WorldWideScience

Sample records for exceed healthful levels

  1. Most American Academy of Orthopaedic Surgeons' online patient education material exceeds average patient reading level.

    Science.gov (United States)

    Eltorai, Adam E M; Sharma, Pranav; Wang, Jing; Daniels, Alan H

    2015-04-01

    Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level. Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

  2. Sound levels in a neonatal intensive care unit significantly exceeded recommendations, especially inside incubators.

    Science.gov (United States)

    Parra, Johanna; de Suremain, Aurelie; Berne Audeoud, Frederique; Ego, Anne; Debillon, Thierry

    2017-12-01

    This study measured sound levels in a 2008 built French neonatal intensive care unit (NICU) and compared them to the 2007 American Academy of Pediatrics (AAP) recommendations. The ultimate aim was to identify factors that could influence noise levels. The study measured sound in 17 single or double rooms in the NICU. Two dosimeters were installed in each room, one inside and one outside the incubators, and these conducted measurements over a 24-hour period. The noise metrics measured were the equivalent continuous sound level (L eq ), the maximum noise level (L max ) and the noise level exceeded for 10% of the measurement period (L 10 ). The mean L eq , L 10 and L max were 60.4, 62.1 and 89.1 decibels (dBA), which exceeded the recommended levels of 45, 50 and 65 dBA (p care was correlated to an increased noise level, except for a postconceptional age below 32 weeks. The sound levels significantly exceeded the AAP recommendations, particularly inside incubators. A multipronged strategy is required to improve the sound environment and protect the neonates' sensory development. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. The Cumulative Daily Tolerance Levels of Potentially Toxic Excipients Ethanol and Propylene Glycol Are Commonly Exceeded in Neonates and Infants

    DEFF Research Database (Denmark)

    Valeur, Kristine Svinning; Hertel, Steen Axel; Lundstrøm, Kaare Engell

    2018-01-01

    neonates and infants and compare these levels to the tolerance limits found in guidelines published by European Medicines Agency (EMA). As part of the SEEN study, all medicinal products administered to neonates and infants were recorded. All included neonates received ≥2 medicinal products/day and infants...... ≥3 medicinal products/day. Daily excipient levels were calculated based on quantities obtained from manufacturers or databases. Excipient levels were compared to tolerance limits proposed by the EMA. Altogether, 470 neonates and 160 infants were included, recording 4207 prescriptions and 316 products...... exceed tolerance limit of 6 mg/kg/day. Of the total number of prescriptions involving PG-containing medicinal products (n = 174), 70% would alone exceed a maximum tolerance limit of 50 mg/kg/day. Maximal daily exposure to ethanol (1563 mg/kg/day) or PG (954 mg/kg/day) exceeded the tolerance limits...

  4. Utilization of low- and high-voltage electric equipment at heights exceeding 1000 m above sea level

    Energy Technology Data Exchange (ETDEWEB)

    Karapetyan, M.M.

    1980-01-01

    The present-day state of high- and low-voltage equipment utilization at heights exceeding 1000 m above sea level is considered with allowance for the technical requirements applicable to the equipment, as provided for in the GOST (All-Union State Standards), and for the results of scientific research studies. 12 refs.

  5. 20 CFR 641.740 - How will the Department determine whether a grantee fails, meets, or exceeds the expected levels...

    Science.gov (United States)

    2010-04-01

    ... determine whether a grantee fails, meets, or exceeds the expected levels of performance for the core indicators and what will be the consequences of failing to meet expected levels of performance? (a) Aggregate... determine if a national grantee has met the expected levels of performance (including any adjustments to...

  6. Does regional disadvantage affect health-related sport and physical activity level? A multi-level analysis of individual behaviour.

    Science.gov (United States)

    Wicker, Pamela; Downward, Paul; Lera-López, Fernando

    2017-11-01

    This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18-64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n = 18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth.

  7. Neurological and neurophysiological examinations of workers exposed to arsenic levels exceeding hygiene standards

    Directory of Open Access Journals (Sweden)

    Halina Sińczuk-Walczak

    2014-12-01

    Full Text Available Objectives: The assessment of the neurotoxic effect of arsenic (As and its inorganic compounds is still the subject of interest due to a growing As application in a large array of technologies and the need to constantly verify the principles of prevention and technological parameters. The aim of this study was to determine the status of the nervous system (NS in workers exposed to As at concentrations exceeding hygiene standards (Threshold Limit Values (TLV – 10 μg/m3, Biological Exposure Index (BEI – 35 μg/l and to analyze the relationship between the NS functional state, species of As in urine and As levels in the workplace air. Material and Methods: The study group comprised 21 men (mean age: 47.43±7.59 employed in a copper smelting factory (mean duration of employment: 22.29±11.09. The control group comprised 16 men, matched by age and work shifts. Arsenic levels in the workplace air (As-A ranged from 0.7 to 92.3 μg/m3; (M = 25.18±28.83. The concentration of total arsenic in urine (Astot-U ranged from 17.35 to 434.68 μg/l (M = 86.82±86.6. Results: Syndrome of peripheral nervous system (PNS was manifested by extremity fatigue (28.6%, extremity pain (33.3% and paresthesia in the lower extremities (33.3%, as well as by neuropathy-type mini-symptoms (23.8%. Electroneurographic (ENeG tests of peroneal nerves showed significantly decreased response amplitude with normal values of motor conduction velocity (MCV. Stimulation of sural nerves revealed a significantly slowed sensory conduction velocity (SCV and decreased sensory potential amplitude. Neurophysiological parameters and the results of biological and environmental monitoring showed a relationship between Astot, AsIII (trivalent arsenic, the sum of iAs (AsIII+AsV (pentavalent arsenic+MMA (monomethylarsonic acid concentration in urine and As levels in the air. Conclusions: The results of the study demonstrate that occupational exposure to inorganic arsenic levels exceeding hygiene

  8. Susceptibility of forests in the northeastern USA to nitrogen and sulfur deposition: critical load exceedance and forest health

    Science.gov (United States)

    N. Duarte; L.H. Pardo; M.J. Robin-Abbott

    2013-01-01

    The objectives of this study were to assess susceptibility to acidification and nitrogen (N) saturation caused by atmospheric deposition to northeastern US forests, evaluate the benefits and shortcomings of making critical load assessments using regional data, and assess the relationship between expected risk (exceedance) and forest health. We calculated the critical...

  9. Levels of infants' urinary arsenic metabolites related to formula feeding and weaning with rice products exceeding the EU inorganic arsenic standard.

    Directory of Open Access Journals (Sweden)

    Antonio J Signes-Pastor

    Full Text Available Early childhood inorganic arsenic (i-As exposure is of particular concern since it may adversely impact on lifetime health outcomes. Infants' urinary arsenic (As metabolites were analysed in 79 infants by inductively coupled plasma-mass spectrometric detection (IC-ICP-MS to evaluate i-As exposure pre- and post-weaning. Levels of i-As in rice-based weaning and infants' foods were also determined to relate to urinary As levels. Higher As levels, especially of monomethylarsonic acid (MMA and dimethylarsinic acid (DMA, were found in urine from formula fed infants compared to those breastfed. Urine from infants post-weaning consuming rice-products resulted in higher urinary MMA and DMA compared to the paired pre-weaning urine samples. The European Union (EU has regulated i-As in rice since 1st January 2016. Comparing infants' rice-based foods before and after this date, little change was found. Nearly ¾ of the rice-based products specifically marketed for infants and young children contained i-As over the 0.1 mg/kg EU limit. Efforts should be made to provide low i-As rice and rice-based products consumed by infants and young children that do not exceed the maximum i-As level to protect this vulnerable subpopulation.

  10. 137Cs activity concentration in wild boar meat may still exceed the permitted levels

    Directory of Open Access Journals (Sweden)

    Rachubik J.

    2012-04-01

    Full Text Available The radiocaesium activity concentration may still remain high in natural products such as game meat, wild mushrooms, and forest berries even more than two decades after the Chernobyl accident. The results of regular control studies of game meat conducted in Poland showed wild boars as the most contaminated game animals. It is well documented that some mushrooms, readily consumed by animals, show high ability to accumulate caesium radioisotopes. Bay bolete, one of the most wide-spread mushroom species in Poland, reveals a unique radiocaesium accumulation feature. Moreover, deer truffle, containing also particularly high levels of radiocaesium, could be another radionu-clide source for wild boars. Furthermore, animals consuming deer truffles could digest contaminated soil components. Among 94 wild boar meat samples analysed in 2008–2009, two exceeded the permitted level. Hence, some precautions should be taken in the population with an elevated intake of wild boar meat. Moreover, since each hunted wild boar is examined for the presence of Trichinella larvae, regular measurements of radiocaesium concentrations in these animals may be advisable for enhancing consumer safety.

  11. 137Cs activity concentration in wild boar meat may still exceed the permitted levels

    Science.gov (United States)

    Rachubik, J.

    2012-04-01

    The radiocaesium activity concentration may still remain high in natural products such as game meat, wild mushrooms, and forest berries even more than two decades after the Chernobyl accident. The results of regular control studies of game meat conducted in Poland showed wild boars as the most contaminated game animals. It is well documented that some mushrooms, readily consumed by animals, show high ability to accumulate caesium radioisotopes. Bay bolete, one of the most wide-spread mushroom species in Poland, reveals a unique radiocaesium accumulation feature. Moreover, deer truffle, containing also particularly high levels of radiocaesium, could be another radionu-clide source for wild boars. Furthermore, animals consuming deer truffles could digest contaminated soil components. Among 94 wild boar meat samples analysed in 2008-2009, two exceeded the permitted level. Hence, some precautions should be taken in the population with an elevated intake of wild boar meat. Moreover, since each hunted wild boar is examined for the presence of Trichinella larvae, regular measurements of radiocaesium concentrations in these animals may be advisable for enhancing consumer safety.

  12. Assessing the Levels and Health Risk of Atmospheric Formaldehyde in Makkah, Saudi Arabia

    OpenAIRE

    Atef M.F. Mohammed; Essam A. Morsy; Turki M. Habeebullah; Said Munir

    2015-01-01

    Atmospheric Formaldehyde (HCHO) was monitored in four sites on the Holy Mosque of Makkah, Saudi Arabia during August, 2013. The daily mean concentrations of HCHO were ranged from 1.09-18.92 g/m3. The levels of HCHO were significantly higher than the permissible exposure limit (0.042 μg/m3) of the Occupational Safety and Health Administration (OSHA). However, it were not exceeded the recommended exposure limit of the National Institute for Occupational Safety and Health (20 μg/m3) and Egyptian...

  13. Modelling of snow exceedances

    Science.gov (United States)

    Jordanova, Pavlina K.; Sadovský, Zoltán; Stehlík, Milan

    2017-07-01

    Modelling of snow exceedances is of great importance and interest for ecology, civil engineering and general public. We suggest the favorable fit for exceedances related to the exceptional snow loads from Slovakia, assuming that the data is driven by Generalised Pareto Distribution or Generalized Extreme Value Distribution. Further, the statistical dependence between the maximal snow loads and the corresponding altitudes is studied.

  14. Organotin levels in seafood and its implications for health risk in high-seafood consumers

    Energy Technology Data Exchange (ETDEWEB)

    Guerin, T. [Agence francaise de securite sanitaire des aliments - Afssa, Unites CIME et PASER, AFSSA-LERQAP, 23 Av. du G. de Gaulle, 94706 Maisons-Alfort Cedex (France)], E-mail: t.guerin@afssa.fr; Sirot, V.; Volatier, J.-L.; Leblanc, J.-C. [Agence francaise de securite sanitaire des aliments - Afssa, Unites CIME et PASER, AFSSA-LERQAP, 23 Av. du G. de Gaulle, 94706 Maisons-Alfort Cedex (France)

    2007-12-15

    Fish and fishery products are considered as the main source of organotin compounds (OTC). Unfortunately, little national contamination data is available to assess food exposure of organotins from French consumers. To provide a more accurate estimate of risks to human health, the butyltin, phenyltin and octyltin compounds sampling in four French coastal areas were measured in 159 composite samples (96 fresh and frozen fish, 28 mollusks, 14 crustaceans, 1 echinoderm, 11 canned foods, 4 smoked fish, 5 prepared seafood-based dishes) by capillary gas chromatography coupled with a microwave induced plasma atomic-emission spectrometer (CGC-MIP-AES). In these samples, butyltins were usually predominant and the range of the contamination levels was generally below those of earlier studies (fish: mean 5.6; min-max 1.1-23 {mu}g/kg; fishery products: mean 6; min-max 0.8-14 {mu}g/kg). Fish, especially tuna, salmon, mackerel, saithe/coalfish and cod were largely the main contributors (38%) to the total organotin exposure. With the supplementary contribution of great scallop, surimi, squid and oysters, the exposure exceeded 50% in all. However, the utmost OTC exposure was lesser than 47% of the provisional tolerable weekly intake [EFSA (European Food Safety Agency). Opinion of the Scientific Panel on Contaminants in the food chain on a request from the Commission to assess the health risks to consumers associated with exposure to organotins in foodstuffs. (Question N{sup o}EFSA-Q-2003-110). The EFSA Journal, 102, 1-119, 2004. (http://www.efsa.eu.int)]. Nobody would exceed this limit. Finally, as this study has some limitations and since some other sources and health effects have not been clearly evaluated, it appears rational from public health and environmental viewpoints to continue to reduce the OTC levels in the environment.

  15. Organotin levels in seafood and its implications for health risk in high-seafood consumers

    International Nuclear Information System (INIS)

    Guerin, T.; Sirot, V.; Volatier, J.-L.; Leblanc, J.-C.

    2007-01-01

    Fish and fishery products are considered as the main source of organotin compounds (OTC). Unfortunately, little national contamination data is available to assess food exposure of organotins from French consumers. To provide a more accurate estimate of risks to human health, the butyltin, phenyltin and octyltin compounds sampling in four French coastal areas were measured in 159 composite samples (96 fresh and frozen fish, 28 mollusks, 14 crustaceans, 1 echinoderm, 11 canned foods, 4 smoked fish, 5 prepared seafood-based dishes) by capillary gas chromatography coupled with a microwave induced plasma atomic-emission spectrometer (CGC-MIP-AES). In these samples, butyltins were usually predominant and the range of the contamination levels was generally below those of earlier studies (fish: mean 5.6; min-max 1.1-23 μg/kg; fishery products: mean 6; min-max 0.8-14 μg/kg). Fish, especially tuna, salmon, mackerel, saithe/coalfish and cod were largely the main contributors (38%) to the total organotin exposure. With the supplementary contribution of great scallop, surimi, squid and oysters, the exposure exceeded 50% in all. However, the utmost OTC exposure was lesser than 47% of the provisional tolerable weekly intake [EFSA (European Food Safety Agency). Opinion of the Scientific Panel on Contaminants in the food chain on a request from the Commission to assess the health risks to consumers associated with exposure to organotins in foodstuffs. (Question N o EFSA-Q-2003-110). The EFSA Journal, 102, 1-119, 2004. (http://www.efsa.eu.int)]. Nobody would exceed this limit. Finally, as this study has some limitations and since some other sources and health effects have not been clearly evaluated, it appears rational from public health and environmental viewpoints to continue to reduce the OTC levels in the environment

  16. Global Ozone Distribution relevant to Human Health: Metrics and present day levels from the Tropospheric Ozone Assessment Report (TOAR)

    Science.gov (United States)

    Fleming, Z. L.; Doherty, R. M.; von Schneidemesser, E.; Cooper, O. R.; Malley, C.; Colette, A.; Xu, X.; Pinto, J. P.; Simpson, D.; Schultz, M. G.; Hamad, S.; Moola, R.; Solberg, S.; Feng, Z.

    2017-12-01

    Using stations from the TOAR surface ozone database, this study quantifies present-day global and regional distributions of five ozone metrics relevant for both short-term and long-term human exposure. These metrics were explored at ozone monitoring sites globally, and re-classified for this project as urban or non-urban using population densities and night-time lights. National surface ozone limit values are usually related to an annual number of exceedances of daily maximum 8-hour running mean (MDA8), with many countries not even having any ozone limit values. A discussion and comparison of exceedances in the different ozone metrics, their locations and the seasonality of exceedances provides clues as to the regions that potentially have more serious ozone health implications. Present day ozone levels (2010-2014) have been compared globally and show definite geographical differences (see Figure showing the annual 4th highest MDA8 for present day ozone for all non-urban stations). Higher ozone levels are seen in western compared to eastern US, and between southern and northern Europe, and generally higher levels in east Asia. The metrics reflective of peak concentrations show highest values in western North America, southern Europe and East Asia. A number of the metrics show similar distributions of North-South gradients, most prominent across Europe and Japan. The interquartile range of the regional ozone metrics was largest in East Asia, higher for urban stations in Asia but higher for non-urban stations in Europe and North America. With over 3000 monitoring stations included in this analysis and despite the higher densities of monitoring stations in Europe, north America and East Asia, this study provides the most comprehensive global picture to date of surface ozone levels in terms of health-relevant metrics.

  17. Heavy metals pollution levels and children health risk assessment of Yerevan kindergartens soils.

    Science.gov (United States)

    Tepanosyan, Gevorg; Maghakyan, Nairuhi; Sahakyan, Lilit; Saghatelyan, Armen

    2017-08-01

    Children, the most vulnerable urban population group, are exceptionally sensitive to polluted environments, particularly urban soils, which can lead to adverse health effects upon exposure. In this study, the total concentrations of Ag, As, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Ti, V, and Zn were determined in 111 topsoil samples collected from kindergartens in Yerevan. The objectives of this study were to evaluate heavy metal pollution levels of kindergarten's soils in Yerevan, compare with national legal and international requirements on heavy metal contents in kindergarten soil, and assess related child health risk. Multivariate geostatistical analyses suggested that the concentrations of Ag, As, Ba, Cd, Cu, Hg, Mo, Pb, and Zn observed in the kindergarten's topsoil may have originated from anthropogenic sources, while Co, Cr, Fe, Mn, Ni, Ti, and V mostly come from natural sources. According to the Summary pollution index (Zc), 102 kindergartens belong to the low pollution level, 7 to the moderate and only 2 to the high level of pollution. Summary concentration index (SCI) showed that 109 kindergartens were in the allowable level, while 2 featured in the low level of pollution. The health risk assessment showed that in all kindergartens except for seven, non-carcinogenic risk for children was detected (HI>1), while carcinogenic risk from arsenic belongs to the very low (allowable) level. Cr and multi-element carcinogenic risk (RI) exceeded the safety level (1.0E- 06) in all kindergartens and showed that the potential of developing cancer, albeit small, does exist. Therefore, city's kindergartens require necessary remedial actions to eliminate or reduce soil pollution and heavy metal-induced health risks. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Mercury in United Kingdom topsoils; concentrations, pools, and Critical Limit exceedances

    Energy Technology Data Exchange (ETDEWEB)

    Tipping, E., E-mail: et@ceh.ac.uk [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP (United Kingdom); Poskitt, J.M.; Lawlor, A.J.; Wadsworth, R.A. [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP (United Kingdom); Norris, D.A.; Hall, J.R. [Centre for Ecology and Hydrology, Bangor, Gwynedd LL57 2UW (United Kingdom)

    2011-12-15

    The median total mercury concentration in 898 UK rural topsoils, sampled between 1998 and 2008, was 0.095 {mu}g g{sup -1}. Approximate adjustment for unreactive metal produced an estimate of 0.052 {mu}g g{sup -1} for reactive Hg. The highest concentrations were in the north and west, where organic-rich soils with low bulk densities dominate, but the spatial pattern was quite different if soil Hg pools (mg m{sup -2}) were considered, the highest values being near to the industrial north of England and London. Possible toxic effects of Hg were best evaluated by comparison with soil Critical Limits expressed as ratios of Hg to soil organic matter, or soil solution Hg{sup 2+} concentrations, estimated by chemical speciation modelling. Only a few percent of the rural UK soils showed exceedance, and this also applied to rural soils from the whole of Europe. UK urban and industrial soils had higher Hg concentrations and more cases of exceedance. - Highlights: > Concentrations of Hg in rural soils are highest near to industrial areas and London. > Mercury is strongly associated with soil organic matter. > Only a few percent of UK rural soils have Hg levels higher than Critical Limits. > Critical Limit exceedances are found for 15-30% of urban and industrial soils. - Mercury contents of 898 UK and 868 European rural soils are largely lower than Critical Limit values, but appreciable numbers of soils in UK urban and industrial areas show exceedance.

  19. Protective containment behaviour under exceeded design loads

    International Nuclear Information System (INIS)

    Holub, I.; Stepan, J.; Maly, J.; Schererova, K.

    2003-01-01

    The contribution describes the calculation results of the behaviour of containment structure if loaded in excess of its design load. The Temelin NPP comprises two WWER 1000 blocks and containment consists of a pre-stressed reinforced concrete structure with a system of unbonded cables. The objective of the calculations was to determine the level of load caused by the internal pressure and temperature at which the containment protective function would fail. In the first step, the maximum overpressure was determined, which may be transferred by the containment structure. In further steps analyses were made of various combinations of simultaneous pressure and temperature loads. The contribution presents relevant calculation results, including the evaluation of containment structure behaviour including liner under loads that exceed its design parameters. (author)

  20. [The Community Care as a model of social and health integration at the local level].

    Science.gov (United States)

    Ridolfi, Luciana

    2013-01-01

    The article develops a hypothesis for improving primary care services through health care solutions that can exceed the models in use (essentially hierarchical and based on tasks) in favor of new relational, multi-sectoral and network approaches that could privilege the integration of social and health services at the regional and district level (Community care). A qualitative methodological approach which analyzes the role of social networks in Community care, some national and international experiences of primary care models and the evaluation of the different role given to primary care both in the hierarchical-pyramidal approach and in the horizontal one (network approach). Some Italian regions are experimenting effective organizational models of care such as Primary Care Teams, Primary Care Units, Regional teams, Departments of Primary Care, Houses of Health ... At international level, it should be mentioned the Chronic Care Model (CCM), recently identified by WHO as a reference model, and adopted by the Tuscany Region (Italy). People-centered health care projects need shared interventions by competent and functional multiprofessional teams: the best outcome for the patient depends on the good interaction between individuals. It's necessary that relationships between members of the group are based on interdependence, integration and consistency to avoid risks of group illusion.

  1. 30 CFR 62.140 - Dual hearing protection level.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Dual hearing protection level. 62.140 Section... HEALTH REGULATIONS OCCUPATIONAL NOISE EXPOSURE § 62.140 Dual hearing protection level. If during any work shift a miner's noise exposure exceeds the dual hearing protection level, the mine operator must, in...

