is decreased by 5 µg/m3, and then a scenario where this PM10 mean is decreased to 20 µg/m3 (World Health Organization annual air quality guideline (WHO-AQG. Annual mean level of PM10 (81.7 µg/m3 was calculated from objective measurements assessed in situ. Each year, about 4 and 55 deaths could be postponed with the first and the second scenarios successfully. Furthermore, decreasing PM10 annual mean by 5 µg/m3 would avoid 5 and 3 respiratory and cardiac hospitalizations, respectively, and not exceeding the PM10 WHO-AQG (20 µg/m3 would result in a potential gain of 36 and 23 per 100000 respiratory and cardiac hospitalizations, respectively. Lowering in current levels of PM10 has a nonnegligible impact in terms of public health that it is expected to be higher in the case of long-term effects.

  7. Environmental health risk assessment and management for global climate change

    Science.gov (United States)

    Carter, P.

    2014-12-01

    This environmental health risk assessment and management approach for atmospheric greenhouse gas (GHG) pollution is based almost entirely on IPCC AR5 (2014) content, but the IPCC does not make recommendations. Large climate model uncertainties may be large environmental health risks. In accordance with environmental health risk management, we use the standard (IPCC-endorsed) formula of risk as the product of magnitude times probability, with an extremely high standard of precaution. Atmospheric GHG pollution, causing global warming, climate change and ocean acidification, is increasing as fast as ever. Time is of the essence to inform and make recommendations to governments and the public. While the 2ºC target is the only formally agreed-upon policy limit, for the most vulnerable nations, a 1.5ºC limit is being considered by the UNFCCC Secretariat. The Climate Action Network International (2014), representing civil society, recommends that the 1.5ºC limit be kept open and that emissions decline from 2015. James Hansen et al (2013) have argued that 1ºC is the danger limit. Taking into account committed global warming, its millennial duration, multiple large sources of amplifying climate feedbacks and multiple adverse impacts of global warming and climate change on crops, and population health impacts, all the IPCC AR5 scenarios carry extreme environmental health risks to large human populations and to the future of humanity as a whole. Our risk consideration finds that 2ºC carries high risks of many catastrophic impacts, that 1.5ºC carries high risks of many disastrous impacts, and that 1ºC is the danger limit. IPCC AR4 (2007) showed that emissions must be reversed by 2015 for a 2ºC warming limit. For the IPCC AR5 only the best-case scenario RCP2.6, is projected to stay under 2ºC by 2100 but the upper range is just above 2ºC. It calls for emissions to decline by 2020. We recommend that for catastrophic environmental health risk aversion, emissions decline

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

    Science.gov (United States)

    Campbell, Princess Christina; Korie, Patrick Chukwuemeka; Nnaji, Feziechukwu Collins

    2014-01-01

    Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance. PMID:25298605

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

    Directory of Open Access Journals (Sweden)

    Princess Christina Campbell

    2014-01-01

    Full Text Available Background: The National Health Insurance Scheme (NHIS, operated majorly in Nigeria by health maintenance organisations (HMOs, took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs. Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS. Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%. The other risk-management strategies not utilised in the NHIS 10 (47.4% were risk equalisation and reinsurance. As high as 11 (52.4% of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1% were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4% participated in the Millennium development goal (MDG maternal and child health insurance programme. Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance.

  10. The human health programme under AMAP. AMAP Human Health Group. Arctic Monitoring and Assessment Program.

    Science.gov (United States)

    Hansen, J C

    1998-10-01

    The human health programme of the first phase of AMAP was planned at an international meeting held in Nuuk, Greenland, October 1992. As the most vulnerable period to adverse effects of contaminants is during fetal development, it was decided to concentrate on analyses of umbilical cord blood and maternal blood. The programme was designed as a core programme in which 150 sample pairs should be collected in each of the 8 arctic countries and analyzed for persistant organic pollutants (POPs) and heavy metals (mercury, lead and cadmium). As some essential elements such as copper, zinc and selenium interfere with heavy metal toxicity these elements should also be analyzed. Additional analyses such as nickel and arsenic in urine, mercury in hair, and POPs in breast milk could be incorporated regionally according to specific local conditions. Radionucleides were not a major focus in the human programme as this issue was be dealt with by AMAP's radiation group. Implementation of the programme was a problem in most of the countries due to lack of funding. However, an offer from Canada to analyze all contaminants in 50 samples from each country enabled the first comparative circumpolar study of human exposure to contaminants to be completed. The study confirmed that in general the most important source of exposure to both POPs and mercury is food of marine origin and that Greenlanders and Inuit from the Canadian Arctic, due to their traditional lifestyle, are among the most highly exposed populations in the Arctic. This is not a result of local pollution in Greenland and Canada, but is due to long range transport of persistent contaminants through the atmosphere and their biomagnification in the marine food chain. For these reasons the most important recommendation of the first AMAP assessment is that priority should be given to the expeditious completion of negotiations to establish protocols for the control of POPs and heavy metals under the Convention on Long Range

  11. Body burdens: an integrated approach to health risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Gasper, J. R.; Dauzvardis, P. A.

    1979-01-01

    Monitoring, modeling, and laboratory data are being integrated with physiological data in order to assess the impact of the release of environmental contaminants on the human receptor. The methodology described in this paper is intended primarily for use as a screening method to identify relative health risks. Comparison of body burdens and critical organ burdens can identify the relative contribution from different sources of exposure, exposure pathways, and routes of entry. These two burdens may be used in conjunction with monitoring data and environmental modeling techniques to assess the relative risk of effluent releases from natural and industrial sources or from different effluent control technologies or waste disposal methods. The relative impact of different levels of regional economic growth or regulatory plans can also be assessed. Body burdens may also serve to indicate where effluent control efforts will be most successful in reducing impacts on humans. The example projects the relative contributions to body burdens of arsenic, cadmium, chromium, mercury and lead resulting from background air and water quality, effluent releases from a coal-fired steam electric power plant, and from diet.

  12. Development of mental health quality indicators (MHQIs for inpatient psychiatry based on the interRAI mental health assessment

    Directory of Open Access Journals (Sweden)

    Perlman Christopher M

    2013-01-01

    Full Text Available Abstract Background Outcome quality indicators are rarely used to evaluate mental health services because most jurisdictions lack clinical data systems to construct indicators in a meaningful way across mental health providers. As a result, important information about the effectiveness of health services remains unknown. This study examined the feasibility of developing mental health quality indicators (MHQIs using the Resident Assessment Instrument - Mental Health (RAI-MH, a clinical assessment system mandated for use in Ontario, Canada as well as many other jurisdictions internationally. Methods Retrospective analyses were performed on two datasets containing RAI-MH assessments for 1,056 patients from 7 facilities and 34,788 patients from 70 facilities in Ontario, Canada. The RAI-MH was completed by clinical staff of each facility at admission and follow-up, typically at discharge. The RAI-MH includes a breadth of information on symptoms, functioning, socio-demographi