  2. Assessing the Levels and Health Risk of Atmospheric Formaldehyde in Makkah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Atef M.F. Mohammed

    2015-07-01

    Full Text Available Atmospheric Formaldehyde (HCHO was monitored in four sites on the Holy Mosque of Makkah, Saudi Arabia during August, 2013. The daily mean concentrations of HCHO were ranged from 1.09-18.92 g/m3. The levels of HCHO were significantly higher than the permissible exposure limit (0.042 μg/m3 of the Occupational Safety and Health Administration (OSHA. However, it were not exceeded the recommended exposure limit of the National Institute for Occupational Safety and Health (20 μg/m3 and Egyptian law 4/1994 (0.37 mg/m3. Spatial variations of HCHO concentrations most probably due to variations in local meteorology and traffic flow, which was considered the main source of emissions. Exposure doses for various age groups were estimated, which ranged from 0.000004 to 0.000259 mg/kg/day. Maximum exposure dose was recorded for boys (age 12-14 years and children (6-8 years and minimum for females (19-65 years.

  3. Using exceedance probabilities to detect anomalies in routinely recorded animal health data, with particular reference to foot-and-mouth disease in Viet Nam.

    Science.gov (United States)

    Richards, K K; Hazelton, M L; Stevenson, M A; Lockhart, C Y; Pinto, J; Nguyen, L

    2014-10-01

    The widespread availability of computer hardware and software for recording and storing disease event information means that, in theory, we have the necessary information to carry out detailed analyses of factors influencing the spatial distribution of disease in animal populations. However, the reliability of such analyses depends on data quality, with anomalous records having the potential to introduce significant bias and lead to inappropriate decision making. In this paper we promote the use of exceedance probabilities as a tool for detecting anomalies when applying hierarchical spatio-temporal models to animal health data. We illustrate this methodology through a case study data on outbreaks of foot-and-mouth disease (FMD) in Viet Nam for the period 2006-2008. A flexible binomial logistic regression was employed to model the number of FMD infected communes within each province of the country. Standard analyses of the residuals from this model failed to identify problems, but exceedance probabilities identified provinces in which the number of reported FMD outbreaks was unexpectedly low. This finding is interesting given that these provinces are on major cattle movement pathways through Viet Nam. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Clinical and psychosocial predictors of exceeding target length of stay during inpatient stroke rehabilitation.

    Science.gov (United States)

    Lai, Wesley; Buttineau, Mackenzie; Harvey, Jennifer K; Pucci, Rebecca A; Wong, Anna P M; Dell'Erario, Linda; Bosnyak, Stephanie; Reid, Shannon; Salbach, Nancy M

    2017-10-01

    In Ontario, Canada, patients admitted to inpatient rehabilitation hospitals post-stroke are classified into rehabilitation patient groups based on age and functional level. Clinical practice guidelines, called quality-based procedures, recommend a target length of stay (LOS) for each group. The study objective was to evaluate the extent to which patients post-stroke at an inpatient rehabilitation hospital are meeting LOS targets and to identify patient characteristics that predict exceeding target LOS. A quantitative, longitudinal study from an inpatient rehabilitation hospital was conducted. Participants included adult patients (≥18 years) with stroke, admitted to an inpatient rehabilitation hospital between 2014 and 2015. The percentage of patients exceeding the recommended target LOS was determined. Logistic regression was performed to identify clinical and psychosocial patient characteristics associated with exceeding target LOS after adjusting for stroke severity. Of 165 patients, 38.8% exceeded their target LOS. Presence of ataxia, recurrent stroke, living alone, absence of a caregiver at admission, and acquiring a caregiver during hospital LOS was each associated with significantly higher odds of exceeding target LOS in comparison to patients without these characteristics after adjusting for stroke severity (p stroke-specific factors may be helpful to adjust LOS expectations and promote efficient resource allocation. This exploratory study was limited to findings from one inpatient rehabilitation hospital. Cross-validation of results using data-sets from multiple rehabilitation hospitals across Ontario is recommended.

  5. Level of acculturation, food intake, dietary changes, and health status of first-generation Filipino Americans in Southern California.

    Science.gov (United States)

    Dela Cruz, Felicitas A; Lao, Brigette T; Heinlein, Catherine

    2013-11-01

    This exploratory descriptive study investigates the acculturation level, food intake, dietary changes and practices, health status perceptions, and diet-related health indicators-body mass index (BMI), waist and hip circumferences, and waist-to-hip ratio-of first-generation Filipino Americans (FAs) in Southern California. Healthy FA adults-20 women and 10 men-were interviewed. Acculturation level was obtained using A Short Acculturation Scale for Filipino Americans. A 24-h dietary recall elicited their food intake. Survey questions revealed dietary changes and practices, health status perceptions, and sociodemographic characteristics. Height, weight, waist and hip circumferences were measured. FAs consider themselves more Filipino than American, but their acculturation level reflects transitioning into biculturalism. FAs relinquish, maintain, and adapt elements of both Philippine and U.S. cultures in food intake, dietary changes, and practices. Although FAs perceive their health status as very good to excellent, many exceed the cut-off points for BMI, waist circumference, and waist-to-hip ratio. This study underscores the importance of nurse practitioners and other healthcare givers conducting cultural dietary assessment as a basis for culturally appropriate dietary counseling. The inclusion of waist measurement to regularly monitor abdominal obesity-a predictor of cardiovascular disease and diabetes-is highly recommended. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  6. Prediction in Partial Duration Series With Generalized Pareto-Distributed Exceedances

    DEFF Research Database (Denmark)

    Rosbjerg, Dan; Madsen, Henrik; Rasmussen, Peter Funder

    1992-01-01

    As a generalization of the common assumption of exponential distribution of the exceedances in Partial duration series the generalized Pareto distribution has been adopted. Estimators for the parameters are presented using estimation by both method of moments and probability-weighted moments......-weighted moments. Maintaining the generalized Pareto distribution as the parent exceedance distribution the T-year event is estimated assuming the exceedances to be exponentially distributed. For moderately long-tailed exceedance distributions and small to moderate sample sizes it is found, by comparing mean...... square errors of the T-year event estimators, that the exponential distribution is preferable to the correct generalized Pareto distribution despite the introduced model error and despite a possible rejection of the exponential hypothesis by a test of significance. For moderately short-tailed exceedance...

  7. Heavy metals in soils along unpaved roads in south west Cameroon: Contamination levels and health risks.

    Science.gov (United States)

    Ngole-Jeme, Veronica M

    2016-04-01

    Soils enriched with heavy metals from vehicular emission present a significant exposure route of heavy metals to individuals using unpaved roads. This study assessed the extent of Cd, Cr, Co, Cu, Ni, Pb and Zn contamination of soils along unpaved roads in Cameroon, and the health risks presented by incidental ingestion and dermal contact with the soils using metal contamination factor (CF) pollution load index, hazard quotients (HQ) and chronic hazard index (CHI). CF values obtained (0.9-12.2) indicate moderate to high contamination levels. HQ values for Cr, Cd and Pb exceeded the reference doses. Moderate health hazard exists for road users in the areas with intense anthropogenic activities and high average daily traffic (ADT) volume according to CHI values (1-4) obtained. The economy and quality of life in cities with unpaved roads could be threatened by health challenges resulting from long-term exposure to heavy metal derived from high ADT volumes.

  8. Readability assessment of internet-based consumer health information.

    Science.gov (United States)

    Walsh, Tiffany M; Volsko, Teresa A

    2008-10-01

    A substantial amount of consumer health-related information is available on the Internet. Studies suggest that consumer comprehension may be compromised if content exceeds a 7th-grade reading level, which is the average American reading level identified by the United States Department of Health and Human Services (USDHHS). To determine the readability of Internet-based consumer health information offered by organizations that represent the top 5 medical-related causes of death in America. We hypothesized that the average readability (reading grade level) of Internet-based consumer health information on heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes would exceed the USDHHS recommended reading level. From the Web sites of the American Heart Association, American Cancer Society, American Lung Association, American Diabetes Association, and American Stroke Association we randomly gathered 100 consumer-health-information articles. We assessed each article with 3 readability-assessment tools: SMOG (Simple Measure of Gobbledygook), Gunning FOG (Frequency of Gobbledygook), and Flesch-Kincaid Grade Level. We also categorized the articles per the USDHHS readability categories: easy to read (below 6th-grade level), average difficulty (7th to 9th grade level), and difficult (above 9th-grade level). Most of the articles exceeded the 7th-grade reading level and were in the USDHHS "difficult" category. The mean +/- SD readability score ranges were: SMOG 11.80 +/- 2.44 to 14.40 +/- 1.47, Flesch-Kincaid 9.85 +/- 2.25 to 11.55 +/- 0.76, and Gunning FOG 13.10 +/- 3.42 to 16.05 +/- 2.31. The articles from the American Lung Association had the lowest reading-level scores with each of the readability-assessment tools. Our findings support that Web-based medical information intended for consumer use is written above USDHHS recommended reading levels. Compliance with these recommendations may increase the likelihood of consumer comprehension.

  9. Assessment of human health risk of reported soil levels of metals and radionuclides in Port Hope

    International Nuclear Information System (INIS)

    1991-11-01

    Risk assessment methods are applied to the question of health implications of contaminated soil in the Port Hope area. Soil-related as well as other pathways of exposure are considered. Exposures to the reported levels of uranium, antimony, chromium, copper, nickel, cadmium, cobalt, selenium, and zinc in Port Hope soils are not expected to result in adverse health consequences. Oral exposure to arsenic in soil at the reported levels is estimated to result in incremental cancer risk levels in the negligible range (10 -5 ). Estimated exposures also fall well below suggested toxic thresholds for arsenic. For the two small areas within the >50 μg/g isopleth, assessment of exposure is difficult without more definitive data on soil concentrations in these zones. Contamination of soils with lead is overall quite limited. In general, the reported soil levels of lead are not anticipated to pose a hazard. The site with the highest concentrations of lead is located on the west bank of the Ganaraska River, a popular fishing area. Depending on the level and extent of contamination, as well as degree of contact with the site, potential exposures could exceed tolerable intakes for children. Exposures to the radionuclides Ra(226), Pb(210), and U(238) in soil at the reported levels are estimated to fall well within recommended population limits

  10. An experimental study on developing seismic damage indicator appearing OBE exceedance

    International Nuclear Information System (INIS)

    Park, D. S.; Kwon, K. J.; Lee, J. L.

    2000-01-01

    Immediate measurement should be taken depending on the level of seismic damage to nuclear power plants when an earthquake exceeds Operating Base Earthquake by NRC regulatory guide. An earthquake at nuclear plant site is felt with seismic instrument and analyzed by seismic monitoring systems. However, if operators of insufficient knowledge to earthquake can recognize the intensity of the earthquake with a subsidiary indicating model, more immediate response can be conducted. This subsidiary indicating model is called seismic damage indicator. In this regard, an experimental study using shaking table was conducted to develop the seismic damage indicator by CAV and OBE compatible with NRC standard response spectrum. In this test result, stacked acrylic cylinders were manufactured to behave consistently for each direction of seismic load. If the developed SDI is installed in nuclear power plants, it is seemed to be useful in easily determining OBE exceedance easily, and counteracting by plant operator along with the existing seismic monitoring systems

  11. Effect of the Apulia air quality plan on PM10 and benzo(apyrene exceedances

    Directory of Open Access Journals (Sweden)

    L. Trizio

    2016-03-01

    Full Text Available During the last years, several exceedances of PM10 and benzo(apyrene limit values exceedances were recorded in Taranto, a city in southern Italy included in so-called areas at high risk of environmental crisis because of the presence of a heavy industrial district including the largest steel factory in Europe. A study of these critical pollution events showed a close correlation with the wind coming from the industrial site to the adjacent urban area. During 2011, at monitoring sites closes to the industrial area, at least the 65% of PM10 exceedances were related to wind day conditions (characterized by at least 3 consecutive hours of wind coming from 270-360±2deg with an associated speed higher than 7 m/s. For this reason, in 2012 an integrated environmental permit and a regional air quality plan were enacted to reduce pollutant emissions from industrial plants. A study of PM10 levels registered during windy days was performed during critical episodes of pollution highlighting that the difference between windy days and no windy days’ concentrations reduces from 2012 to 2014 in industrial site. False negative events (verified ex-post by observed meteorological data not identified by the forecast model - did not show a significant influence on PM concentration: PM10 values were comparable and sometimes lower than windy days levels. It is reasonable that the new scenario with a relevant reduction emissions form Ilva plant reduced the pollutants contribution from industrial area, contributing to PM10 levels decrease, also in false negative events.

  12. Does nitrite and nitrate levels in drinking water impact the health of people in Dakahlia governorate, Egypt?

    Science.gov (United States)

    Mortada, Wael I; Shokeir, Ahmed A

    2018-05-07

    A total of 1291 drinking water samples were examined for nitrite and nitrate during 6 months from December, 2015 to May, 2016 at 17 cities of Dakahlia governorate (Nile Delta, north of Egypt), and the results were utilized for assessment of health risk of the exposure from drinking water by calculating average daily intake (ADI), hazard quotient (HQ), and the hazard index (HI). The nitrite and nitrate in drinking water had a concentration range of 0.030-0.113 and 2.41-8.70 mg L -1 , with mean values of 0.059 ± 0.014 and 5.25 ± 1.61 mg L -1 , respectively. Nitrite and nitrate levels in rural areas and ground water samples were significantly higher than that in the urban ones. None of the analyzed samples exceeded WHO guideline values that set out to prevent methemoglobinemia. The values of HQ and HI for all age groups do not exceed unity indicating a low risk of methaemoglobinaemia for the population in this area. Results of the present study indicate that there is no health risk of residents from nitrite and nitrate through drinking water in the studied area. However, the other sources of exposure to nitrite and nitrate should be investigated in further studies.

  13. Human health risks associated with residual pesticide levels in edible tissues of slaughtered cattle in Benin City, Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Isioma Tongo

    2015-01-01

    Full Text Available Pesticide residues in meat is of growing concern due to possible adverse effects on humans. Pesticide levels were assessed in five edible cattle parts: muscle, liver, kidney and tongue tissues to determine human health risk associated with consumption of these tissues. Health risk estimates were analysed using estimated daily intake (EDI, hazard quotient (HQ and hazard index (HI for two (2 age/weight categories: 1–11years/30 kg for children while 70 kg was used for adult. Risks were categorized for non-carcinogenic and carcinogenic health effects and measured at the average, maximum, 50th and 95th percentiles of the measured exposure concentrations (MEC. Total pesticide residues ranged from 2.38 to 3.86 μg/kg (muscle, 3.58 to 6.3 μg/kg (liver, 1.87 to 4.59 μg/kg (kidney and 2.54 to 4.35 μg/kg (tongue. Residual pesticide concentrations in the tissues were in the order: Liver > Tongue > Muscle > Kidney. The concentrations of all the assessed pesticides observed in the tissues were however lower than the recommended maximum residual limits (MRLs. Human health risk estimations for the children showed EDI values for heptachlor epoxide, aldrin and dieldrin exceeding threshold values. Non-cancer risk posed to children on consumption of contaminated cattle parts showed HQ values for heptachlor epoxide, aldrin, dieldrin and HI values for organochlorines exceeding 1, indicating the possibility of non-carcinogenic health risks to consumers especially children from consumption of cattle meat from the selected abattoirs.

  14. Significance of beach geomorphology on fecal indicator bacteria levels.

    Science.gov (United States)

    Donahue, Allison; Feng, Zhixuan; Kelly, Elizabeth; Reniers, Ad; Solo-Gabriele, Helena M

    2017-08-15

    Large databases of fecal indicator bacteria (FIB) measurements are available for coastal waters. With the assistance of satellite imagery, we illustrated the power of assessing data for many sites by evaluating beach features such as geomorphology, distance from rivers and canals, presence of piers and causeways, and degree of urbanization coupled with the enterococci FIB database for the state of Florida. We found that beach geomorphology was the primary characteristic associated with enterococci levels that exceeded regulatory guidelines. Beaches in close proximity to marshes or within bays had higher enterococci exceedances in comparison to open coast beaches. For open coast beaches, greater enterococci exceedances were associated with nearby rivers and higher levels of urbanization. Piers and causeways had a minimal contribution, as their effect was often overwhelmed by beach geomorphology. Results can be used to understand the potential causes of elevated enterococci levels and to promote public health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Modeling environmental noise exceedances using non-homogeneous Poisson processes.

    Science.gov (United States)

    Guarnaccia, Claudio; Quartieri, Joseph; Barrios, Juan M; Rodrigues, Eliane R

    2014-10-01

    In this work a non-homogeneous Poisson model is considered to study noise exposure. The Poisson process, counting the number of times that a sound level surpasses a threshold, is used to estimate the probability that a population is exposed to high levels of noise a certain number of times in a given time interval. The rate function of the Poisson process is assumed to be of a Weibull type. The presented model is applied to community noise data from Messina, Sicily (Italy). Four sets of data are used to estimate the parameters involved in the model. After the estimation and tuning are made, a way of estimating the probability that an environmental noise threshold is exceeded a certain number of times in a given time interval is presented. This estimation can be very useful in the study of noise exposure of a population and also to predict, given the current behavior of the data, the probability of occurrence of high levels of noise in the near future. One of the most important features of the model is that it implicitly takes into account different noise sources, which need to be treated separately when using usual models.

  16. Screening-level ecological and human health risk assessment of polycyclic aromatic hydrocarbons in stormwater detention pond sediments of Coastal South Carolina, USA

    Energy Technology Data Exchange (ETDEWEB)

    Weinstein, John E., E-mail: john.weinstein@citadel.edu [Department of Biology, The Citadel, Charleston, SC (United States); Crawford, Kevin D. [Department of Chemistry, University of Wisconsin-Oshkosh, Oshkosh, WI (United States); Garner, Thomas R. [Institute of Environmental Toxicology, Clemson University, Pendleton, SC (United States); Flemming, Alan J. [South Carolina Department of Health and Environmental Control, Charleston, SC (United States)

    2010-06-15

    Screening-level ecological and human health assessments were performed for polycyclic aromatic hydrocarbon (PAH) contamination in the sediments of 19 stormwater detention ponds located in coastal South Carolina. For ecological screening benchmarks, we used threshold and probable effect concentrations (TEC and PEC) derived from consensus-based sediment quality guidelines for individual PAH analytes and equilibrium partitioning sediment benchmarks-toxic units ({Sigma}ESB-TU) derived for PAH mixtures. For human health benchmarks, we used preliminary remediation goals (PRGs). Sediments of five stormwater ponds (four commercial ponds and one residential pond with a large drainage area) exceeded PEC values for several PAH analytes and the {Sigma}ESB-TU safe value of 1 for PAH mixtures. These same five stormwater ponds also exceeded the PRG values for five carcinogenic PAH analytes. These results suggest that the PAH levels in sediments from certain commercial and residential ponds have the potential to pose moderate to high risks for adverse, chronic effects to benthic organisms in situ and an increased risk of cancer to humans ex situ following excavation and on-site disposal. We recommend that sediment from these stormwater ponds be tested prior to excavation to determine the appropriate method of disposal. We also recommend that regulatory agencies enforce guidelines for periodic sediment removal as this should reduce both in situ and ex situ risks resulting from sediment PAH exposure.

  17. Screening-level ecological and human health risk assessment of polycyclic aromatic hydrocarbons in stormwater detention pond sediments of Coastal South Carolina, USA

    International Nuclear Information System (INIS)

    Weinstein, John E.; Crawford, Kevin D.; Garner, Thomas R.; Flemming, Alan J.

    2010-01-01

    Screening-level ecological and human health assessments were performed for polycyclic aromatic hydrocarbon (PAH) contamination in the sediments of 19 stormwater detention ponds located in coastal South Carolina. For ecological screening benchmarks, we used threshold and probable effect concentrations (TEC and PEC) derived from consensus-based sediment quality guidelines for individual PAH analytes and equilibrium partitioning sediment benchmarks-toxic units (ΣESB-TU) derived for PAH mixtures. For human health benchmarks, we used preliminary remediation goals (PRGs). Sediments of five stormwater ponds (four commercial ponds and one residential pond with a large drainage area) exceeded PEC values for several PAH analytes and the ΣESB-TU safe value of 1 for PAH mixtures. These same five stormwater ponds also exceeded the PRG values for five carcinogenic PAH analytes. These results suggest that the PAH levels in sediments from certain commercial and residential ponds have the potential to pose moderate to high risks for adverse, chronic effects to benthic organisms in situ and an increased risk of cancer to humans ex situ following excavation and on-site disposal. We recommend that sediment from these stormwater ponds be tested prior to excavation to determine the appropriate method of disposal. We also recommend that regulatory agencies enforce guidelines for periodic sediment removal as this should reduce both in situ and ex situ risks resulting from sediment PAH exposure.

  18. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Science.gov (United States)

    Patel, Rachana; Ladusingh, Laishram

    2015-01-01

    This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

  19. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Directory of Open Access Journals (Sweden)

    Rachana Patel

    Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

  20. A Study on OBE Exceedance Criteria Using the CAV Concept for NPPs in Korea

    International Nuclear Information System (INIS)

    Park, Se Moon; Cho, Sung Il; Yun, Kwan Hee

    2009-01-01

    NPPs in Korea have so far complied with the US Regulatory Guide 1.12 Rev.1 (1974) for the seismic monitoring systems. However, researchers in Korea have been considering attempting to comply with Regulatory Guide 1.12 rev.2 (1997) when implementing all future seismic monitoring systems. To comply with the new regulations, Operating Basis Earthquake (OBE) Exceedance Criteria applied with the Cumulative Absolute Velocity (CAV) has to be developed for local use. The CAV was developed in the USA as one reasonable OBE exceedance criterion for NPPs; however, it has not been widely used outside the USA, not-withstanding its solid technical basis. It is, however, expected that the worldwide NPP construction boom will necessitate development and more frequent use of reasonable OBE exceedance criteria. As multi-units (four or more) are situated in one site in Korea, prevention of simultaneous shutdown of multi-unit caused by non damaging earthquakes is very important; otherwise, a serious economic loss could occur, and there could also be a great impact on the stability of the power grid that would arise due to the unnecessary shutdown. Actually, we have had the experience of observing a Peak Ground Acceleration (PGA)-value greater than 0.1g (the current OBE level for Korean NPPs) due to an M=4.8 earthquake (20 th Jan. '07) that did not even cause any damage to the poorly-designed structures nearby. This experience gave a motivation to the KHNP should concern the needs of study on OBE exceedance criteria in view of application of the CAV to Korean seismic situation, which will be more practical. The present paper is intended to show the intermediate result of the research on Operating Basis Earthquake (OBE) exceedance criteria in Korea

  1. Can LENR Energy Gains Exceed 1000?

    Science.gov (United States)

    Nagel, David J.

    2011-03-01

    Energy gain is defined as the energy realized from reactions divided by the energy required to produce those reactions. Low Energy Nuclear Reactions (LENR) have already been measured to significantly exceed the energy gain of 10 projected from ITER,possibly 15 years from now. Electrochemical experiments using the Pd-D system have shown energy gains exceeding 10. Gas phase experiments with the Ni-H system were reported to yield energy gains of over 100. Neither of these reports has been adequately verified or reproduced. However, the question in the title still deserves consideration. If, as thought by many, it is possible to trigger nuclear reactions that yield MeV energies with chemical energies of the order of eV, then the most optimistic expectation is that LENR gains could approach one million. Hence, the very tentative answer to the question above is yes. However, if LENR could be initiated with some energy cost, and then continue to ``burn,'' very high energy gains might be realized. Consider a match and a pile of dry logs. The phenomenon termed ``heat after death'' will be examined to see if it might be the initial evidence for nuclear ``burning.''

  2. Observed ozone exceedances in Italy: statistical analysis and modelling in the period 2002-2015

    Science.gov (United States)

    Falasca, Serena; Curci, Gabriele; Candeloro, Luca; Conte, Annamaria; Ippoliti, Carla

    2017-04-01

    Local ambient air quality is strongly influenced by anthropogenic emissions and meteorological conditions. The year 2015 is considered by NASA scientists as one of the hottest at the global scale since 1880. Furthermore, in Europe it was the first summer after the introduction of Euro6 regulation, the latest emission standard for passenger vehicles. The goal of this study is twofold: (1) the investigation of the impact of the heat wave occurred in the summer of 2015 on ozone levels and (2) the exploration of the weight of temperature as driver of high-level ozone events with respect to other variables. We performed a quantitative examination of the ozone seasons (May-September) for the period 2002-2015 using ozone concentration and weather data from 24 stations across Italy. The number of exceedances of limit values set by the European directive was calculated for each year, and compared with the trend of ozone concentration and temperature. Furthermore, the data were grouped in clusters of consecutive days of ozone exceedances in order to characterize the duration and the intensity of high ozone events. Finally, we developed a multivariate logistic regression model to investigate the role of a set of independent variables (meteorological, and temporal variables, altitude, number of inhabitants, vehicle emission standard) on the probability of exceedances. Results show that 2015 is one of the hottest years after 2003. During the period 2002-2015, the average number of exceedances per station of the daily maximum 8-hour average is often higher than the limit established by the European directive (25 per year). The highest number of exceedances was 65 per station, reached in 2003. The Po Valley is confirmed as a hot spot for pollution, with more frequent exceedances and a higher sensitivity to temperature, especially at urban sites. Ozone events in 2015 were fewer than recent years, but of longer duration (on average 4 days against 3 days), and with similar mean

  3. Relating road salt to exceedances of the water quality standard for chloride in New Hampshire streams.

    Science.gov (United States)

    Trowbridge, Philip R; Kahl, J Steve; Sassan, Dari A; Heath, Douglas L; Walsh, Edward M

    2010-07-01

    Six watersheds in New Hampshire were studied to determine the effects of road salt on stream water quality. Specific conductance in streams was monitored every 15 min for one year using dataloggers. Chloride concentrations were calculated from specific conductance using empirical relationships. Stream chloride concentrations were directly correlated with development in the watersheds and were inversely related to streamflow. Exceedances of the EPA water quality standard for chloride were detected in the four watersheds with the most development. The number of exceedances during a year was linearly related to the annual average concentration of chloride. Exceedances of the water quality standard were not predicted for streams with annual average concentrations less than 102 mg L(-1). Chloride was imported into three of the watersheds at rates ranging from 45 to 98 Mg Cl km(-2) yr(-1). Ninety-one percent of the chloride imported was road salt for deicing roadways and parking lots. A simple, mass balance equation was shown to predict annual average chloride concentrations from streamflow and chloride import rates to the watershed. This equation, combined with the apparent threshold for exceedances of the water quality standard, can be used for screening-level TMDLs for road salt in impaired watersheds.

  4. Prediction in Partial Duration Series With Generalized Pareto-Distributed Exceedances

    DEFF Research Database (Denmark)

    Rosbjerg, Dan; Madsen, Henrik; Rasmussen, Peter Funder

    1992-01-01

    As a generalization of the common assumption of exponential distribution of the exceedances in Partial duration series the generalized Pareto distribution has been adopted. Estimators for the parameters are presented using estimation by both method of moments and probability-weighted moments...... distributions (with physically justified upper limit) the correct exceedance distribution should be applied despite a possible acceptance of the exponential assumption by a test of significance....

  5. Spot volume exceeds 2 million lbs (again); restricted price hits $10/lb

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    This article is the January 1995 uranium market summary. Volume on the spot concentrates market exceeded 2 million lbs equivalent for the second consecutive month. Six deals took place; four in the spot concentrates market, one in the conversion market, and one in the enrichment market. No deals took place in the medium or long-term market. The upper end of the restricted price range reached $10.00 per lb U3O8, its highest level since December 1993. The lower end of the restricted price range strengthened to $9.75. The lower end of the spot conversion price range strengthed to $5.70 per kg U, and SWU prices firmed to the $75.00 to $87.00 level

  6. Derivation and Mapping of Critical Loads for Nitrogen and Trends in Their Exceedance in Germany

    Directory of Open Access Journals (Sweden)

    Hans-Dieter Nagel

    2001-01-01

    Full Text Available The term “critical load” means a quantitative estimate of an exposure to one or more pollutants below which significant harmful effects on specified sensitive elements of the environment do not occur, according to present knowledge. In the case of nitrogen, both oxidised and reduced compounds contribute to the total deposition of acidity, which exceeds critical loads in many forest ecosystems. These also cause negative effects through eutrophication. Critical loads of nitrogen were derived for forest soils (deciduous and coniferous forest, natural grassland, acid fens, heathland, and mesotrophic peat bogs. In Germany, a decrease in sulphur emissions over the past 15 years resulted in a reduced exceedance of critical loads for acid deposition. In the same period it was noted that reduction in the emissions of nitrogen oxides and ammonia remained insignificant. Therefore, emissions of nitrogen compounds have become relatively more important and will continue to threaten ecosystem function and stability. The risk of environmental damage remains at an unacceptable level. The German maps show the degree to which the critical loads are exceeded, and they present current developments and an expected future trend. Results indicate that recovery from pollutant stress occurs only gradually.

  7. Recommended action levels for radon in dwellings

    International Nuclear Information System (INIS)

    1988-01-01

    The recommendation made by a group appointed by the Directorate of Public Health, arrives at the conclusion that radon in Norwegian dwellings implies a substantial health problem for the country. For this reason it is recommended that actions should be taken to reduce the radiation exposure from radon in Norway. Upper levels for such actions are set to 200 Bq/m 3 (radon in air of dwellings) for new contructions. For existing dwellings having concentrations of 200 - 800 Bq/m 3 , simple and unexpensive remedial actions to reduce levels are sufficient. When levels exceed 800 Bq/m 3 , more elaborate and costly actions are necessary. An evaluation of the extent of the radon problem in Norway is included, together with a survey of the cost and benefit involved in choosing various levels for remedial actions

  8. Heavy metal levels in kiwifruit orchard soils and trees and its potential health risk assessment in Shaanxi, China.

    Science.gov (United States)

    Guo, Jing; Yue, Tianli; Li, Xiaotong; Yuan, Yahong

    2016-07-01

    Concentrations of five heavy metals (Cr, Cu, Cd, Hg, and Pb) in orchard soils and kiwifruit tissues (root, twig, leave, fruit) collected from Shaanxi province in China were measured, and the potential health risk for human through the fruit consumption was assessed. The orchard soils were in no pollution for Cr, Cu, Hg, and Pb, with their pollution index (PI) ≤1, while 10.0 % of the soil samples were under Cd contamination. Furthermore, kiwifruit tended to have a higher Cd and Hg accumulation (as indicated by Biological Accumulation Coefficient) from soil and have a higher Cu and Hg translocation (as reflected by Biological Transfer Coefficient) to aboveground parts. From the human health point of view, the DIM and HRI values for all the fruit samples were within the safe limits, while for Cr, Cu, Cd, Hg, and Pb, about 22.5, 12.5, 52.5, 15.0, and 47.5 % of the fruit samples exceeded the national maximum permissible levels, respectively. These results showed that, although there was no possible health risk to consumers due to intake of studied kiwifruit fruits under the current consumption rate, the regular survey of heavy metal pollution levels should be performed for the kiwifruit in Shaanxi province and a strict management program should be established to reduce the amount of chemical fertilizers and pesticides used in fruit production in order to prevent the potential health risk.

  9. 29 CFR 4.162 - Fringe benefits under contracts exceeding $2,500.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Fringe benefits under contracts exceeding $2,500. 4.162... Compensation Standards § 4.162 Fringe benefits under contracts exceeding $2,500. (a) Pursuant to the statutory... contain a provision specifying the fringe benefits to be furnished the various classes of service...

  10. Associations between chlorophyll a and various microcystin health advisory concentrations [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Hollister

    2016-06-01

    Full Text Available Cyanobacteria harmful algal blooms (cHABs are associated with a wide range of adverse health effects that stem mostly from the presence of cyanotoxins. To help protect against these impacts, several health advisory levels have been set for some toxins. In particular, one of the more common toxins, microcystin, has several advisory levels set for drinking water and recreational use. However, compared to other water quality measures, field measurements of microcystin are not commonly available due to cost and advanced understanding required to interpret results. Addressing these issues will take time and resources. Thus, there is utility in finding indicators of microcystin that are already widely available, can be estimated quickly and in situ, and used as a first defense against high levels of microcystin. Chlorophyll a is commonly measured, can be estimated in situ, and has been shown to be positively associated with microcystin. In this paper, we use this association to provide estimates of chlorophyll a concentrations that are indicative of a higher probability of exceeding select health advisory concentrations for microcystin. Using the 2007 National Lakes Assessment and a conditional probability approach, we identify chlorophyll a concentrations that are more likely than not to be associated with an exceedance of a microcystin health advisory level. We look at the recent US EPA health advisories for drinking water as well as the World Health Organization levels for drinking water and recreational use and identify a range of chlorophyll a thresholds. A 50% chance of exceeding one of the specific advisory microcystin concentrations of 0.3, 1, 1.6, and 2 μg/L is associated with chlorophyll a concentration thresholds of 23, 68, 84, and 104 μg/L, respectively. When managing for these various microcystin levels, exceeding these reported chlorophyll a concentrations should be a trigger for further testing and possible management action.

  11. Physical Activity, Energy Expenditure, Nutritional Habits, Quality of Sleep and Stress Levels in Shift-Working Health Care Personnel.

    Science.gov (United States)

    Roskoden, Frederick Charles; Krüger, Janine; Vogt, Lena Johanna; Gärtner, Simone; Hannich, Hans Joachim; Steveling, Antje; Lerch, Markus M; Aghdassi, Ali A

    2017-01-01

    Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups. We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff). All were investigated over 7 days by multisensory accelerometer (SenseWear Bodymedia® armband) and kept a detailed food diary. Physical activity and resting energy expenditure (REE) were measured in metabolic equivalents of task (METs). Quality of sleep was assessed as Pittsburgh Sleeping Quality Index and stress load using the Trier Inventory for Chronic Stress questionnaire (TICS). No significant differences were found for overall physical activity, steps per minute, time of exceeding the 3 METs level or sleep quality. A significant difference for physical activity during working hours was found between shift-workers vs. non-shift-workers (pworking nurses (median = 2.1 METs SE = 0.1) vs. non-shift-working clerical personnel (median = 1.5 METs SE = 0.07, pworking nurses had a significantly lower REE than the other groups (pworking nurses consumed significantly more carbohydrates (median = 46% SE = 1.4) than clerical staff (median = 41% SE = 1.7). Stress assessment by TICS confirmed a significantly higher level of social overload in the shift working group (pworking had no influence on overall physical activity. Lower physical activity during working hours appears to be compensated for during off-hours. Differences in nutritional habits and stress load warrant larger scale trials to determine the effect on implicit health-associated conditions.

  12. [Impact of mid-level management and support on the performance of a district health system in the Democratic Republic of the Congo].

    Science.gov (United States)

    Kahindo, M J B; Schirvel, C; Karemere, H; Mitangala, P; Wodon, A; Porignon, D

    2011-04-01

    The aim of this study was to assess the contribution of mid-level management and support practices to the overall performance of a district healthcare system. This case study was carried out in the North Kivu Province of the Democratic Republic of the Congo. It was based on analysis of (i) preventive and curative healthcare services and (ii) management and support practices provided from 2000 to 2008. In response to recurring sociopolitical unrest since 1992, the mid-level health system (provincial level) in North Kivu has strengthened management and support practices. The main goals have been to optimize allocation of interventions by external emergency organizations and integration of specialized program activities, to harmonize intervention techniques implemented by external partners, to standardize supervision of sanitary districts with regard to care provider skills, and to adapt strategic options defined by the Ministry of Health to the provincial level. Using this comprehensive approach, the performance of the North Kivu Province in terms of curative and preventive care has exceeded the national average since 2001. Between 2001 and 2008, use of curative services progressed from 0.36 to 0.50 new cases/capita/year. Positive results have also been recorded for infrastructure coverage, essential medicine stock, health information system, and emergency preparedness. Stronger mid-level management and support practices have improved care activities in the health district while protecting the population from unstructured interventions by emergency organizations or specialized programs. A comprehensive management approach has also improved the resilience of the district and increased its contribution to Millennium Development Goals.

  13. Readability levels of health pamphlets distributed in hospitals and health centres in Athens, Greece.

    Science.gov (United States)

    Kondilis, B K; Akrivos, P D; Sardi, T A; Soteriades, E S; Falagas, M E

    2010-10-01

    Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics. Observational study in the greater metropolitan area of Athens, Greece. Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software. Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (PPamphlets from private hospitals were one grade more difficult than those from public hospitals. Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Promoting health equity: WHO health inequality monitoring at global and national levels

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

    2015-01-01

    Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

  15. Promoting health equity: WHO health inequality monitoring at global and national levels.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

    2015-01-01

    Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

  16. Promoting health equity: WHO health inequality monitoring at global and national levels

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Hosseinpoor

    2015-09-01

    Full Text Available Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

  17. ATLAS: Exceeding all expectations

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    “One year ago it would have been impossible for us to guess that the machine and the experiments could achieve so much so quickly”, says Fabiola Gianotti, ATLAS spokesperson. The whole chain – from collision to data analysis – has worked remarkably well in ATLAS.   The first LHC proton run undoubtedly exceeded expectations for the ATLAS experiment. “ATLAS has worked very well since the beginning. Its overall data-taking efficiency is greater than 90%”, says Fabiola Gianotti. “The quality and maturity of the reconstruction and simulation software turned out to be better than we expected for this initial stage of the experiment. The Grid is a great success, and right from the beginning it has allowed members of the collaboration all over the world to participate in the data analysis in an effective and timely manner, and to deliver physics results very quickly”. In just a few months of data taking, ATLAS has observed t...

  18. Public health assessment for Carroll and Dubies Sewage Disposal, Port Jervis, Orange County, New York, Region 2. Cerclis No. NYD010968014. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-26

    The Carroll and Dubies site contains seven former waste water lagoons which received waste from septic tanks and industries (primarily two cosmetic manufacturers). On-site shallow oil, subsurface soil, lagoon surface water and sludge, and groundwater are contaminated with volatile and semi-volatile organic compounds and metals at levels exceeding public health assessment comparison values. Off-site groundwater samples taken near the site, in the direction of groundwater flow, contain volatile organic compounds at levels exceeding public health assessment comparison values. There are no past or current exposures to site-related chemicals at levels that are a public health concern; therefore, the site is categorized as no apparent public health hazard as long as the site is properly remediated.

  19. Exceedance probability map: a tool helping the definition of arsenic Natural Background Level (NBL) within the Drainage Basin to the Venice Lagoon (NE Italy)

    Science.gov (United States)

    Dalla Libera, Nico; Fabbri, Paolo; Mason, Leonardo; Piccinini, Leonardo; Pola, Marco

    2017-04-01

    Arsenic groundwater contamination affects worldwide shallower groundwater bodies. Starting from the actual knowledges around arsenic origin into groundwater, we know that the major part of dissolved arsenic is naturally occurring through the dissolution of As-bearing minerals and ores. Several studies on the shallow aquifers of both the regional Venetian Plain (NE Italy) and the local Drainage Basin to the Venice Lagoon (DBVL) show local high arsenic concentration related to peculiar geochemical conditions, which drive arsenic mobilization. The uncertainty of arsenic spatial distribution makes difficult both the evaluation of the processes involved in arsenic mobilization and the stakeholders' decision about environmental management. Considering the latter aspect, the present study treats the problem of the Natural Background Level (NBL) definition as the threshold discriminating the natural contamination from the anthropogenic pollution. Actually, the UE's Directive 2006/118/EC suggests the procedures and criteria to set up the water quality standards guaranteeing a healthy status and reversing any contamination trends. In addition, the UE's BRIDGE project proposes some criteria, based on the 90th percentile of the contaminant's concentrations dataset, to estimate the NBL. Nevertheless, these methods provides just a statistical NBL for the whole area without considering the spatial variation of the contaminant's concentration. In this sense, we would reinforce the NBL concept using a geostatistical approach, which is able to give some detailed information about the distribution of arsenic concentrations and unveiling zones with high concentrations referred to the Italian drinking water standard (IDWS = 10 µg/liter). Once obtained the spatial information about arsenic distribution, we can apply the 90th percentile methods to estimate some Local NBL referring to every zones with arsenic higher than IDWS. The indicator kriging method was considered because it

  20. Public health risk assessment of groundwater contamination in Batman, Turkey.

    Science.gov (United States)

    Nalbantcilar, M Tahir; Pinarkara, Sukru Yavuz

    2016-08-01

    In this study, a comprehensive analysis of groundwater was performed to assess contamination and phenol content in Batman, Turkey, particularly in residential areas near agriculture, livestock and oil industry facilities. From these areas, where potentially contaminated groundwater used for drinking and irrigation threatens public health, 30 groundwater samples were collected and analyzed for heavy metal concentrations (Al, As, B, Ba, Ca, Cd, Cl, Co, Cr, Cu, Fe, Hg, Li, Mg, Mn, Mo, Na, Ni, NO3, P, Pb, phenol, S, Sb, Se, SO4, Sr, U, and Zn). Compared with the standards of the Environmental Protection Agency, Al, Fe, and Mn concentrations in groundwater exceeded secondary drinking water regulations, NO3 concentrations were high for maximum contaminant levels, and As, Pb, and U concentrations exceeded maximum contaminant level goals in all samples. Ni, Sb, and Se concentrations also exceeded limits set by the Turkish Standards Institution. Nearly all samples revealed concentrations of Se, Sb, Hg, and phenol due to nearby petroleum refineries, oil storage plants, and agricultural and livestock areas. The results obtained from this study indicate that the groundwater in Batman contains elements in concentrations that approach or exceed limits and thus threatens public health with increased blood cholesterol, decreased blood sugar, and circulatory problems.

  1. Conducting Organizational-level occupational health interventions: What works?

    DEFF Research Database (Denmark)

    Nielsen, Karina; Randall, Raymond; Holten, Ann-Louise

    2010-01-01

    In recent years, there has been an increasing interest in how organizational-level occupational health interventions aimed at improving psychosocial working conditions and employee health and well-being may be planned, implemented and evaluated. It has been claimed that such interventions have...... the alteration of the way in which work is designed, organized and managed. The methods identified are the Risk Management approach and the Management Standards from Great Britain, the German Health Circles approach, Work Positive from Ireland and Prevenlab from Spain. Comparative analyses reveal...... their appropriateness in conducting organizationallevel occupational health interventions. Finally, we discuss where we still need more research to determine the working ingredients of organizational-level occupational health interventions....

  2. Physical Activity, Energy Expenditure, Nutritional Habits, Quality of Sleep and Stress Levels in Shift-Working Health Care Personnel

    Science.gov (United States)

    Vogt, Lena Johanna; Gärtner, Simone; Hannich, Hans Joachim; Steveling, Antje; Lerch, Markus M.

    2017-01-01

    Background Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups. Methods We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff). All were investigated over 7 days by multisensory accelerometer (SenseWear Bodymedia® armband) and kept a detailed food diary. Physical activity and resting energy expenditure (REE) were measured in metabolic equivalents of task (METs). Quality of sleep was assessed as Pittsburgh Sleeping Quality Index and stress load using the Trier Inventory for Chronic Stress questionnaire (TICS). Results No significant differences were found for overall physical activity, steps per minute, time of exceeding the 3 METs level or sleep quality. A significant difference for physical activity during working hours was found between shift-workers vs. non-shift-workers (pshift-working nurses (median = 2.1 METs SE = 0.1) vs. non-shift-working clerical personnel (median = 1.5 METs SE = 0.07, pshift-working nurses had a significantly lower REE than the other groups (pshift-working nurses consumed significantly more carbohydrates (median = 46% SE = 1.4) than clerical staff (median = 41% SE = 1.7). Stress assessment by TICS confirmed a significantly higher level of social overload in the shift working group (pshift-working had no influence on overall physical activity. Lower physical activity during working hours appears to be compensated for during off-hours. Differences in nutritional habits and stress load warrant larger scale trials to determine the effect on implicit health-associated conditions. PMID:28081231

  3. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  6. HELLE: Health Effects of Low Level Exposures

    International Nuclear Information System (INIS)

    Schoten, Eert

    1998-01-01

    The Health Council is closely involved in establishing the scientific foundation of exposure limits for substances and radiation in order to protect public health. Through the years, the Council has contributed to the formulation of principles and procedures, both for carcinogenic and for noncarcinogenic agents. As a rule, the discussion with regard to the derivation of health-based recommended exposure limits centers around the appropriateness of extrapolation methods (What can be inferred from data on high exposure levels and on experimental animals?). Generally speaking, there is a lack of direct information on the health effects of low levels of exposure. Effects at these levels cannot usually be detected by means of traditional animal experiments or epidemiological research. The capacity of these analytical instruments to distinguish between ''signal'' and ''noise'' is inadequate in most cases. Annex B of this report contains a brief outline of the difficulties and the established methods for tackling this problem. In spite of this, the hope exists that the posited weak signals, if they are indeed present, can be detected by other means. The search will have to take place on a deeper level. In other words, effort must be made to discover what occurs at underlying levels of biological organization when organisms are exposed to low doses of radiation or substances. Molecular and cell biology provide various methods and techniques which give an insight into the processes within the cell. This results in an increase in the knowledge about the molecular and cellular effects of exposure to agents, or stated differently, the working mechanisms which form the basis of the health effects. Last year, the Health Council considered that the time was ripe to take stock of the state of knowledge in this field. To this end, an international working conference was held from 19 to 21 October 1997, entitled ''Health Effects of Low Level Exposures: Scientific Developments and

  7. Broader health coverage is good for the nation's health: evidence from country level panel data.

    Science.gov (United States)

    Moreno-Serra, Rodrigo; Smith, Peter C

    2015-01-01

    Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries.

  8. 40 CFR 1045.107 - What are the not-to-exceed emission standards?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false What are the not-to-exceed emission... Emission Standards and Related Requirements § 1045.107 What are the not-to-exceed emission standards? Not...) For engines equipped with a catalyst, use NTE multipliers from the following table across the...

  9. Human Health Risk from Metals in Fish from Saudi Arabia: Consumption Patterns for Some Species Exceed Allowable Limits

    KAUST Repository

    Burger, Joanna

    2014-10-06

    ABSTRACT: Fish are a healthful source of protein, but contaminants in some fish pose a risk. While there are multiple risk assessments from Europe and North America, there are far fewer for other parts of the world. We examined the risks from mercury, arsenic, lead, and other metals in fish consumed by people in Jeddah area, Saudi Arabia, using site-specific data on consumption patterns and metal levels in fish. The U.S. Environmental Protection Agency\\'s Hazard Quotient (HQ) and cumulative Hazard Index (HI) for non-cancer endpoints and Carcinogenic Index for cancer were used to determine the health risk based on fish consumption rates. Of the 13 fish species examined, HQ was greater than 1 (indicating elevated risk) in two species for arsenic, and seven species for methylmercury. The cumulative HI for all metals was above 1 for all but three species of fish at the mean consumption rates. Generally, fish species with HI above 1 for one sampling location, had HI above 1 for all sampling locations. The implications of these findings are discussed in the light of strategies for reducing risk from fish consumption while encouraging dietary intakes of fish with low mercury and arsenic levels.

  10. Operating room sound level hazards for patients and physicians.

    Science.gov (United States)

    Fritsch, Michael H; Chacko, Chris E; Patterson, Emily B

    2010-07-01

    Exposure to certain new surgical instruments and operating room devices during procedures could cause hearing damage to patients and personnel. Surgical instruments and related equipment generate significant sound levels during routine usage. Both patients and physicians are exposed to these levels during the operative cases, many of which can last for hours. The noise loads during cases are cumulative. Occupational Safety and Health Administration (OSHA) and National Institute for Occupational Safety and Health (NIOSH) standards are inconsistent in their appraisals of potential damage. Implications of the newer power instruments are not widely recognized. Bruel and Kjaer sound meter spectral recordings for 20 major instruments from 5 surgical specialties were obtained at the ear levels for the patient and the surgeon between 32 and 20 kHz. Routinely used instruments generated sound levels as high as 131 dB. Patient and operator exposures differed. There were unilateral dominant exposures. Many instruments had levels that became hazardous well within the length of an average surgical procedure. The OSHA and NIOSH systems gave contradicting results when applied to individual instruments and types of cases. Background noise, especially in its intermittent form, was also of significant nature. Some patients and personnel have additional predisposing physiologic factors. Instrument noise levels for average length surgical cases may exceed OSHA and NIOSH recommendations for hearing safety. Specialties such as Otolaryngology, Orthopedics, and Neurosurgery use instruments that regularly exceed limits. General operating room noise also contributes to overall personnel exposures. Innovative countermeasures are suggested.

  11. Levels of narrative analysis in health psychology.

    Science.gov (United States)

    Murray, M

    2000-05-01

    The past 10-15 years have seen a rapid increase in the study of narrative across all the social sciences. It is sometimes assumed that narrative has the same meaning irrespective of the context in which it is expressed. This article considers different levels of narrative analysis within health psychology. Specifically, it considers the character of health and illness narratives as a function of the personal, interpersonal, positional and societal levels of analysis. At the personal level of analysis narratives are portrayed as expressions of the lived experience of the narrator. At the interpersonal level of analysis the narrative is one that is co-created in dialogue. At the positional level of analysis the analysis considers the differences in social position between the narrator and the listener. The societal level of analysis is concerned with the socially shared stories that are characteristic of certain communities or societies. The challenge is to articulate the connections between these different levels of narrative analysis and to develop strategies to promote emancipatory narratives.

  12. Home modification to reduce falls at a health district level: Modeling health gain, health inequalities and health costs.

    Directory of Open Access Journals (Sweden)

    Nick Wilson

    Full Text Available There is some evidence that home safety assessment and modification (HSAM is effective in reducing falls in older people. But there are various knowledge gaps, including around cost-effectiveness and also the impacts at a health district-level.A previously established Markov macro-simulation model built for the whole New Zealand (NZ population (Pega et al 2016, Injury Prevention was enhanced and adapted to a health district level. This district was Counties Manukau District Health Board, which hosts 42,000 people aged 65+ years. A health system perspective was taken and a discount rate of 3% was used for both health gain and costs. Intervention effectiveness estimates came from a systematic review, and NZ-specific intervention costs were extracted from a randomized controlled trial. In the 65+ age-group in this health district, the HSAM program was estimated to achieve health gains of 2800 quality-adjusted life-years (QALYs; 95% uncertainty interval [UI]: 547 to 5280. The net health system cost was estimated at NZ$8.44 million (95% UI: $663 to $14.3 million. The incremental cost-effectiveness ratio (ICER was estimated at NZ$5480 suggesting HSAM is cost-effective (95%UI: cost saving to NZ$15,300 [equivalent to US$10,300]. Targeting HSAM only to people age 65+ or 75+ with previous injurious falls was estimated to be particularly cost-effective (ICERs: $700 and $832, respectively with the latter intervention being cost-saving. There was no evidence for differential cost-effectiveness by sex or by ethnicity: Māori (Indigenous population vs non-Māori.This modeling study suggests that a HSAM program could produce considerable health gain and be cost-effective for older people at a health district level. Nevertheless, comparisons may be desirable with other falls prevention interventions such as group exercise programs, which also provide social contact and may prevent various chronic diseases.

  13. Human health risk due to variations in PM10-PM2.5 and associated PAHs levels

    Science.gov (United States)

    Sosa, Beatriz S.; Porta, Andrés; Colman Lerner, Jorge Esteban; Banda Noriega, Roxana; Massolo, Laura

    2017-07-01

    WHO (2012) reports that chronic exposure to air pollutants, including particulate matter (PM), causes the death of 7 million people, constituting the most important environmental risk for health in the world. IARC classifies contaminated outdoor air as carcinogenic, Group 1 category. However, in our countries there are few studies regarding air pollution levels and possible associated effects on public health. The current study determined PM and associated polycyclic aromatic hydrocarbons (PAHs) levels in outdoor air, identified their possible emission sources and analysed health risks in the city of Tandil (Argentina). PM10 and PM2.5 samples were collected using a low volume sampler (MiniVol TAS) in three areas: city centre, industrial and residential. Concentrations were determined by gravimetric methods and the content of the US EPA 16 priority PAHs was found by high performance liquid chromatography (HPLC). Description of the main emission sources and selection of monitoring sites resulted from spatial analysis and the IVE (International Vehicle Emissions) model was used in the characterisation of the traffic flow. Median values of 35.7 μgm-3 and 9.6 μgm-3 in PM10 and PM2.5 respectively and characteristic profiles were found for each area. Local values PAHs associated to PM10 and PM2.5, in general, were lower than 10ngm-3. The estimated Unit Risk for the three areas exceeds US EPA standards (9 × 10-5). The number of deaths attributable to short term exposure to outdoor PM10 was 4 cases in children under 5 years of age, and 21 cases in total population, for a relative risk of 1.037.

  14. Occupational Health and Safety. Level 1. Level 2. Level 3. Support Materials for Agricultural Training.

    Science.gov (United States)

    Batman, Kangan; Gadd, Nick; Lucas, Michele

    This publication contains the three communication skills units of the three levels of Support Materials for Agricultural Training (SMAT) in the area of occupational health and safety: Level 1 (starting), 2 (continuing), and 3 (completing). The units are designed to help the learner improve his or her written and spoken communication skills needed…

  15. Level of health care and services in a tertiary health setting in Nigeria

    African Journals Online (AJOL)

    Level of health care and services in a tertiary health setting in Nigeria. ... Background: There is a growing awareness and demand for quality health care across the world; hence the ... Doctors and nurses formed 64.3% of the study population.

  16. Health effects of low-level ionizing radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1979-04-01

    It is now assumed that any exposure to radiaton at low levels of dose carries some risk of deleterious effects. How low this level may be, or the probability or magnitude of the risk, still are not known. Our best scientific knowledge and advice are essential for the protection of the public health, for the effective application of new technologies in medicine and industry and for guidance in the production of nuclear energy. Unless man wishes to dispense with those activities which inevitably involve exposure to low levels of ionizing radiations, he must recognize that some degree of risk to health, however small, exists. A pragmatic appraisal of how man wishes to continue to derive the benefits of health and happiness from such activities involving ionizing radiaton in times of everchanging conditions and public attitudes in our resource-limited society is the task which lies before all of us - all men and women of our society, of science and of medicine, and of law and government - now and in the future

  17. Low-level maternal methylmercury exposure through rice ingestion and potential implications for offspring health

    International Nuclear Information System (INIS)

    Rothenberg, Sarah E.; Feng Xinbin; Li Ping

    2011-01-01

    Fish consumption is considered the primary pathway for MeHg (MeHg) exposure; however, MeHg exposure also occurs through rice ingestion. Rice is grown in an aquatic environment and although documented MeHg concentrations in rice are lower compared to fish tissue, human exposures exceed international guidelines in some regions where rice is a staple food and rice MeHg levels are elevated. Studies concerning human health exposure to MeHg should also include populations where maternal MeHg exposure occurs through ingestion of rice. Rice does not contain long-chain polyunsaturated fatty acids, which are associated with confounding developmental outcomes in offspring. Rice is also a staple food for more than half the world's population; therefore, it is critical to investigate the potential health risks of maternal ingestion of rice to the developing fetus, the most susceptible population to the deleterious effects of MeHg. Data concerning MeHg in rice are reviewed and micronutrients in rice are discussed. - Research highlights: → Maternal methylmercury exposure through rice may be important. → Rice does not contain the same micronutrients as fish, but may contain methylmercury. → Effects to offspring from methylmercury without beneficial micronutrients are unknown. - Studies concerning maternal methylmercury exposure and cognitive outcomes for offspring should include populations where rice ingestion is the primary methylmercury exposure pathway.

  18. Low-level maternal methylmercury exposure through rice ingestion and potential implications for offspring health

    Energy Technology Data Exchange (ETDEWEB)

    Rothenberg, Sarah E., E-mail: rothenberg.sarah@gmail.com [State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, 46 Guanshui Lu, Guiyang 550002 (China); Feng Xinbin, E-mail: fengxinbin@vip.skleg.cn [State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, 46 Guanshui Lu, Guiyang 550002 (China); Li Ping [State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, 46 Guanshui Lu, Guiyang 550002 (China)

    2011-04-15

    Fish consumption is considered the primary pathway for MeHg (MeHg) exposure; however, MeHg exposure also occurs through rice ingestion. Rice is grown in an aquatic environment and although documented MeHg concentrations in rice are lower compared to fish tissue, human exposures exceed international guidelines in some regions where rice is a staple food and rice MeHg levels are elevated. Studies concerning human health exposure to MeHg should also include populations where maternal MeHg exposure occurs through ingestion of rice. Rice does not contain long-chain polyunsaturated fatty acids, which are associated with confounding developmental outcomes in offspring. Rice is also a staple food for more than half the world's population; therefore, it is critical to investigate the potential health risks of maternal ingestion of rice to the developing fetus, the most susceptible population to the deleterious effects of MeHg. Data concerning MeHg in rice are reviewed and micronutrients in rice are discussed. - Research highlights: > Maternal methylmercury exposure through rice may be important. > Rice does not contain the same micronutrients as fish, but may contain methylmercury. > Effects to offspring from methylmercury without beneficial micronutrients are unknown. - Studies concerning maternal methylmercury exposure and cognitive outcomes for offspring should include populations where rice ingestion is the primary methylmercury exposure pathway.

  19. Economic impacts from PM2.5 pollution-related health effects in China's road transport sector: A provincial-level analysis.

    Science.gov (United States)

    Tian, Xu; Dai, Hancheng; Geng, Yong; Wilson, Jeffrey; Wu, Rui; Xie, Yang; Hao, Han

    2018-06-01

    Economic impact assessments of air pollution-related health effects from a sectoral perspective in China is still deficient. This study evaluates the PM 2.5 pollution-related health impacts of the road transport sector on China's economy at both national and provincial levels in 2030 under various air mitigation technologies scenarios. Health impacts are estimated using an integrated approach that combines the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, a computable general equilibrium (CGE) model and a health model. Results show that at a national level, the road transport sector leads to 163.64 thousand deaths per year, increases the per capita risk of morbidity by 0.37% and accounts for 1.43 billion Yuan in health care expenditures. We estimate 442.90 billion Yuan of the value of statistical life loss and 2.09 h/capita of work time loss in 2015. Without additional control measures, air pollution related to the transport sector will cause 177.50 thousand deaths in 2030, a 0.40% per capita increase in the risk of morbidity, accounting for 4.12 billion Yuan in health care expenditures, 737.15 billion Yuan of statistical life loss and 2.23 h/capita of work time loss. Based on our model, implementing the most strict control strategy scenario would decrease mortality by 42.14%, morbidity risk by 42.14%, health care expenditures by 41.94%, statistical life loss by 26.22% and hours of work time loss by 42.65%, comparing with the no control measure scenario. In addition, PM 2.5 pollution from the road transport sector will cause 0.68% GDP loss in 2030. At a provincial level, GDP losses in 14 out of 30 provinces far exceed the national rate. Henan (1.20%), Sichuan (1.07%), Chongqing (0.99%), Hubei (0.94%), and Shandong (0.90%) would experience the highest GDP loss in 2030. Implementing control strategies to reduce PM 2.5 pollution in the road transport sector could bring positive benefits in half of the Chinese provinces especially in

  20. Public health leadership competency level among health professionals in a South Eastern European country

    Directory of Open Access Journals (Sweden)

    Orjola Pampuri

    2015-12-01

    the overall scores and the subscale scores of the current and the required level of leadership competencies among health professionals. Results: Mean value of the overall summary score for the 52 items of the instrument was significantly lower for the current leadership competency level compared with the required leadership competency level (138.4±11.2 vs. 159.7±25.3, respectively; P<0.001. Most of the subscales’ scores were significantly higher for the required than for the current leadership competency level. Conclusion: Our study provides useful evidence about the current and the required level of leadership competencies among health professionals in transitional Albania. Findings of this study may help policymakers in Albania to identify the gap between the required and the current level of leadership competencies among health  professionals. Furthermore, findings of this study should be expanded in the neighbouring countries of the South Eastern European region and beyond.

  1. How much Baltic salmon can be consumed without exceeding the tolerable safety limit ?

    Energy Technology Data Exchange (ETDEWEB)

    Kristiansen, H.R. [Mobile Nutrients Ltd. (Denmark)

    2004-09-15

    Because Baltic salmon is a top predator preying on sprat, herring and tobis, it is very vulnerable to contamination with dioxin and PCBs. The EU safety limit (SL) for fish is 4 picogram (pg) WHOTEQ g{sup -1} fresh fish. In April 2004, Danish commercial salmon fishing was banned to in the Baltic sea around Bornholm and Gotland (mainly ICES areas 25, 26), because the Food Administration reported dioxin levels exceeding the intervention level of 3 pg g{sup -1} fresh salmon. Their report was based on data from 10 individual salmon, and 3 pooled samples, each with 10 salmon. Since dioxins are widespread in the environment, the human population face a trade off to produce sufficient food that is safe to eat and avoid eating contaminated food. The world population is increasing, and the demand for healthy food is steadily increasing. Consequently, there is a need for risk assessments, where the consequences of eating foods with different grades of contamination is evaluated. The evaluation must be based on data of high quality, and because dioxin accumulation is a slow proces, the risk assessments should consider long time periods of months and years instead of days and weeks. The purpose of the present study is to evaluate the statistical variation of dioxin data from Baltic herring and salmon. The data are used to calculate the quantity of herring and salmon, that humans of different body weight can eat without exceeding the tolerable daily intake (TDI). (In dietary recommendations exposure from dairy products etc. must also be taken into account). A PCDD/F box model is proposed that subtract losses during cooking and postprandially.

  2. Pollution level and human health risk assessment of some pesticides and polychlorinated biphenyls in Nantong of Southeast China

    Institute of Scientific and Technical Information of China (English)

    Na Wang; Li Yi; Lili Shi; Deyang Kong; Daoji Cai; Donghua Wang; Zhengjun Shan

    2012-01-01

    Food consumption is one of the key exposure routes of humans to contaminants.This article evaluated the residue levels of 51 pesticides and 16 polychlorinated biphenyls (PCBs) in selected fish and food items which were commonly consumed in the Nantong area of Jiangsu Province,Southeast China.The 51 pesticides and 16 PCBs were analyzed by highly sensitive gas chromatographytandem mass spectrometry (GC-MS/MS).The results showed that organochlorine pesticides such as dichlorodiphenyltrichloroethanes (DDTs),hexachlorocyclohexanes (HCHs),hexachlorobenzene (HCB) and mirex and other pesticides including chlorpyrifos,pyrethroid pesticides,metolachlor,pyridaben and trifluralin were frequently detected in the samples,which was consistent with the accumulation level and characteristics of these toxic chemicals in human adipose tissue of people living in Nantong.Meanwhile,correlation of the residue level of toxic chemicals with their physical chemical properties and historic use pattern in Nantong area was observed.Combined with dietary survey results at the same sampling locations,human health risk assessment of ingestion through the dietary route was performed.The results suggested that the non-cancer risks of the chemicals investigated can be considered negligible in the Nantong area,however,the cancer risks from lifetime dietary exposure to DDTs and HCB have exceeded the acceptable levels.

  3. Is health workforce planning recognising the dynamic interplay between health literacy at an individual, organisation and system level?

    Science.gov (United States)

    Naccarella, Lucio; Wraight, Brenda; Gorman, Des

    2016-02-01

    The growing demands on the health system to adapt to constant change has led to investment in health workforce planning agencies and approaches. Health workforce planning approaches focusing on identifying, predicting and modelling workforce supply and demand are criticised as being simplistic and not contributing to system-level resiliency. Alternative evidence- and needs-based health workforce planning approaches are being suggested. However, to contribute to system-level resiliency, workforce planning approaches need to also adopt system-based approaches. The increased complexity and fragmentation of the healthcare system, especially for patients with complex and chronic conditions, has also led to a focus on health literacy not simply as an individual trait, but also as a dynamic product of the interaction between individual (patients, workforce)-, organisational- and system-level health literacy. Although it is absolutely essential that patients have a level of health literacy that enables them to navigate and make decisions, so too the health workforce, organisations and indeed the system also needs to be health literate. Herein we explore whether health workforce planning is recognising the dynamic interplay between health literacy at an individual, organisation and system level, and the potential for strengthening resiliency across all those levels.

  4. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  5. Problem drinking and exceeding guidelines for 'sensible' alcohol consumption in Scottish men: associations with life course socioeconomic disadvantage in a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Benzeval Michaela

    2008-09-01

    Full Text Available Abstract Background With surveys suggesting that exceeding guidelines for 'sensible' alcohol intake is commonplace, the health and social impact of modifying intake on a population level is potentially considerable. If public health interventions are to be successfully implemented, it is first important to identify correlates of such behaviours, including socioeconomic disadvantage. This was the aim of the present study. Methods Population-representative cohort study of 576 men from the West of Scotland. Data on life course socioeconomic position were collected in 1988 (at around 55 years of age. Alcohol consumption patterns (detailed seven day recall and problem drinking (CAGE questionnaire were ascertained in 1990/2 (at around 59 years of age. A relative index of inequality was computed to explore the comparative strength of different indicators of social circumstances from different periods of the life course. Results Socioeconomic adversity in both early life and in adulthood was related to an increased risk of exceeding the weekly and daily alcohol guidelines, with adult indicators of socioeconomic position revealing the strongest associations. Of these, material indicators of socioeconomic deprivation in adulthood – car ownership, housing tenure – were marginally more strongly related to heavy alcohol intake and problem drinking than education, income and occupational social class. A substantial proportion of the influence of early life deprivation on alcohol intake was mediated via adult socioeconomic position. Similar results were apparent when problem drinking was the outcome of interest. Conclusion In men in this cohort, exposure to disadvantaged social circumstances across the lifecourse, but particularly in adulthood, is associated with detrimental patterns of alcohol consumption and problem drinking in late middle age.

  6. Occupational Health and Safety. Numeracy. Level 1. Level 2. Level 3. Support Materials for Agricultural Training.

    Science.gov (United States)

    Batman, Kangan; Tully, Chris

    This publication contains the three numeracy units of the three levels of Support Materials for Agricultural Training (SMAT) in the area of occupational health and safety: Level 1 (starting), 2 (continuing), and 3 (completing). The units are designed to help the learner improve his or her numeracy skills needed to deal with occupational safety and…

  7. Music Listening Behavior, Health, Hearing and Otoacoustic Emission Levels

    Directory of Open Access Journals (Sweden)

    Kathleen Hutchinson Marron

    2014-07-01

    Full Text Available This study examined the relationship between hearing levels, otoacoustic emission levels and listening habits related to the use of personal listening devices (PLDs in adults with varying health-related fitness. Duration of PLD use was estimated and volume level was directly measured. Biomarkers of health-related fitness were co-factored into the analyses. 115 subjects ages 18–84 participated in this study. Subjects were divided into two sub-groups; PLD users and non-PLD users. Both groups completed audiological and health-related fitness tests. Due to the mismatch in the mean age of the PLD user versus the non-PLD user groups, age-adjusted statistics were performed to determine factors that contributed to hearing levels. Age was the most significant predictor of hearing levels across listening and health-related fitness variables. PLD user status did not impact hearing measures, yet PLD users who listened less than 8 hours per week with intensities of less than 80 dBA were found to have better hearing. Other variables found to be associated with hearing levels included: years listening to PLD, number of noise environments and use of ear protection. Finally, a healthy waist-to-hip ratio was a significant predictor of better hearing, while body mass index approached, but did not reach statistical significance.

  8. Public health preparedness in Alberta: a systems-level study

    Directory of Open Access Journals (Sweden)

    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  9. How "ought" exceeds but implies "can": Description and encouragement in moral judgment.

    Science.gov (United States)

    Turri, John

    2017-11-01

    This paper tests a theory about the relationship between two important topics in moral philosophy and psychology. One topic is the function of normative language, specifically claims that one "ought" to do something. Do these claims function to describe moral responsibilities, encourage specific behavior, or both? The other topic is the relationship between saying that one "ought" to do something and one's ability to do it. In what respect, if any, does what one "ought" to do exceed what one "can" do? The theory tested here has two parts: (1) "ought" claims function to both describe responsibilities and encourage people to fulfill them (the dual-function hypothesis); (2) the two functions relate differently to ability, because the encouragement function is limited by the person's ability, but the descriptive function is not (the interaction hypothesis). If this theory is correct, then in one respect "ought implies can" is false because people have responsibilities that exceed their abilities. But in another respect "ought implies can" is legitimate because it is not worthwhile to encourage people to do things that exceed their ability. Results from two behavioral experiments support the theory that "ought" exceeds but implies "can." Results from a third experiment provide further evidence regarding an "ought" claim's primary function and how contextual features can affect the interpretation of its functions. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Networking health: multi-level marketing of health products in Ghana.

    Science.gov (United States)

    Droney, Damien

    2016-01-01

    Multi-level marketing (MLM0), a business model in which product distributors are compensated for enrolling further distributors as well as for selling products, has experienced dramatic growth in recent decades, especially in the so-called global South. This paper argues that the global success of MLM is due to its involvement in local health markets. While MLM has been subject to a number of critiques, few have analyzed the explicit health claims of MLM distributors. The majority of the products distributed through MLM are health products, which are presented as offering transformative health benefits. Based on interviews with MLM distributors in Ghana, but focusing on the experiences of one woman, this paper shows that MLM companies become intimately entwined with Ghanaian quests for health by providing their distributors with the materials to become informal health experts, allowing their distributors to present their products as medicines, and presenting MLM as an avenue to middle class cosmopolitanism. Ghanaian distributors promote MLM products as medically powerful, and the distribution of these products as an avenue to status and profit. As a result, individuals seeking health become a part of ethically questionable forms of medical provision based on the exploitation of personal relationships. The success of MLM therefore suggests that the health industry is at the forefront of transnational corporations' extraction of value from informal economies, drawing on features of health markets to monetize personal relationships.

  11. A Global Perspective of Fine Particulate Matter Pollution and Its Health Effects.

    Science.gov (United States)

    Mukherjee, Arideep; Agrawal, Madhoolika

    Fine particulate matter (PM) in the ambient air is implicated in a variety of human health issues throughout the globe. Regulation of fine PM in the atmosphere requires information on the dimension of the problem with respect to variations in concentrations and sources. To understand the current status of fine particles in the atmosphere and their potential harmful health effects in different regions of the world this review article was prepared based on peer-reviewed scientific papers, scientific reports, and database from government organizations published after the year 2000 to evaluate the global scenario of the PM 2.5 (particles levels and exceedances of national and international standards were several times higher in Asian countries, while levels in Europe and USA were mostly well below the respective standards. Vehicular traffic has a significant influence on PM 2.5 levels in urban areas; followed by combustion activities (biomass, industrial, and waste burning) and road dust. In urban atmosphere, fine particles are mostly associated with different health effects with old aged people, pregnant women, and more so children being the most susceptible ones. Fine PM chemical constituents severely effect health due to their carcinogenic or mutagenic nature. Most of the research indicated an exceedance of fine PM level of the standards with a diverse array of health effects based on PM 2.5 chemical constituents. Emission reduction policies with epidemiological studies are needed to understand the benefits of sustainable control measures for fine PM mitigation.

  12. SPORT AND MENTAL HEALTH LEVEL AMONG UNIVERSITY STUDENTS

    Directory of Open Access Journals (Sweden)

    Mouloud Kenioua

    2016-06-01

    Full Text Available Purpose: study of mental health level of university student, athletes and non-athletes. Material: The tested group consisted of 160 male and female undergraduates from Ouargla University, Algeria; 80 students-athletes from Institute of Physical Education and Sports and 80 students-non-athletes from Department of Psychology, English and Mathematics. In the study we used health mental scale, adapted by Diab (2006 to Arab version scale, formed from five dimensions (Competence and self-confidence, Capacity for social interaction, Emotional maturity, Freedom from neurotic symptoms, self rating and aspects of natural deficiencies. Results: the findings indicated that university students have high level of mental health. And the mean of the responses of students-athletes group by mental health scale reached (M = 32.40, with standard deviation (STD =5.83, while the mean of the responses of students-non athletes group by mental health scale has reached (M=27.47, with standard deviation (STD=7.88. T-value, required to know significance of differences between means of students-athletes and students-non athletes has reached (T=4.51, (DF=185, p -0.01. So there are significant statistical differences between student athletes and non-athletes in their responses by mental health scale in favor of the student athletes. Conclusion:sports are beneficial in respect to mental health among university students and emphasizing the importance of the mental health of university students through its integration in the various recreational and competitive activities. Future qualitative research, covering multi-variables’ tests on mental health and others psychological characteristics could be performed in sports area.

  13. Acceptable-doses exceeding in radionuclides transport

    International Nuclear Information System (INIS)

    Delabarre, P.

    2006-01-01

    Without any foregoing signal, the 12-gliding month dose in an employee of a radionuclides transporting firm raised to 44,30 mSv (over the double of the ICRP recommended yearly maximum of 20 mSv). Apart from immediate prohibition of any further professional exposure to ionising radiation for the employee concerned, and an inquiry for possible explanations concerning as well the employer as the employee, an in-depth investigation of the employees previous records took place. Except from the sudden rise, the investigation showed that the personal dosimeter was mostly presented for analysis weeks, even months, too late, what made any immediate action from occupational health and radioprotection side difficult and anyhow far too late. Investigation of the records of the other 30 employees showed that 1) mostly the dosimeters were not presented on the assumed date for analysis, but months to (sometimes) nearly one year late behind schedule 2) for the same job in the same period, registered doses varied from naught to over 8,00 mSv, depending on the employee 3) several employees had a 12-gliding months dose of over 10,00 mSv, even over 15,00 mSv During discussion with employee, employer, occupational physician and an agent of the qualified organisation for dosimeter analysis, the employer was anything but cooperative; the employee also was rather reluctant to answer questions, and given possible causes could not be corroborated. In an attempt to clarify the multiple problems, the Governmental Agency for Nuclear Control was involved, which imposed in a first time a( not very stringent, rather indulgent) action plan. Meanwhile, a written comment on the monthly dosimeter analyses was sent from as well the occupational physician as the analytical firm to the employer and to the concerned employees if a 12-gliding months dose exceeding 10 mSv was determined, without any reaction neither from the employer nor the employees. At the moment of the abstract submission (sept 05

  14. Effectiveness of counseling at primary health facilities: Level of ...

    African Journals Online (AJOL)

    Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their ... Objectives: To determine the effectiveness of counseling on HIV done in primary health facilities ... AJOL African Journals Online.

  15. The relationship between modifiable health risks and group-level health care expenditures. Health Enhancement Research Organization (HERO) Research Committee.

    Science.gov (United States)

    Anderson, D R; Whitmer, R W; Goetzel, R Z; Ozminkowski, R J; Dunn, R L; Wasserman, J; Serxner, S

    2000-01-01

    To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Eleven risk factors (exercise, alcohol use, eating, current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.

  16. Future health physics prospects in high-level nuclear waste management

    International Nuclear Information System (INIS)

    Waite, D.A.; Mayberry, J.J.

    1986-01-01

    The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

  17. General aviation accidents related to exceedance of airplane weight/center of gravity limits.

    Science.gov (United States)

    Boyd, Douglas D

    2016-06-01

    Obesity, affects a third of the US population and its corollary occupant weight adversely impacts safe flight operations. Increased aircraft weight results in longer takeoff/landing distances, degraded climb gradients and airframe failure may occur in turbulence. In this study, the rate, temporal changes, and lethality of accidents in piston-powered, general aviation aircraft related to exceeding the maximum aircraft weight/center of gravity (CG) limits were determined. Nation-wide person body mass were from the National Health and Nutrition Examination Survey. The NTSB database was used to identify accidents related to operation of aircraft outside of their weight/CG envelope. Statistical analyses employed T-tests, proportion tests and a Poisson distribution. While the average body mass climbed steadily (p<0.001) between 1999 and 2014 the rate of accidents related to exceedance of the weight/CG limits did not change (p=0.072). However, 57% were fatal, higher (p<0.001) than the 21% for mishaps attributed to other causes/factors. The majority (77%) of accidents were due to an overloaded aircraft operating within its CG limits. As to the phase of flight, accidents during takeoff and those occurring enroute carried the lowest (50%) and highest (85%) proportion of fatal accidents respectively. While the rate of general aviation accidents related to operating an aircraft outside of its weight/CG envelope has not increased over the past 15 years, these types of accidents carry a high risk of fatality. Airmen should be educated as to such risks and to dispel the notion held by some that flights may be safely conducted with an overloaded aircraft within its CG limits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Science.gov (United States)

    Lovell, Sarah A; Gray, Andrew R; Boucher, Sara E

    2017-12-01

    Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  19. Estimating the exceedance probability of rain rate by logistic regression

    Science.gov (United States)

    Chiu, Long S.; Kedem, Benjamin

    1990-01-01

    Recent studies have shown that the fraction of an area with rain intensity above a fixed threshold is highly correlated with the area-averaged rain rate. To estimate the fractional rainy area, a logistic regression model, which estimates the conditional probability that rain rate over an area exceeds a fixed threshold given the values of related covariates, is developed. The problem of dependency in the data in the estimation procedure is bypassed by the method of partial likelihood. Analyses of simulated scanning multichannel microwave radiometer and observed electrically scanning microwave radiometer data during the Global Atlantic Tropical Experiment period show that the use of logistic regression in pixel classification is superior to multiple regression in predicting whether rain rate at each pixel exceeds a given threshold, even in the presence of noisy data. The potential of the logistic regression technique in satellite rain rate estimation is discussed.

  20. The impact of health claims and food deprivation levels on health risk perceptions of fast-food restaurants.

    Science.gov (United States)

    Cadario, Romain

    2016-01-01

    We examined the effect of health claims and food deprivation levels on the health risk perceptions of fast-food restaurants. Consistent with previous research, we used a within-subjects experimental design to manipulate the health claims of fast-food restaurants using real brands: Subway, expressing strong health claims vs. McDonald's, expressing weak health claims. Participants who did not have access to nutrition information were asked to estimate the health risk associated with food items that were slightly more caloric for Subway than McDonald's (640 kcal vs. 600 kcal). We collected data through a web survey with a sample consisting of 414 American adults. Based on the USDA Food Insufficiency Indicator, participants were classified into two categorical food deprivation levels: food sufficiency and food insufficiency. We find that risk perceptions for obesity, diabetes and cardiac illnesses are lower (higher) for the restaurant with stronger (lower) health claims, i.e., Subway (McDonald's). Moreover, we also find that food deprivation levels moderate this effect, such that health risk underestimation is aggravated for individuals who suffer from food insufficiency. More precisely, we find that food insufficient individuals are more responsive to health claims, such that they perceive less health risk than food sufficient individuals for the restaurant with stronger health claims (Subway). Exploring the underlying mechanism of the latter effect, we found that dietary involvement mediates the relationship between food deprivation levels and health risk perceptions for the restaurant with stronger health claims (Subway). These results provide an interdisciplinary contribution in consumer psychology and public health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level

    Directory of Open Access Journals (Sweden)

    Abdur Razzaque

    2010-09-01

    Full Text Available Background: Mortality has been declining in Bangladesh since the mid- twentieth century, while fertility has been declining since the late 1970s, and the country is now passing through the third stage of demographic transition. This type of demographic transition has produced a huge youthful population with a growing number of older people. For assessing health among older people, this study examines self-rated health, health state, quality of life and disability level in persons aged 50 and over. Data and methods: This is a collaborative study between the World Health Organization Study on global AGEing and adult health and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries which collected data from eight countries. Two sources of data from the Matlab study area were used: health indicator data collected as a part of the study, together with the ongoing Health and Demographic Surveillance System (HDSS data. For the survey, a total of 4,000 randomly selected people aged 50 and over (HDSS database were interviewed. The four health indicators derived from these data are self-rated health (five categories, health state (eight domains, quality of life (eight items and disability level (12 items. Self-rated health was coded as dummy while scores were calculated for the rest of the three health indicators using WHO-tested instruments. Results: After controlling for all the variables in the regression model, all four indicators of health (self-rated health, health state, quality of life and disability level documented that health was better for males than females, and health deteriorates with increasing age. Those people who were in current partnerships had generally better health than those who were single, and better health was associated with higher levels of education and asset score. Conclusions: To improve the health of the population it is important to know health conditions in

  2. Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level

    Science.gov (United States)

    Razzaque, Abdur; Nahar, Lutfun; Akter Khanam, Masuma; Kim Streatfield, Peter

    2010-01-01

    Background Mortality has been declining in Bangladesh since the mid- twentieth century, while fertility has been declining since the late 1970s, and the country is now passing through the third stage of demographic transition. This type of demographic transition has produced a huge youthful population with a growing number of older people. For assessing health among older people, this study examines self-rated health, health state, quality of life and disability level in persons aged 50 and over. Data and methods This is a collaborative study between the World Health Organization Study on global AGEing and adult health and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries which collected data from eight countries. Two sources of data from the Matlab study area were used: health indicator data collected as a part of the study, together with the ongoing Health and Demographic Surveillance System (HDSS) data. For the survey, a total of 4,000 randomly selected people aged 50 and over (HDSS database) were interviewed. The four health indicators derived from these data are self-rated health (five categories), health state (eight domains), quality of life (eight items) and disability level (12 items). Self-rated health was coded as dummy while scores were calculated for the rest of the three health indicators using WHO-tested instruments. Results After controlling for all the variables in the regression model, all four indicators of health (self-rated health, health state, quality of life and disability level) documented that health was better for males than females, and health deteriorates with increasing age. Those people who were in current partnerships had generally better health than those who were single, and better health was associated with higher levels of education and asset score. Conclusions To improve the health of the population it is important to know health conditions in advance rather than

  3. Food survey: levels and potential health risks of chromium, lead, zinc and copper content in fruits and vegetables consumed in Algeria.

    Science.gov (United States)

    Cherfi, Abdelhamid; Abdoun, Samira; Gaci, Ouardia

    2014-08-01

    A food survey was carried out with the aim to investigate the levels of lead (Pb), zinc (Zn), copper (Cu) and chromium (Cr) in various fruits and vegetables sold in Algeria. Concentrations (mg/kgdry wt.) in selected foodstuffs were detected within the following ranges: 4-29.49, 11.17-49, 12.33-39.33 and 3-16.33 for Cu, Zn, Pb and Cr respectively. The food ingestion rate of the selected items was investigated by self-administered questionnaires which were filled by a total of 843 people randomly recruited at the exit of markets. The potential health risk for consumers was investigated by estimating the daily intake (EDI) and the target hazard quotient (THQ) for each heavy metal. For all foodstuffs, the EDI and the THQ were below the threshold values for Cu, Zn and Cr while they exceeded the thresholds for Pb (EDI: 15.66μgPb/kg body weight/day; THQ: 4.37), indicating an obvious health risk over a life time of exposure. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Public health leadership competency level among health professionals in a South Eastern European country

    NARCIS (Netherlands)

    Pampuri, O.; Czabanowska, K.; Hysa, B.; Roshi, E.; Burazeri, G.

    2015-01-01

    Pampuri O, Czabanowska K, Hysa B, Roshi E, Burazeri G. Public health leadership competency level among health professionals in a South Eastern European country (Original research). SEEJPH 2015, posted: 10 February 2015. DOI 10.12908/SEEJPH-2014-40

  5. Associations between chlorophyll a and various microcystin-LR health advisory concentrations [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Hollister

    2016-02-01

    Full Text Available Cyanobacteria harmful algal blooms (cHABs are associated with a wide range of adverse health effects that stem mostly from the presence of cyanotoxins. To help protect against these impacts, several health advisory levels have been set for some toxins. In particular, one of the more common toxins, microcystin-LR, has several advisory levels set for drinking water and recreational use. However, compared to other water quality measures, field measurements of microcystin-LR are not commonly available due to cost and advanced understanding required to interpret results. Addressing these issues will take time and resources. Thus, there is utility in finding indicators of microcystin-LR that are already widely available, can be estimated quickly and in situ, and used as a first defense against high concentrations of microcystin-LR. Chlorophyll a is commonly measured, can be estimated in situ, and has been shown to be positively associated with microcystin-LR. In this paper, we use this association to provide estimates of chlorophyll a concentrations that are indicative of a higher probability of exceeding select health advisory concentrations for microcystin-LR. Using the 2007 National Lakes Assessment and a conditional probability approach, we identify chlorophyll a concentrations that are more likely than not to be associated with an exceedance of a microcystin-LR health advisory level. We look at the recent US EPA health advisories for drinking water as well as the World Health Organization levels for drinking water and recreational use and identify a range of chlorophyll a thresholds. A 50% chance of exceeding one of the microcystin-LR advisory concentrations of 0.3, 1, 1.6, and 2 g/L is associated with chlorophyll a concentration thresholds of 23.4, 67.0, 83.5, and 105.8, respectively. When managing for these various microcystin-LR levels, exceeding these reported chlorophyll a concentrations should be a trigger for

  6. Mental health and physical activity levels of school children

    Directory of Open Access Journals (Sweden)

    Gabrielle Cerqueira da Silva

    2017-03-01

    Full Text Available Introduction: The regular practice of physical activity is fundamental to the health of children, it has been cited as factor of protection for mental disorders in school age. Objective: To verify the relation between mental health and physical activity levels in schoolchildren of the city Jacobina, Bahia. Method: Sample composed of 55 students between the ages 08 to 10 and their parents, who participated as secondary informants in this study. The Child Behavior Checklist (CBCL was used for evaluation of mental health problems of the schoolchildren, Physical Activity Questionnaire for Older Children (PAQ-C, for evaluation of the physical activity levels of the subject, and a social-demographic questionnaire. Results: Most children were classified as sedentary (80% and only 7.3% of the sample showed positive for trace of mental disorder. No significant association was found between mental disorders and physical activity levels among the group, or between these variables and socio-demographic characteristics of children. It was observed that the girls were more sedentary than boys, with significant difference (p < 0.01. Conclusion: Despite the low prevalence of mental health problems among schoolchildren and the non-association with physical activity levels, special attention is necessary with this audience, aiming to strengthen physical activity as a protective factor for children’s mental health, with investments in actions aimed at the encouragement of regular practice of physical activity, combining family and school. Studies with a larger number of samples need to be conducted and its findings must be thoroughly analyzed.

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

    Science.gov (United States)

    Mittelmark, M B

    2001-09-01

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

  8. Radon in Rented Accommodation and Variables Determining Its Level

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2017-01-01

    Indoor radon levels were measured in 221 homes in rented accommodation. In addition, buildings were registered for a series of variables describing building characteristics and used materials. The mean year value of the indoor radon level was 30.7 (1~250) Bq/m3. The indoor radon level exceeded 100...... Bq/m3 in 5.9% of the homes. Of the investigated variables, only homes in single-family terraced houses, were statistically significant. Approx. 75% of homes exceeding 100 Bq/m3 indoor radon level had levels between 100 and 200 Bq/m3 and 25% had indoor radon levels exceeding 200 Bq/m3. Significant...... differences in indoor radon levels were found in homes located in multi-occupant houses. Additionally, the risk of indoor radon levels exceeding 100 Bq/m3 in homes in multi-occupant houses was found to be very low, but the risk was the highest on the ground floor in a building constructed with slab on ground....

  9. Extreme Temperature Exceedances Change more Rapidly Under Future Warming in Regions of non-Gaussian Short Temperature Distribution Tails

    Science.gov (United States)

    Loikith, P. C.; Neelin, J. D.; Meyerson, J.

    2017-12-01

    Regions of shorter-than-Gaussian warm and cold side temperature distribution tails are shown to occur in spatially coherent patterns in the current climate. Under such conditions, warming may be manifested in more complex ways than if the underlying distribution were close to Gaussian. For example, under a uniform warm shift, the simplest prototype for future warming, a location with a short warm side tail would experience a greater increase in extreme warm exceedances compared to if the distribution were Gaussian. Similarly, for a location with a short cold side tail, a uniform warm shift would result in a rapid decrease in extreme cold exceedances. Both scenarios carry major societal and environmental implications including but not limited to negative impacts on human and ecosystem health, agriculture, and the economy. It is therefore important for climate models to be able to realistically reproduce short tails in simulations of historical climate in order to boost confidence in projections of future temperature extremes. Overall, climate models contributing to the fifth phase of the Coupled Model Intercomparison Project capture many of the principal observed regions of short tails. This suggests the underlying dynamics and physics occur on scales resolved by the models, and helps build confidence in model projections of extremes. Furthermore, most GCMs show more rapid changes in exceedances of extreme temperature thresholds in regions of short tails. Results therefore suggest that the shape of the tails of the underlying temperature distribution is an indicator of how rapidly a location will experience changes to extreme temperature occurrence under future warming.

  10. [Supporting the intermediate level of health care in urban health areas in Kinshasa (1995-2005), DR Congo].

    Science.gov (United States)

    Mbeva, Jean-Bosco Kahindo; Schirvel, Carole; Karemere, Hermès; Porignon, Denis

    2012-06-08

    As a result of the decentralization of health systems, some countries have introduced intermediate (provincial) levels in their public health system. This paper presents the results of a case study conducted in Kinshasa on health system decentralization. The study identified a shift from a focus on regulation compliance assessment to an emphasis on health system coordination and health district support. It also highlighted the emergence of a?managerial (as opposed to a bureaucratic) approach to health district support. The performance of health districts in terms of health care coverage and health service use were also found to have improved. The results highlight the importance of intermediate levels in?the health care system and the value of a more organic and managerial rationality in supporting health districts faced with the complexity of urban environments and the integration of specialized multi-partner programs and interventions.

  11. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Directory of Open Access Journals (Sweden)

    Sarah A. Lovell

    2017-12-01

    Full Text Available Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500–2000 New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  12. Global health and economic impacts of future ozone pollution

    International Nuclear Information System (INIS)

    Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S

    2009-01-01

    We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.

  13. County-level job automation risk and health: Evidence from the United States.

    Science.gov (United States)

    Patel, Pankaj C; Devaraj, Srikant; Hicks, Michael J; Wornell, Emily J

    2018-04-01

    Previous studies have observed a positive association between automation risk and employment loss. Based on the job insecurity-health risk hypothesis, greater exposure to automation risk could also be negatively associated with health outcomes. The main objective of this paper is to investigate the county-level association between prevalence of workers in jobs exposed to automation risk and general, physical, and mental health outcomes. As a preliminary assessment of the job insecurity-health risk hypothesis (automation risk → job insecurity → poorer health), a structural equation model was used based on individual-level data in the two cross-sectional waves (2012 and 2014) of General Social Survey (GSS). Next, using county-level data from County Health Rankings 2017, American Community Survey (ACS) 2015, and Statistics of US Businesses 2014, Two Stage Least Squares (2SLS) regression models were fitted to predict county-level health outcomes. Using the 2012 and 2014 waves of the GSS, employees in occupational classes at higher risk of automation reported more job insecurity, that, in turn, was associated with poorer health. The 2SLS estimates show that a 10% increase in automation risk at county-level is associated with 2.38, 0.8, and 0.6 percentage point lower general, physical, and mental health, respectively. Evidence suggests that exposure to automation risk may be negatively associated with health outcomes, plausibly through perceptions of poorer job security. More research is needed on interventions aimed at mitigating negative influence of automation risk on health. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Association between Municipal Health Promotion Volunteers' Health Literacy and Their Level of Outreach Activities in Japan.

    Directory of Open Access Journals (Sweden)

    Atsuko Taguchi

    Full Text Available To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members.A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community.Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community" and the levels of health literacy (low, medium, high among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities.Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%. Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core

  15. MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

    Science.gov (United States)

    ROBBINS, JACOB A.

    2015-01-01

    The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

  16. A Mismatch Between Patient Education Materials About Sickle Cell Disease and the Literacy Level of Their Intended Audience.

    Science.gov (United States)

    McClure, Elizabeth; Ng, Jared; Vitzthum, Kelly; Rudd, Rima

    2016-05-12

    Despite the first goal of the 2010 National Action Plan to Improve Health Literacy, the literacy demands of much health information exceeds the reading skills of most US adults. The objective of this study was to assess the health literacy level of publicly available patient education materials for people with sickle cell disease (SCD). We used 5 validated tools to evaluate 9 print and 4 online patient education materials: the simple measure of gobbledygook (SMOG) to assess reading grade level, the Peter Mosenthal and Irwin Kirsch readability formula (PMOSE/IKIRSCH) to assess structure and density, the Patient Education Materials Assessment Tool (PEMAT) to assess actionability (how well readers will know what to do after reading the material) and understandability, the Centers for Disease Control and Prevention's (CDC's) Clear Communication Index (Index) to obtain a comprehensive literacy demand score, and the Printed Cancer Education Materials for African Americans Cultural Sensitivity Assessment Tool. Materials' scores reflected high reading levels ranging from 8th grade to 12th grade, appropriate (low) structural demand, and low actionability relative to understandability. CDC suggests that an appropriate Index score should fall in or above the 90th percentile. The scores yielded by materials evaluated in this assessment ranged from the 44th to the 76th percentiles. Eight of the 13 materials scored within the acceptable range for cultural sensitivity. Reading levels of available patient education materials exceed the documented average literacy level of the US adult population. Health literacy demands should be a key consideration in the revision and development of patient education materials for people with SCD.

  17. Major surgery delegation to mid-level health practitioners in Mozambique: health professionals' perceptions

    Directory of Open Access Journals (Sweden)

    McCord Colin

    2007-12-01

    Full Text Available Abstract Background This study examines the opinions of health professionals about the capacity and performance of the 'técnico de cirurgia', a surgically trained assistant medical officer in the Mozambican health system. Particular attention is paid to the views of medical doctors and maternal and child health nurses. Methods The results are derived from a qualitative study using both semi-structured interviews and group discussions. Health professionals (n = 71 were interviewed at both facility and system level. Eight group discussion sessions of about two hours each were run in eight rural hospitals with a total of 48 participants. Medical doctors and district officers were excluded from group discussion sessions due to their hierarchical position which could have prevented other workers from expressing opinions freely. Results Health workers at all levels voiced satisfaction with the work of the "técnicos de cirurgia". They stressed the life-saving skills of these cadres, the advantages resulting from a reduction in the need for patient referrals and the considerable cost reduction for patients and their families. Important problems in the professional status and remuneration of "técnicos de cirurgia" were identified. Conclusion This study, the first one to scrutinize the judgements and attitudes of health workers towards the "técnico de cirurgia", showed that, despite some shortcomings, this cadre is highly appreciated and that the health delivery system does not recognize and motivate them enough. The findings of this study can be used to direct efforts to improve motivation of health workers in general and of técnicos de cirurgia in particular.

  18. [Environmental noise levels in 2 intensive care units in a tertiary care centre].

    Science.gov (United States)

    Ornelas-Aguirre, José Manuel; Zárate-Coronado, Olivia; Gaxiola-González, Fabiola; Neyoy-Sombra, Venigna

    2017-04-03

    The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Reading level of privacy policies on Internet health Web sites.

    Science.gov (United States)

    Graber, Mark A; D'Alessandro, Donna M; Johnson-West, Jill

    2002-07-01

    Most individuals would like to maintain the privacy of their medical information on the World Wide Web (WWW). In response, commercial interests and other sites post privacy policies that are designed to inform users of how their information will be used. However, it is not known if these statements are comprehensible to most WWW users. The purpose of this study was to determine the reading level of privacy statements on Internet health Web sites and to determine whether these statements can inform users of their rights. This was a descriptive study. Eighty Internet health sites were examined and the readability of their privacy policies was determined. The selected sample included the top 25 Internet health sites as well as other sites that a user might encounter while researching a common problem such as high blood pressure. Sixty percent of the sites were commercial (.com), 17.5% were organizations (.org), 8.8% were from the United Kingdom (.uk), 3.8% were United States governmental (.gov), and 2.5% were educational (.edu). The readability level of the privacy policies was calculated using the Flesch, the Fry, and the SMOG readability levels. Of the 80 Internet health Web sites studied, 30% (including 23% of the commercial Web sites) had no privacy policy posted. The average readability level of the remaining sites required 2 years of college level education to comprehend, and no Web site had a privacy policy that was comprehensible by most English-speaking individuals in the United States. The privacy policies of health Web sites are not easily understood by most individuals in the United States and do not serve to inform users of their rights. Possible remedies include rewriting policies to make them comprehensible and protecting online health information by using legal statutes or standardized insignias indicating compliance with a set of privacy standards (eg, "Health on the Net" [HON] http://www.hon.ch).

  20. High levels of uranium in groundwater of Ulaanbaatar, Mongolia

    Energy Technology Data Exchange (ETDEWEB)

    Nriagu, Jerome, E-mail: stoten@umich.edu [Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109 (United States); Nam, Dong-Ha; Ayanwola, Titilayo A. [Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109 (United States); Dinh, Hau [College of Literature, Science and Arts, University of Michigan (United States); Erdenechimeg, Erdenebayar; Ochir, Chimedsuren [Department Of Preventive Medicine, School Of Public Health, Health Science University, Mongolia, Ulaanbaatar (Mongolia); Bolormaa, Tsend-Ayush [Central Water Laboratory of Water Supply and Sewerage Authority (USUG), Ulaanbaatar (Mongolia)

    2012-01-01

    Water samples collected from 129 wells in seven of the nine sub-divisions of Ulaanbaatar were analyzed by inductively coupled plasma mass spectrometry (ICP-MS) using Clean Lab methods. The levels of many trace elements were found to be low with the average concentrations (ranges in brackets) being 0.9 (< 0.1-7.9) {mu}g/L for As; 7.7 (0.12-177) {mu}g/L for Mn; 0.2 (< 0.05-1.9) {mu}g/L for Co; 16 (< 0.1-686) {mu}g/L for Zn; 0.7 (< 0.1-1.8) {mu}g/L for Se; < 0.1 (< 0.02-0.69) {mu}g/L for Cd; and 1.3 (< 0.02-32) {mu}g/L for Pb. The levels of uranium were surprisingly elevated (mean, 4.6 {mu}g/L; range < 0.01-57 {mu}g/L), with the values for many samples exceeding the World Health Organization's guideline of 15 {mu}g/L for uranium in drinking water. Local rocks and soils appear to be the natural source of the uranium. The levels of uranium in Ulaanbaatar's groundwater are in the range that has been associated with nephrotoxicity, high blood pressure, bone dysfunction and likely reproductive impairment in human populations. We consider the risk associated with drinking the groundwater with elevated levels of uranium in Ulaanbaatar to be a matter for some public health concern and conclude that the paucity of data on chronic effects of low level exposure is a risk factor for continuing the injury to many people in this city. - Highlights: Black-Right-Pointing-Pointer We analyzed water samples from wells across the city of Ulaanbaatar, Mongolia for total uranium along with arsenic, manganese, cobalt, zinc, selenium, cadmium and lead. Black-Right-Pointing-Pointer We found that compared to other trace metals and metalloids, the levels of uranium were surprisingly elevated with the values for many samples exceeding the World Health Organization's guideline for drinking water. Black-Right-Pointing-Pointer Local rocks and soils appear to be the natural source of the uranium. Black-Right-Pointing-Pointer The health risk associated with drinking the groundwater

  1. Community-based population-level interventions for promoting child oral health.

    OpenAIRE

    de Silva, AM; Hegde, S; Akudo Nwagbara, B; Calache, H; Gussy, MG; Nasser, M; Morrice, HR; Riggs, E; Leong, PM; Meyenn, LK; Yousefi-Nooraie, R

    2016-01-01

    BACKGROUND: Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES: Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and period...

  2. Positive mental health and well-being among a third level student population.

    LENUS (Irish Health Repository)

    Davoren, Martin P

    2013-01-01

    Much research on the health and well-being of third level students is focused on poor mental health leading to a dearth of information on positive mental health and well-being. Recently, the Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed as a measurement of positive mental health and well-being. The aim of this research is to investigate the distribution and determinants of positive mental health and well-being in a large, broadly representative sample of third level students using WEMWBS.

  3. ATRF Earns Three Green Globes, Exceeds NIH Building Standards | Poster

    Science.gov (United States)

    By Ashley DeVine, Staff Writer From project management and energy and water efficiency to emissions and the indoor environment, the Advanced Technology Research Facility (ATRF) was built with sustainability in mind, exceeding the National Institutes of Health’s (NIH’s) building standards and earning three Green Globes from the Green Building Initiative (GBI).

  4. Pilot survey of subway and bus stop noise levels.

    Science.gov (United States)

    Gershon, Robyn R M; Neitzel, Richard; Barrera, Marissa A; Akram, Muhammad

    2006-09-01

    Excessive noise exposure is a serious global urban health problem, adversely affecting millions of people. One often cited source of urban noise is mass transit, particularly subway systems. As a first step in determining risk within this context, we recently conducted an environmental survey of noise levels of the New York City transit system. Over 90 noise measurements were made using a sound level meter. Average and maximum noise levels were measured on subway platforms, and maximum levels were measured inside subway cars and at several bus stops for comparison purposes. The average noise level measured on the subway platforms was 86 +/- 4 dBA (decibel-A weighting). Maximum levels of 106, 112, and 89 dBA were measured on subway platforms, inside subway cars, and at bus stops, respectively. These results indicate that noise levels in subway and bus stop environments have the potential to exceed recommended exposure guidelines from the World Health Organization (WHO) and U.S. Environmental Protection Agency (EPA), given sufficient exposure duration. Risk reduction strategies following the standard hierarchy of control measures should be applied, where feasible, to reduce subway noise exposure.

  5. Heavy metals in apple orchard soils and fruits and their health risks in Liaodong Peninsula, Northeast China.

    Science.gov (United States)

    Wang, Quanying; Liu, Jingshuang; Cheng, Shuai

    2015-01-01

    This study aimed to assess the heavy metal concentrations in soils and fruits and their possible human health risk in apple orchards of Liaodong Peninsula-a well-known fruit-producing area of China. The soil pollution index (PI) and health risk assessment methods (daily intake of metals (DIM) and health risk index (HRI)) were employed to explore the soil pollution levels and the potential health hazards of heavy metals in fruits. The results showed that all orchard soils were with low PI values (PI ≤1) for Cd and Zn, while 2.78 and 5.56% of the soil samples exceeded the allowable levels of Cr and Cu for orchard soil, respectively. The Cd, Cu, and Zn concentrations for the apple flesh samples were all lower than the national maximum permissible concentrations. While 6.34% of apple peel samples for Cd, 76.5% of apple peel samples and 65.6% of apple flesh samples for Cr, and 28.1% of apple peel samples for Zn exceeded the national maximum permissible levels, respectively. Furthermore, both the DIM and the HRI values for all the apple flesh samples were within the safe limits, indicating that no health risk was found for heavy metals in the fruits of the study area. In order to protect the consumers from fruits that might cause health risks, results from this study suggested that the regular survey of heavy metal pollution levels should be conducted for the orchards of Liaodong Peninsula.

  6. Modeling per capita state health expenditure variation: state-level characteristics matter.

    Science.gov (United States)

    Cuckler, Gigi; Sisko, Andrea

    2013-01-01

    In this paper, we describe the methods underlying the econometric model developed by the Office of the Actuary in the Centers for Medicare & Medicaid Services, to explain differences in per capita total personal health care spending by state, as described in Cuckler, et al. (2011). Additionally, we discuss many alternative model specifications to provide additional insights for valid interpretation of the model. We study per capita personal health care spending as measured by the State Health Expenditures, by State of Residence for 1991-2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. State-level demographic, health status, economic, and health economy characteristics were gathered from a variety of U.S. government sources, such as the Census Bureau, Bureau of Economic Analysis, the Centers for Disease Control, the American Hospital Association, and HealthLeaders-InterStudy. State-specific factors, such as income, health care capacity, and the share of elderly residents, are important factors in explaining the level of per capita personal health care spending variation among states over time. However, the slow-moving nature of health spending per capita and close relationships among state-level factors create inefficiencies in modeling this variation, likely resulting in incorrectly estimated standard errors. In addition, we find that both pooled and fixed effects models primarily capture cross-sectional variation rather than period-specific variation.

  7. Effect of stress on serum lipid levels in lady health visitors and housewives

    International Nuclear Information System (INIS)

    Wattoo, F.H.; Memon, M.S.; Memon, A.N.; Wattoo, M.H.S.; Tirmizi, S.A.; Iqbal, J.

    2007-01-01

    To study the effects of stress among lady health visitors and housewives in regard to their serum total cholesterol, HDL cholesterol, and LDL cholesterol and triglyceride levels. The study was performed at the Institute of Biochemistry, University of Sindh, Jamshoro, Pakistan during the years 2003 to 2005. Seventy lady health visitor and housewives aged between 25-40 years participated in this study and were selected from Hyderabad and its adjoining areas. Environmental, psychological and physiological stress levels were measured with likert scale. Total cholesterol, LDL cholesterol and HDL cholesterol and triglyceride levels were measured. Environmental, psychological and physiological stresses were significantly higher in housewives as compared to lady health visitors. A low level of HDL cholesterol was observed in housewives as compared to lady health visitors. The levels of total cholesterol, LDL cholesterol and triglyceride were found higher in housewives than lady health visitors. Housewives are under more stress than lady health visitors. The levels of total cholesterol, LDL cholesterol and triglyceride increases but HDL cholesterol decrease with stress. (author)

  8. Identifying ozone-sensitive communities of (semi-)natural vegetation suitable for mapping exceedance of critical levels

    International Nuclear Information System (INIS)

    Mills, G.; Hayes, F.; Jones, M.L.M.; Cinderby, S.

    2007-01-01

    Using published data on the responses of individual species to ozone, 54 EUNIS (European Nature Information System) level 4 communities with six or more ozone-sensitive species (%OS) and c. 20% or more species tested for ozone sensitivity, were identified as potentially ozone-sensitive. The largest number of these communities (23) was associated with Grasslands, with Heathland, scrub and tundra, and Mires, bogs and fens having the next highest representation at 11 and 8 level 4 communities each respectively. Within the grasslands classification, E4 (Alpine and sub-alpine grasslands), E5 (Woodland fringes and clearings) and E1 (Dry grasslands) were the most sensitive with 68.1, 51.6 and 48.6%OS respectively. It is feasible to map the land-cover for these and other communities at level 2, but it may not be currently possible to map the land-cover for all communities identified to be ozone-sensitive at levels 3 and 4. - Grassland communities such as alpine and sub-alpine grasslands have the highest potential sensitivity ozone, based on the responses of their component species

  9. Occupational health risks associated with the use of germicides in health care.

    Science.gov (United States)

    Weber, David J; Consoli, Stephanie A; Rutala, William A

    2016-05-02

    Environmental surfaces have been clearly linked to transmission of key pathogens in health care facilities, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Clostridium difficile, norovirus, and multidrug-resistant gram-negative bacilli. For this reason, routine disinfection of environmental surfaces in patient rooms is recommended. In addition, decontamination of shared medical devices between use by different patients is also recommended. Environmental surfaces and noncritical shared medical devices are decontaminated by low-level disinfectants, most commonly phenolics, quaternary ammonium compounds, improved hydrogen peroxides, and hypochlorites. Concern has been raised that the use of germicides by health care personnel may increase the risk of these persons for developing respiratory illnesses (principally asthma) and contact dermatitis. Our data demonstrate that dermatitis and respiratory symptoms (eg, asthma) as a result of chemical exposures, including low-level disinfectants, are exceedingly rare. Unprotected exposures to high-level disinfectants may cause dermatitis and respiratory symptoms. Engineering controls (eg, closed containers, adequate ventilation) and the use of personal protective equipment (eg, gloves) should be used to minimize exposure to high-level disinfectants. The scientific evidence does not support that the use of low-level disinfectants by health care personnel is an important risk for the development of asthma or contact dermatitis. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. The level of health education in the Polish population.

    Science.gov (United States)

    Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy

    2013-01-01

    The study assessed factors influencing awareness of Poles concerning lifestyle factors that affect development of obesity, type 2 diabetes and cardiovascular diseases (CVD). A questionnaire survey covering awareness of lifestyle factors performed by general practitioners in 37,557 unselected patients. 96.1% of respondents believed that lifestyle has an impact on the occurrence of CVDs, especially: tobacco smoking (91.4%), excessive intake of fat (81.3%), alcohol (67.5%), salt (64.9%), and stress (64.9%). 79.0% respondents believed the smoking cessation, 77.5% weight loss and 66.8% healthy diet are most important to prevent diseases. Additionally, the belief in the need for an early weight reduction decreased with increasing BMI (82.9% with normal weight vs. 77.5% overweight and 70.4% obese). The most common source of health education was a physician (75.8%), the mass media, such as television and the press (62.0% and 64.8%, respectively), less often were educational materials (37.8%) and books (20.3 %), the Internet (3.8%) and radio (0.8%). Younger respondents presented a higher level of awareness about all analysed aspects of healthy lifestyle. The multiple regression analysis revealed that low education level and rural residence are the most important factors decreasing awareness of the lifestyle effect on health. 1. The level of knowledge about non-pharmacological methods of preventing lifestyle diseases in the Polish population is high except of the role of physical activity and daily vegetables consumption. This, however, has no impact on reducing the percentage of overweight and obese people and on increasing the tendency to pursue lifestyle changes. 2. Frustrating is the fact that more than one fifth of the study population is unaware that excessive weight reduction prevents development of cardiovascular diseases. Moreover, the convince to early weight decreases with increasing BMI. 3. The highest level of the knowledge among younger subjects reflect

  11. Positive mental health and well-being among a third level student population.

    Directory of Open Access Journals (Sweden)

    Martin P Davoren

    Full Text Available INTRODUCTION: Much research on the health and well-being of third level students is focused on poor mental health leading to a dearth of information on positive mental health and well-being. Recently, the Warwick Edinburgh Mental Well-being scale (WEMWBS was developed as a measurement of positive mental health and well-being. The aim of this research is to investigate the distribution and determinants of positive mental health and well-being in a large, broadly representative sample of third level students using WEMWBS. METHODS: Undergraduate students from one large third level institution were sampled using probability proportional to size sampling. Questionnaires were distributed to students attending lectures in the randomly selected degrees. A total of 2,332 self-completed questionnaires were obtained, yielding a response rate of 51% based on students registered to relevant modules and 84% based on attendance. One-way ANOVAs and multivariate logistic regression were utilised to investigate factors associated with positive mental health and well-being. RESULTS: The sample was predominantly female (62.66%, in first year (46.9% and living in their parents' house (42.4% or in a rented house or flat (40.8%. In multivariate analysis adjusted for age and stratified by gender, no significant differences in WEMWBS score were observed by area of study, alcohol, smoking or drug use. WEMWBS scores were higher among male students with low levels of physical activity (p=0.04. Men and women reporting one or more sexual partners (p<0.001 were also more likely to report above average mental health and well-being. CONCLUSION: This is the first study to examine positive mental health and well-being scores in a third level student sample using WEMWBS. The findings suggest that students with a relatively adverse health and lifestyle profile have higher than average mental health and well-being. To confirm these results, this work needs to be replicated across

  12. Health implications of PAH release from coated cast iron drinking water distribution systems in The Netherlands.

    Science.gov (United States)

    Blokker, E J Mirjam; van de Ven, Bianca M; de Jongh, Cindy M; Slaats, P G G Nellie

    2013-05-01

    Coal tar and bitumen have been historically used to coat the insides of cast iron drinking water mains. Polycyclic aromatic hydrocarbons (PAHs) may leach from these coatings into the drinking water and form a potential health risk for humans. We estimated the potential human cancer risk from PAHs in coated cast iron water mains. In a Dutch nationwide study, we collected drinking water samples at 120 locations over a period of 17 days under various operational conditions, such as undisturbed operation, during flushing of pipes, and after a mains repair, and analyzed these samples for PAHs. We then estimated the health risk associated with an exposure scenario over a lifetime. During flushing, PAH levels frequently exceeded drinking water quality standards; after flushing, these levels dropped rapidly. After the repair of cast iron water mains, PAH levels exceeded the drinking water standards for up to 40 days in some locations. The estimated margin of exposure for PAH exposure through drinking water was > 10,000 for all 120 measurement locations, which suggests that PAH exposure through drinking water is of low concern for consumer health. However, factors that differ among water systems, such as the use of chlorination for disinfection, may influence PAH levels in other locations.

  13. Cameroon mid-level providers offer a promising public health dentistry model

    Directory of Open Access Journals (Sweden)

    Achembong Leo

    2012-11-01

    Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

  14. 41 CFR 102-85.105 - How does an agency pay for customer alterations that exceed the TI allowance?

    Science.gov (United States)

    2010-07-01

    ... for customer alterations that exceed the TI allowance? 102-85.105 Section 102-85.105 Public Contracts....105 How does an agency pay for customer alterations that exceed the TI allowance? Amounts exceeding the TI allowance are paid in a one-time lump sum and are not amortized over the term of the occupancy...

  15. Team-level flexibility, work–home spillover, and health behavior

    Science.gov (United States)

    Moen, Phyllis; Fan, Wen; Kelly, Erin L.

    2013-01-01

    Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE – Results Only Work Environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large US corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees’ health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. PMID:23517706

  16. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

    Directory of Open Access Journals (Sweden)

    Christoph Aluttis

    2014-04-01

    Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

  17. Health system performance at the district level in Indonesia after decentralization

    Directory of Open Access Journals (Sweden)

    Choi Yoonjoung

    2010-03-01

    Full Text Available Abstract Background Assessments over the last two decades have showed an overall low level of performance of the health system in Indonesia with wide variation between districts. The reasons advanced for these low levels of performance include the low level of public funding for health and the lack of discretion for health system managers at the district level. When, in 2001, Indonesia implemented a radical decentralization and significantly increased the central transfer of funds to district governments it was widely expected that the performance of the health system would improve. This paper assesses the extent to which the performance of the health system has improved since decentralization. Methods We measured a set of indicators relevant to assessing changes in performance of the health system between two surveys in three areas: utilization of maternal antenatal and delivery care; immunization coverage; and contraceptive source and use. We also measured respondents' demographic characteristics and their living circumstances. These measurements were made in population-based surveys in 10 districts in 2002-03 and repeated in 2007 in the same 10 districts using the same instruments and sampling methods. Results The dominant providers of maternal and child health in these 10 districts are in the private sector. There was a significant decrease in birth deliveries at home, and a corresponding increase in deliveries in health facilities in 5 of the 10 districts, largely due to increased use of private facilities with little change in the already low use of public facilities. Overall, there was no improvement in vaccination of mothers and their children. Of those using modern contraceptive methods, the majority obtained them from the private sector in all districts. Conclusions There has been little improvement in the performance of the health system since decentralization occurred in 2001 even though there have also been significant increases in

  18. Cardiovascular health metrics and accelerometer-measured physical activity levels: National Health and Nutrition Examination Survey, 2003-2006.

    Science.gov (United States)

    Barreira, Tiago V; Harrington, Deirdre M; Katzmarzyk, Peter T

    2014-01-01

    To determine whether relationships exist between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and other cardiovascular (CV) health metrics in a large sample. Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) collected from January 1, 2003, through December 31, 2006, were used. Overall, 3454 nonpregnant adults 20 years or older who fasted for 6 hours or longer, with valid accelerometer data and with CV health metrics, were included in the study. Blood pressure (BP), body mass index (BMI), smoking status, diet, fasting plasma glucose level, and total cholesterol level were defined as ideal, intermediate, and poor on the basis of American Heart Association criteria. Results were weighted to account for sampling design, oversampling, and nonresponse. Significant increasing linear trends in mean daily MVPA were observed across CV health levels for BMI, BP, and fasting plasma glucose (Pphysical activity in the overall definition of ideal CV health. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. Social trust, interpersonal trust and self-rated health in China: a multi-level study.

    Science.gov (United States)

    Feng, Zhixin; Vlachantoni, Athina; Liu, Xiaoting; Jones, Kelvyn

    2016-11-08

    Trust is important for health at both the individual and societal level. Previous research using Western concepts of trust has shown that a high level of trust in society can positively affect individuals' health; however, it has been found that the concepts and culture of trust in China are different from those in Western countries and research on the relationship between trust and health in China is scarce. The analyses use data from the national scale China General Social Survey (CGSS) on adults aged above 18 in 2005 and 2010. Two concepts of trust ("out-group" and "in-group" trust) are used to examine the relationship between trust and self-rated health in China. Multilevel logistical models are applied, examining the trust at the individual and societal level on individuals' self-rated health. In terms of interpersonal trust, both "out-group" and "in-group" trust are positively associated with good health in 2005 and 2010. At the societal level, the relationships between the two concepts of trust and health are different. In 2005, higher "out-group" social trust (derived from trust in strangers) is positively associated with better health; however, higher "in-group" social trust (derived from trust in most people) is negatively associated with good health in 2010. The cross-level interactions show that lower educated individuals (no education or only primary level), rural residents and those on lower incomes are the most affected groups in societies with higher "out-group" social trust; whereas people with lower levels of educational attainment, a lower income, and those who think that most people can be trusted are the most affected groups in societies with higher "in-group" social trust. High levels of interpersonal trust are of benefit to health. Higher "out-group" social trust is positively associated with better health; while higher "in-group" social trust is negatively associated with good health. Individuals with different levels of educational

  20. Association between Municipal Health Promotion Volunteers' Health Literacy and Their Level of Outreach Activities in Japan.

    Science.gov (United States)

    Taguchi, Atsuko; Murayama, Hiroshi; Murashima, Sachiyo

    2016-01-01

    To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members). A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers. The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community") and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities. Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health

  1. Association between Municipal Health Promotion Volunteers’ Health Literacy and Their Level of Outreach Activities in Japan

    Science.gov (United States)

    Taguchi, Atsuko; Murayama, Hiroshi; Murashima, Sachiyo

    2016-01-01

    Objectives To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members). Study Design A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers. Methods The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities (“healthy lifestyle,” “outreach to family,” “outreach to community”) and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers’ outreach activities. Results Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the

  2. Relationships among exceedences of metals criteria, the results of ambient bioassays, and community metrics in mining-impacted streams.

    Science.gov (United States)

    Griffith, Michael B; Lazorchak, James M; Herlihy, Alan T

    2004-07-01

    If bioassessments are to help diagnose the specific environmental stressors affecting streams, a better understanding is needed of the relationships between community metrics and ambient criteria or ambient bioassays. However, this relationship is not simple, because metrics assess responses at the community level of biological organization, while ambient criteria and ambient bioassays assess or are based on responses at the individual level. For metals, the relationship is further complicated by the influence of other chemical variables, such as hardness, on their bioavailability and toxicity. In 1993 and 1994, U.S. Environmental Protection Agency (U.S. EPA) conducted a Regional Environmental Monitoring and Assessment Program (REMAP) survey on wadeable streams in Colorado's (USA) Southern Rockies Ecoregion. In this ecoregion, mining over the past century has resulted in metals contamination of streams. The surveys collected data on fish and macroinvertebrate assemblages, physical habitat, and sediment and water chemistry and toxicity. These data provide a framework for assessing diagnostic community metrics for specific environmental stressors. We characterized streams as metals-affected based on exceedence of hardness-adjusted criteria for cadmium, copper, lead, and zinc in water; on water toxicity tests (48-h Pimephales promelas and Ceriodaphnia dubia survival); on exceedence of sediment threshold effect levels (TELs); or on sediment toxicity tests (7-d Hyalella azteca survival and growth). Macroinvertebrate and fish metrics were compared among affected and unaffected sites to identify metrics sensitive to metals. Several macroinvertebrate metrics, particularly richness metrics, were less in affected streams, while other metrics were not. This is a function of the sensitivity of the individual metrics to metals effects. Fish metrics were less sensitive to metals because of the low diversity of fish in these streams.

  3. The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

    Science.gov (United States)

    Yu, Hao; Greenberg, Michael; Haviland, Amelia

    2017-12-01

    Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

  4. Large deviation estimates for exceedance times of perpetuity sequences and their dual processes

    DEFF Research Database (Denmark)

    Buraczewski, Dariusz; Collamore, Jeffrey F.; Damek, Ewa

    2016-01-01

    In a variety of problems in pure and applied probability, it is of relevant to study the large exceedance probabilities of the perpetuity sequence $Y_n := B_1 + A_1 B_2 + \\cdots + (A_1 \\cdots A_{n-1}) B_n$, where $(A_i,B_i) \\subset (0,\\infty) \\times \\reals$. Estimates for the stationary tail dist......-time exceedance probabilities of $\\{ M_n^\\ast \\}$, yielding a new result concerning the convergence of $\\{ M_n^\\ast \\}$ to its stationary distribution.......In a variety of problems in pure and applied probability, it is of relevant to study the large exceedance probabilities of the perpetuity sequence $Y_n := B_1 + A_1 B_2 + \\cdots + (A_1 \\cdots A_{n-1}) B_n$, where $(A_i,B_i) \\subset (0,\\infty) \\times \\reals$. Estimates for the stationary tail...... distribution of $\\{ Y_n \\}$ have been developed in the seminal papers of Kesten (1973) and Goldie (1991). Specifically, it is well-known that if $M := \\sup_n Y_n$, then ${\\mathbb P} \\left\\{ M > u \\right\\} \\sim {\\cal C}_M u^{-\\xi}$ as $u \\to \\infty$. While much attention has been focused on extending...

  5. Sources of atmospheric aerosols controlling PM10 levels in Heraklion, Crete during winter time

    Science.gov (United States)

    Kalivitis, Nikolaos; Kouvarakis, Giorgos; Stavroulas, Iasonas; Kandilogiannaki, Maria; Vavadaki, Katerina; Mihalopoulos, Nikolaos

    2016-04-01

    High concentrations of Particulate Matter (PM) in the atmosphere have negative impact to human health. Thresholds for ambient concentrations that are defined by the directive 2008/50/EC are frequently exceeded even at background conditions in the Mediterranean region as shown in earlier studies. The sources of atmospheric particles in the urban environment of a medium size city of eastern Mediterranean are studied in the present work in order to better understand the causes and characteristics of exceedances of the daily mean PM10limit value of 50 μg m-3. Measurements were performed at the atmospheric quality measurement station of the Region of Crete, at the Heraklion city center on Crete island, during the winter/spring period of 2014-2015 and 2015-2016. Special emphasis was given to the study of the contribution of Black Carbon (BC) to the levels of PM10. Continuous measurements were performed using a beta-attenuation PM10monitor and a 7-wavelength Aethalometer with a time resolution of 30 and 5 minutes respectively. For direct comparison to background regional conditions, concurrent routine measurements at the atmospheric research station of University of Crete at Finokalia were used as background reference. Analysis of exceedances in the daily PM10 mass concentration showed that the total of the exceedances was related to long range transport of Saharan dust rather than local sources. However, compared to the Finokalia station it was found that there were 20% more exceedances in Heraklion, the addition of transported dust on the local pollution was the reason for the additional exceedance days. Excluding dust events, it was found that the PM10variability was dependent on the BC abundance, traffic during rush hours in the morning and biomass burning for domestic heating in the evening contributed significantly to PM10levels in Heraklion.

  6. Public health assessment for public health implications of radiation contamination at former clock factories located in Bristo (Hartford County), New Haven, (New Haven County), Thomaston (Litchfield County), and Waterbury (New Haven County), Connecticut, Region 1. Final report

    International Nuclear Information System (INIS)

    1999-01-01

    This public health assessment was developed (1) to evaluate the radiation data collected by the Connecticut Department of Environmental Protection (CT DEP) at structures that once housed clock factories in four Connecticut municipalities, and (2) to determine whether a public health hazard exists at any of these sites from the contamination. Contamination was detected at levels that may pose a health risk to current occupants at the former Waterbury Clock Factory, the former Lux Clock Factory, and the former Benrus Clock Company buildings in Waterbury; the former Sessions Clock Company in Bristol; and the former Seth Thomas Clock Company in Thomaston. However, none of the radiation levels detected pose an immediate health problem. The Connecticut Department of Public Health recommends that individuals be disassociated from areas with radiation at levels exceeding 15 mRem/year

  7. Approach to evaluating health level and adaptation possibilities in schoolchildren

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    O.V. Andrieieva

    2014-02-01

    Full Text Available Purpose: substantiate the results of theoretical and practical investigations aimed at improving the health of students. Material: the study involved 187 children including 103 boys and 84 girls aged 7-10 years. Results: through a rapid assessment of physical health it was found that pupils of primary school age have an average level of the functional state of the organism, with a minimum resistance to risk factors (chronic non-infective diseases, etc.. For the first time, a technique for determining the level of adaptation and reserve capacity of school students proposed by Ukrainian hygienists was used in physical culture and sports practice. Conclusions: the technique reveals strain in adaptation mechanisms that corresponds to donozological condition. An idea is proposed that Nordic walking, through the positive impact on the body of aerobic mode of energy supply, is able to increase the reserve-adaptive capabilities of primary school students by improvement of their health as well as to solve the problems of health formation and health care in the physical education of youth.

  8. Health promotion behaviors in adolescents: prevalence and association with mental health status in a statewide sample.

    Science.gov (United States)

    Adrian, Molly; Charlesworth-Attie, Sarah; Vander Stoep, Ann; McCauley, Elizabeth; Becker, Linda

    2014-04-01

    The purpose of this study is to estimate the proportion of adolescents meeting Healthy People 2020 health behavior recommendations for the prevention of chronic disease and to determine the association between mental health status (depression and/or conduct problems) and the likelihood of meeting these recommendations. The data used for this study are from the 2010 Washington State Healthy Youth Survey. Descriptive statistics and linear regression were utilized to estimate the proportion of adolescents meeting recommendations and associations between youth mental health status indicators and health-promoting behaviors. A small minority (5.8 %) of youth met all six recommendations in domains of tobacco abstinence, substance use abstinence, daily physical activity, breakfast consumption, weight below obese levels, and adequate sleep, though most (84.3 %) met at least three. At the aggregate level, the proportion of Washington State youth who met Healthy People 2020 guidelines exceeded targets, with the exception of substance use abstinence. A minority of youth reported guideline levels of daily physical activity (23.3 %) and sleep (39.8 %). Mental health status was strongly associated with the number of health-promoting behaviors adolescents endorsed. Interventions to increase the adoption of sleep hygiene and exercise habits should be added to an integrative positive youth development framework within school-, community-, and primary care-based adolescent health initiatives. Attention to adolescent mental health and shared risk factors may be critical for reducing barriers to healthy behavior.

  9. Examining levels, distribution and correlates of health insurance coverage in Kenya.

    Science.gov (United States)

    Kazungu, Jacob S; Barasa, Edwine W

    2017-09-01

    To examine the levels, inequalities and factors associated with health insurance coverage in Kenya. We analysed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorise households into five socio-economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high-low ratio (Q5/Q1 ratio), concentration curve and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage. Overall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX = 0.61, 95% CI 0.52-0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX = 0.49, 95% CI 0.45-0.52). Individuals that were older, employed in the formal sector; married, exposed to media; and male, belonged to a small household, had a chronic disease and belonged to rich households, had increased odds of health insurance coverage. Health insurance coverage in Kenya remains low and is characterised by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax-funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered. © 2017 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  10. Mercury content in Chilean fish and estimated intake levels.

    Science.gov (United States)

    Cortes, Sandra; Fortt, Antonia

    2007-09-01

    The intake of fish products is a major public health concern due to possible methyl mercury exposure, which is especially toxic to the human nervous system. This pilot study (n = 46) was designed to determine mercury concentrations in fish products for national consumption (Chilean jack mackerel, hake, Chilean mussel, tuna) and for export (salmon, Patagonian toothfish, swordfish, southern hake), and to estimate the exposure of the general population. The fish products were collected from markets in Talcahuano, Puerto Montt and Santiago. Samples were analyzed at the National Environmental Center by cold vapor atomic absorption spectrophotometry. Mercury levels in swordfish and one canned tuna sample exceeded levels prescribed by national and international standards. The remaining two export products (Patagonian toothfish, also known as Chilean sea bass, and salmon) complied with international limits, which are more demanding than Chilean regulations. Theoretical estimates of mercury intake varied from 0.08 to 3.8 microg kg(-1) bw day(-1) for high fish consumers, exceeding the provisional tolerable intake for tuna, Chilean seabass, Chilean jack mackerel and swordfish. This group appears to be at the greatest risk from mercury contamination among the Chilean population.

  11. Mercury levels in the Smooth Hammerhead Shark Sphyrna zygaena (Carcharhiniformes: Sphyrnidae from Northern Peru

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    Adriana Gonzalez-Pestana

    2017-12-01

    Full Text Available The smooth hammerhead shark Sphyrna zygaena (Linnaeus, 1758 is one of the elasmobranch species most used for human consumption in Peru. However, the level of mercury in hammerhead muscle tissue is unknown. This study assessed the level of mercury found in the muscle of hammerhead sharks and its relation with human health. Moreover, we evaluated the relationship between shark body size and mercury levels. We analyzed 27 muscle samples of neonates and juveniles captured in northern Peru. Mercury concentrations varied between 0.13 and 0.86 mg kg-1 wet weight. Moreover, we found a negative and significant relationship between shark body size and mercury levels. This study represents the first evaluation of mercury levels of sharks in Peru. Although the values found do not exceed levels recommended by the World Health Organization (< 1 mg kg-1, we recommend expanding this study to include other size classes of sharks as well as other marine resources used for human consumption.

  12. Team-level flexibility, work-home spillover, and health behavior.

    Science.gov (United States)

    Moen, Phyllis; Fan, Wen; Kelly, Erin L

    2013-05-01

    Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE--results only work environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large U.S. corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees' health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. Copyright © 2013. Published by Elsevier Ltd.

  13. High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates.

    Science.gov (United States)

    Carrel, Margaret; Zahrieh, David; Young, Sean G; Oleson, Jacob; Ryckman, Kelli K; Wels, Brian; Simmons, Donald L; Saftlas, Audrey

    2017-01-01

    Lead in maternal blood can cross the placenta and result in elevated blood lead levels in newborns, potentially producing negative effects on neurocognitive function, particularly if combined with childhood lead exposure. Little research exists, however, into the burden of elevated blood lead levels in newborns, or the places and populations in which elevated lead levels are observed in newborns, particularly in rural settings. Using ~2300 dried bloods spots collected within 1-3 days of birth among Iowa newborns, linked with the area of mother's residence at the time of birth, we examine the spatial patterns of elevated (>5 μg/dL) blood lead levels and the ecological-level predictors of elevated blood lead levels. We find that one in five newborns exceed the 5 μg/dL action level set by the US Centers for Disease Control & Prevention (CDC). Bayesian spatial zero inflated regression indicates that elevated blood lead in newborns is associated with areas of increased pre-1940s housing and childbearing-age women with low educational status in both rural and urban settings. No differences in blood lead levels or the proportion of children exceeding 5 μg/dL are observed between urban and rural maternal residence, though a spatial cluster of elevated blood lead is observed in rural counties. These characteristics can guide the recommendation for testing of infants at well-baby appointments in places where risk factors are present, potentially leading to earlier initiation of case management. The findings also suggest that rural populations are at as great of risk of elevated blood lead levels as are urban populations. Analysis of newborn dried blood spots is an important tool for lead poisoning surveillance in newborns and can direct public health efforts towards specific places and populations where lead testing and case management will have the greatest impact.

  14. Area-level income inequality and oral health among Australian adults-A population-based multilevel study.

    Directory of Open Access Journals (Sweden)

    Ankur Singh

    Full Text Available A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (<21 teeth and poor self-rated oral health among Australian adults. Variations in the association between area-level income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared.For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income.LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87 after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality.Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse association between income

  15. Health risk assessment of hazardous metals for population via consumption of seafood from Ogoniland, Rivers State, Nigeria; a case study of Kaa, B-Dere, and Bodo City.

    Science.gov (United States)

    Nkpaa, K W; Patrick-Iwuanyanwu, K C; Wegwu, M O; Essien, E B

    2016-01-01

    This study was designed to investigate the human health risk through consumption of seafood from contaminated sites in Kaa, B-Dere, and Bodo City all in Ogoniland. The potential non-carcinogenic health risk for consumers were investigated by assessing the estimated daily intake and target hazard quotients for Cr, Cd, Zn, Pb, Mn, and Fe while carcinogenic health effect from Cr, Cd, and Pb was also estimated. The estimated daily intake from seafood consumption was below the threshold values for Cr, Mn, and Zn while they exceeded the threshold for Cd, Pb, and Fe. The target hazard quotients for Zn and Cr were below 1. Target hazard quotients values for Cd, Pb, Mn, and Fe were greater than 1 except for Fe level in Liza falcipinis from Kaa. Furthermore, estimation of carcinogenic risk for Cr in all samples under study exceeded the accepted risk level of 10E-4. Also, Cd carcinogenic risk level for L. falcipinis and Callinectes pallidus collected from B-Dere and C. pallidus collected from Bodo City was 1.1E-3 which also exceeded the accepted risk level of 10E-4 for Cd. Estimation of carcinogenic risk for Pb was within the acceptable range of 10E-4. Consumers of seafood from these sites in Ogoniland may be exposed to metal pollution.

  16. Measurement of health system performance at district level: A study protocol

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    Atul Sharma

    2018-01-01

    Full Text Available Background: Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. Methods: A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. Expected impact for public health: The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components.

  17. Composition and sources of particles in Mannerheimintie during exceedance days of PM{sub 10} limit value in 2009; Hiukkasten koostumus ja laehteet Mannerheimintiellae PM{sub 10}-raja-arvon ylityspaeivinae 2009

    Energy Technology Data Exchange (ETDEWEB)

    Kupiainen, K.; Stojiljkovic, A.; Ritola, R. (Nordic Envicon Oy, Helsinki (Finland))

    2011-06-15

    The purpose of the work was to determine sources of thoracic particles (PM{sub 10}) in the center of Helsinki, in Mannerheimintie, in 2009 during the days when the daily average concentration of PM{sub 10} exceeded 50 mug/m3. Work was commissioned by the Helsinki City Public Works department, the Helsinki Environment Centre and the Helsinki Region Environmental Services Authority HSY (formerly YTV). By the end of the year there were altogether 30 exceedance days. The allowed number of exceedance days per year is 35, so the limit value was not exceeded in 2009. HSY is responsible for monitoring the air quality in the Helsinki metropolitan area. The PM{sub 10} monitoring data in combination with electron microscopy based single particle compositional analysis and receptor modeling was used to evaluate dust source contributions on the exceedance days at HSY's air quality monitoring station in Mannerheimintie. Dust sources related to traction control (winter maintenance and pavement wear by studded tyres) contributed most to the PM{sub 10} concentrations in Mannerheimintie. On 12 exceeding days this group accounted for more than 50 % of PM{sub 10} particles, on 3 days the group alone was sufficient to cause the exceedance. On 3 of the exceedance days long-range transboundary air pollution or traffic exhaust emissions were on the same level with the traction control sources. On 11 days the most significant impact came from construction sites. (orig.)

  18. ENVIRONMENTAL LEVELS AND DISTRIBUTION OF CARBON MONOXIDE IN BUCHAREST URBAN AREA CASE STUDY: 1. 07. 2006 – 31.03.2007

    Directory of Open Access Journals (Sweden)

    POPESCU NICOLAE CRISTIAN

    2013-03-01

    Full Text Available Ambient concentrations of carbon monoxide in the vicinity of or inside urban and industrial areas can substantially exceed environmental background levels and can be detrimental to human health and welfare. In this period of analysis (July 2006 – March 2007, the maximum allowable concentration (MAC was exceeded especially at Mihai Bravu and Cercul Militar. The accompanying diagrams showing the time evolution and charts revealing the spatial distribution of CO ambient air concentrations (based on GIS techniques can be useful instruments in identifying the potential risk areas, like the important streets in the center of Bucharest.

  19. Community air monitoring for pesticides. Part 3: using health-based screening levels to evaluate results collected for a year.

    Science.gov (United States)

    Wofford, Pamela; Segawa, Randy; Schreider, Jay; Federighi, Veda; Neal, Rosemary; Brattesani, Madeline

    2014-03-01

    The CA Department of Pesticide Regulation (CDPR) and the CA Air Resources Board monitored 40 pesticides, including five degradation products, in Parlier, CA, to determine if its residents were exposed to any of these pesticides and, if so, in what amounts. They included 1,3-dichloropropene, acrolein, arsenic, azinphos-methyl, carbon disulfide, chlorpyrifos and its degradation product, chlorthalonil, copper, cypermethrin, diazinon and its degradation product, dichlorvos, dicofol, dimethoate and its degradation product, diuron, endosulfan and its degradation product, S-ethyl dipropylcarbamothioate (EPTC), formaldehyde, malathion and its degradation product, methyl isothiocyanate (MITC), methyl bromide, metolachlor, molinate, norflurazon, oryzalin, oxyfluorfen, permethrin, phosmet, propanil, propargite, simazine, SSS-tributylphosphorotrithioate, sulfur, thiobencarb, trifluralin, and xylene. Monitoring was conducted 3 days per week for a year. Twenty-three pesticides and degradation products were detected. Acrolein, arsenic, carbon disulfide, chlorpyrifos, copper, formaldehyde, methyl bromide, MITC, and sulfur were detected in more than half the samples. Since no regulatory ambient air standards exist for these pesticides, CDPR developed advisory, health-based non-cancer screening levels (SLs) to assess acute, subchronic, and chronic exposures. For carcinogenic pesticides, CDPR assessed risk using cancer potency values. Amongst non-carcinogenic agricultural use pesticides, only diazinon exceeded its SL. For carcinogens, 1,3-dichloropropene concentrations exceeded its cancer potency value. Based on these findings, CDPR has undertaken a more comprehensive evaluation of 1,3-dichloropropene, diazinon, and the closely related chlorpyrifos that was frequently detected. Four chemicals-acrolein, arsenic, carbon disulfide, and formaldehyde-sometimes used as pesticides were detected, although no pesticidal use was reported in the area during this study. Their presence was most

  20. Estimates of state-level health-care expenditures associated with disability.

    Science.gov (United States)

    Anderson, Wayne L; Armour, Brian S; Finkelstein, Eric A; Wiener, Joshua M

    2010-01-01

    We estimated state-level disability-associated health-care expenditures (DAHE) for the U.S. adult population. We used a two-part model to estimate DAHE for the noninstitutionalized U.S. civilian adult population using data from the 2002-2003 Medical Expenditure Panel Survey and state-level data from the Behavioral Risk Factor Surveillance System. Administrative data for people in institutions were added to generate estimates for the total adult noninstitutionalized population. Individual-level data on total health-care expenditures along with demographic, socioeconomic, geographic, and payer characteristics were used in the models. The DAHE for all U.S. adults totaled $397.8 billion in 2006, with state expenditures ranging from $598 million in Wyoming to $40.1 billion in New York. Of the national total, the DAHE were $118.9 billion for the Medicare population, $161.1 billion for Medicaid recipients, and $117.8 billion for the privately insured and uninsured populations. For the total U.S. adult population, 26.7% of health-care expenditures were associated with disability, with proportions by state ranging from 16.9% in Hawaii to 32.8% in New York. This proportion varied greatly by payer, with 38.1% for Medicare expenditures, 68.7% for Medicaid expenditures, and 12.5% for nonpublic health-care expenditures associated with disability. DAHE vary greatly by state and are borne largely by the public sector, and particularly by Medicaid. Policy makers need to consider initiatives that will help reduce the prevalence of disabilities and disability-related health disparities, as well as improve the lives of people with disabilities.

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

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    Šćepanović Aleksandar

    2017-01-01

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

  2. Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults

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    Peter D. Hart

    2017-01-01

    Full Text Available Objectives The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA with health status and preventive health behavior in adults. Methods A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables. Results Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9% of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1% reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3% who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker. Conclusions In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.

  3. Assessment of exposure to heavy metals and health risks among residents near abandoned metal mines in Goseong, Korea

    International Nuclear Information System (INIS)

    Ji, Kyunghee; Kim, Jungkon; Lee, Minjung; Park, Soyoung; Kwon, Ho-Jang; Cheong, Hae-Kwan; Jang, Jae-Yeon; Kim, Dae-Seon; Yu, Seungdo; Kim, Young-Wook; Lee, Kwang-Young; Yang, Seoung-Oh; Jhung, Ik Jae; Yang, Won-Ho; Paek, Do-Hyun; Hong, Yun-Chul; Choi, Kyungho

    2013-01-01

    Metal contamination from mining activity is of great concern because of potential health risks to the local inhabitants. In the present study, we investigated the levels of Cd, Cu, As, Pb, and Zn in environmental samples and foodstuffs grown in the vicinity of the mines in Goseong, Korea, and evaluated potential health risks among local residents. Soils near the mines exceeded the soil quality standard values of Cu, As, and Zn contamination. The concentrations of Cd, Cu, Pb, and Zn in crop samples collected from the study area were significantly higher than those of the reference area. Some rice samples collected from the study area exceeded the maximum permissible level of 0.2 mg Cd/kg. The intake of rice was identified as a major contributor (≥75%) to the estimated daily intake among the residents. The average estimated daily intakes of metals were, however, below the provisional tolerable daily intake. -- Highlights: •Area near the abandoned mines was significantly contaminated with metals. •Some rice grains exceeded the maximum permissible level of Cd. •The estimated daily intake of metals was below the provisional tolerable daily intake. •Intake of rice was constituted the major proportion of estimated daily intake. -- Cadmium was detected relatively high in rice, and was identified as a chemical of potential concern in an area near abandoned copper mines of Goseong, Korea

  4. Atmospheric dry and wet deposition of sulphur and nitrogen species and assessment of critical loads of acidic deposition exceedance in South Africa

    Directory of Open Access Journals (Sweden)

    Stuart J. Piketh

    2011-03-01

    Full Text Available We tested the hypothesis that acidic atmospheric pollution deposition, originating from the South African central industrial area, poses an environmental threat across a larger region within the dispersal footprint. A network of 37 passive monitoring sites to measure SO2 and NO2 was operated from August 2005 to September 2007. The area extended over the entire northern and eastern interior of South Africa. Monitoring locations were chosen to avoid direct impacts from local sources such as towns, mines and highways. Dry deposition rates of SO2 and NO2 were calculated from the measured concentrations. Concentrations of sulphur and nitrogen species in wet deposition from a previous study were used in conjunction with measured rainfall for the years 2006 and 2007 to estimate the wet deposition over the region. The calculated total (non-organic acidic deposition formed the basis for an assessment of exceedance of critical loads based on sensitivity of the regional soils. Regional soil sensitivity was determined by combining two major soil attributes available in the World Inventory of Soil Emission Potentials (International Soil Reference and Information Centre. Results indicate that certain parts of the central pollution source area on the South African Highveld have the potential for critical load exceedance, while limited areas downwind show lower levels of exceedance. Areas upwind and remote areas up and downwind, including forested areas of the Drakensberg escarpment, do not show any exceedance of the critical loads.

  5. Area-level income inequality and oral health among Australian adults-A population-based multilevel study.

    Science.gov (United States)

    Singh, Ankur; Harford, Jane; Antunes, José Leopoldo Ferreira; Peres, Marco A

    2018-01-01

    A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income. LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87) after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality. Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse association between income inequality and inadequate dentition is likely due to the contextual differences between Australia and other high-income countries.

  6. Area-level income inequality and oral health among Australian adults—A population-based multilevel study

    Science.gov (United States)

    2018-01-01

    Background A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. Methods For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income. Results LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87) after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality. Conclusion Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse association between income inequality and inadequate dentition is likely due to the contextual differences between Australia

  7. Effects of state-level Earned Income Tax Credit laws in the U.S. on maternal health behaviors and infant health outcomes.

    Science.gov (United States)

    Markowitz, Sara; Komro, Kelli A; Livingston, Melvin D; Lenhart, Otto; Wagenaar, Alexander C

    2017-12-01

    The purpose of this paper is to investigate the effects of state-level Earned Income Tax Credit (EITC) laws in the U.S. on maternal health behaviors and infant health outcomes. Using multi-state, multi-year difference-in-differences analyses, we estimated effects of state EITC generosity on maternal health behaviors, birth weight and gestation weeks. We find little difference in maternal health behaviors associated with state-level EITC. In contrast, results for key infant health outcomes of birth weight and gestation weeks show small improvements in states with EITCs, with larger effects seen among states with more generous EITCs. Our results provide evidence for important health benefits of state-level EITC policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Development of a Health-Protective Drinking Water Level for Perchlorate

    Science.gov (United States)

    Ting, David; Howd, Robert A.; Fan, Anna M.; Alexeeff, George V.

    2006-01-01

    We evaluated animal and human toxicity data for perchlorate and identified reduction of thyroidal iodide uptake as the critical end point in the development of a health-protective drinking water level [also known as the public health goal (PHG)] for the chemical. This work was performed under the drinking water program of the Office of Environmental Health Hazard Assessment of the California Environmental Protection Agency. For dose–response characterization, we applied benchmark-dose modeling to human data and determined a point of departure (the 95% lower confidence limit for 5% inhibition of iodide uptake) of 0.0037 mg/kg/day. A PHG of 6 ppb was calculated by using an uncertainty factor of 10, a relative source contribution of 60%, and exposure assumptions specific to pregnant women. The California Department of Health Services will use the PHG, together with other considerations such as economic impact and engineering feasibility, to develop a California maximum contaminant level for perchlorate. We consider the PHG to be adequately protective of sensitive subpopulations, including pregnant women, their fetuses, infants, and people with hypothyroidism. PMID:16759989

  9. State-level marriage equality and the health of same-sex couples.

    Science.gov (United States)

    Kail, Ben Lennox; Acosta, Katie L; Wright, Eric R

    2015-06-01

    We assessed the association between the health of people in same-sex relationships and the degree and nature of the legal recognition of same-sex relationships offered in the states in which they resided. We conducted secondary data analyses on the 2010 to 2013 Current Population Survey and publicly available data from Freedom to Marry, Inc. We estimated ordered logistic regression models in a 4-level framework to assess the impact of states' legal stances toward same-sex marriage on self-assessed health. Our findings indicated, relative to states with antigay constitutional amendments, that same-sex couples living in states with legally sanctioned marriage reported higher levels of self-assessed health. Our findings suggested that full legal recognition of same-sex relationships through marriage might be an important legal and policy strategy for improving the health of same-sex couples.

  10. Urbanization and health in China, thinking at the national, local and individual levels.

    Science.gov (United States)

    Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

    2016-03-08

    China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take

  11. Assessment of the English literacy level of patients in primary health ...

    African Journals Online (AJOL)

    ... of patients in primary health care services in Tshwane, Gauteng province: Part 2. ... levels of primary health care patients using the Learning Ability Battery (LAB) ... Data were collected by means of a self-report whereby the participants had ...

  12. SHAM: High-level seismic tests of piping at the HDR

    International Nuclear Information System (INIS)

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J.; Malcher, L.; Schrammel, D.; Steinhilber, H.; Costello, J.F.

    1988-01-01

    As part of the second phase of vibrational/earthquake investigations at the HDR (Heissdampfreaktor) Test Facility in Kahl/Main, FRG, high-level simulated seismic tests (SHAM) were performed during April--May 1988 on the VKL (Versuchskreislauf) in-plant piping system with two servohydraulic actuators, each capable of generating 40 tons of force. The purpose of these experiments was to study the behavior of piping subjected to seismic excitation levels that exceed design levels manifold and may result in failure/plastification of pipe supports and pipe elements, and to establish seismic margins for piping and pipe supports. The performance of six different dynamic pipe support systems was compared in these tests and the response, operability, and fragility of dynamic supports and of a typical US gate valve were investigated. Data obtained in the tests are used to validate analysis methods. Very preliminary evaluations lead to the observation that, in general, failures of dynamic supports (in particular snubbers) occur only at load levels that substantially exceed the design capacity. Pipe strains at load levels exceeding the design level threefold are quite small, and even when exceeding the design level eightfold are quite tolerable. Hence, under seismic loading, even at extreme levels and in spite of multiple support failures, pipe failure is unlikely. 5 refs., 16 figs

  13. Mapping critical levels/loads for the Slovak Republic. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Zavodsky, D; Babiakova, G; Mitosinkova, M [and others

    1996-08-01

    As a part of the Agreement on Environmental Cooperation between Norway and Slovakia a project ``Mapping Critical Levels/Loads for Slovakia`` was established. This report presents the final project results. Critical loads for forest, surface and ground waters and their exceedances were calculated by means of the steady-state mass balance model PROFILE for soils, and the steady-state water chemistry method for waters. A grid distance of 10 km was used. Because the sulphur deposition has been decreasing, the exceedances of critical load of acidity and critical sulphur deposition of forest soils have decreased from 1990 to 1995. Practically no acidity exceedances for surface water or ground water were found in 1995. The critical level of forest ozone was exceeded all over Slovakia. In the Tatra mountains the exceedance was over 25000 ppb.h. 23 refs., 3 figs., 3 tabs.

  14. Indoor air quality in Portuguese schools: levels and sources of pollutants.

    Science.gov (United States)

    Madureira, J; Paciência, I; Pereira, C; Teixeira, J P; Fernandes, E de O

    2016-08-01

    Indoor air quality (IAQ) parameters in 73 primary classrooms in Porto were examined for the purpose of assessing levels of volatile organic compounds (VOCs), aldehydes, particulate matter, ventilation rates and bioaerosols within and between schools, and potential sources. Levels of VOCs, aldehydes, PM2.5 , PM10 , bacteria and fungi, carbon dioxide (CO2 ), carbon monoxide, temperature and relative humidity were measured indoors and outdoors and a walkthrough survey was performed concurrently. Ventilation rates were derived from CO2 and occupancy data. Concentrations of CO2 exceeding 1000 ppm were often encountered, indicating poor ventilation. Most VOCs had low concentrations (median of individual species <5 μg/m(3) ) and were below the respective WHO guidelines. Concentrations of particulate matter and culturable bacteria were frequently higher than guidelines/reference values. The variability of VOCs, aldehydes, bioaerosol concentrations, and CO2 levels between schools exceeded the variability within schools. These findings indicate that IAQ problems may persist in classrooms where pollutant sources exist and classrooms are poorly ventilated; source control strategies (related to building location, occupant behavior, maintenance/cleaning activities) are deemed to be the most reliable for the prevention of adverse health consequences in children in schools. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Readability Levels of Health-Based Websites: From Content to Comprehension

    Science.gov (United States)

    Schutten, Mary; McFarland, Allison

    2009-01-01

    Three of the national health education standards include decision-making, accessing information and analyzing influences. WebQuests are a popular inquiry-oriented method used by secondary teachers to help students achieve these content standards. While WebQuests support higher level thinking skills, the readability level of the information on the…

  16. HELLE: Health Effects of Low Level Exposures/ Gezondheidseffecten van lage blootstellingniveaus [International workshop: Influence of low level exposures to chemicals and radiation on human and ecological health

    Energy Technology Data Exchange (ETDEWEB)

    Schoten, Eert

    1998-11-26

    The Health Council is closely involved in establishing the scientific foundation of exposure limits for substances and radiation in order to protect public health. Through the years, the Council has contributed to the formulation of principles and procedures, both for carcinogenic and for noncarcinogenic agents. As a rule, the discussion with regard to the derivation of health-based recommended exposure limits centers around the appropriateness of extrapolation methods (What can be inferred from data on high exposure levels and on experimental animals?). Generally speaking, there is a lack of direct information on the health effects of low levels of exposure. Effects at these levels cannot usually be detected by means of traditional animal experiments or epidemiological research. The capacity of these analytical instruments to distinguish between ''signal'' and ''noise'' is inadequate in most cases. Annex B of this report contains a brief outline of the difficulties and the established methods for tackling this problem. In spite of this, the hope exists that the posited weak signals, if they are indeed present, can be detected by other means. The search will have to take place on a deeper level. In other words, effort must be made to discover what occurs at underlying levels of biological organization when organisms are exposed to low doses of radiation or substances. Molecular and cell biology provide various methods and techniques which give an insight into the processes within the cell. This results in an increase in the knowledge about the molecular and cellular effects of exposure to agents, or stated differently, the working mechanisms which form the basis of the health effects. Last year, the Health Council considered that the time was ripe to take stock of the state of knowledge in this field. To this end, an international working conference was held from 19 to 21 October 1997, entitled ''Health Effects of

  17. Women's Education Levels and Its Impact on Their Attitudes towards Children's Health Development

    Science.gov (United States)

    Bjorgen, Kathrine

    2011-01-01

    Relations between socio-economic differences and health have previously been well documented, but women's education level and relative attitudes towards children's health development has been seldom found in studies. This paper examines the relation between women's education level and their attitudes in understanding kindergarten children's health…

  18. Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

    Science.gov (United States)

    McGrath, Jennifer J.

    2015-01-01

    Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533

  19. Impact of Individual-, Environmental-, and Policy-Level Factors on Health Care Utilization Among US Farmworkers

    Science.gov (United States)

    Mayer, Joni A.; Gabbard, Susan; Kronick, Richard G.; Roesch, Scott C.; Malcarne, Vanessa L.; Zuniga, Maria L.

    2011-01-01

    Objectives. We examined individual-, environmental-, and policy-level correlates of US farmworker health care utilization, guided by the behavioral model for vulnerable populations and the ecological model. Methods. The 2006 and 2007 administrations of the National Agricultural Workers Survey (n = 2884) provided the primary data. Geographic information systems, the 2005 Uniform Data System, and rurality and border proximity indices provided environmental variables. To identify factors associated with health care use, we performed logistic regression using weighted hierarchical linear modeling. Results. Approximately half (55.3%) of farmworkers utilized US health care in the previous 2 years. Several factors were independently associated with use at the individual level (gender, immigration and migrant status, English proficiency, transportation access, health status, and non-US health care utilization), the environmental level (proximity to US–Mexico border), and the policy level (insurance status and workplace payment structure). County Federally Qualified Health Center resources were not independently associated. Conclusions. We identified farmworkers at greatest risk for poor access. We made recommendations for change to farmworker health care access at all 3 levels of influence, emphasizing Federally Qualified Health Center service delivery. PMID:21330594

  20. Analysing local-level responses to migration and urban health in Hillbrow: the Johannesburg Migrant Health Forum

    Directory of Open Access Journals (Sweden)

    Jo Vearey

    2017-07-01

    Full Text Available Abstract Johannesburg is home to a diverse migrant population and a range of urban health challenges. Locally informed and implemented responses to migration and health that are sensitive to the particular needs of diverse migrant groups are urgently required. In the absence of a coordinated response to migration and health in the city, the Johannesburg Migrant Health Forum (MHF – an unfunded informal working group of civil society actors – was established in 2008. We assess the impact, contributions and challenges of the MHF on the development of local-level responses to migration and urban health in Johannesburg to date. In this Commentary, we draw on data from participant observation in MHF meetings and activities, a review of core MHF documents, and semi-structured interviews conducted with 15 MHF members. The MHF is contributing to the development of local-level migration and health responses in Johannesburg in three key ways: (1 tracking poor quality or denial of public services to migrants; (2 diverse organisational membership linking the policy process with community experiences; and (3 improving service delivery to migrant clients through participation of diverse service providers and civil society organisations in the Forum. Our findings indicate that the MHF has a vital role to play in supporting the development of appropriate local responses to migration and health in a context of continued – and increasing – migration, and against the backdrop of rising anti-immigrant sentiments.

  1. Measuring total health inequality: adding individual variation to group-level differences

    Directory of Open Access Journals (Sweden)

    Gakidou Emmanuela

    2002-08-01

    Full Text Available Abstract Background Studies have revealed large variations in average health status across social, economic, and other groups. No study exists on the distribution of the risk of ill-health across individuals, either within groups or across all people in a society, and as such a crucial piece of total health inequality has been overlooked. Some of the reason for this neglect has been that the risk of death, which forms the basis for most measures, is impossible to observe directly and difficult to estimate. Methods We develop a measure of total health inequality – encompassing all inequalities among people in a society, including variation between and within groups – by adapting a beta-binomial regression model. We apply it to children under age two in 50 low- and middle-income countries. Our method has been adopted by the World Health Organization and is being implemented in surveys around the world; preliminary estimates have appeared in the World Health Report (2000. Results Countries with similar average child mortality differ considerably in total health inequality. Liberia and Mozambique have the largest inequalities in child survival, while Colombia, the Philippines and Kazakhstan have the lowest levels among the countries measured. Conclusions Total health inequality estimates should be routinely reported alongside average levels of health in populations and groups, as they reveal important policy-related information not otherwise knowable. This approach enables meaningful comparisons of inequality across countries and future analyses of the determinants of inequality.

  2. Addressing the social determinants of health at the local level: Opportunities and challenges.

    Science.gov (United States)

    Fosse, E; Helgesen, M K; Hagen, S; Torp, S

    2018-02-01

    The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities. In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level. Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient. A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.

  3. Health and ecological risk-based characterization of soil and sediment contamination in shipyard with long-term use of DDT-containing antifouling paint

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Guanlin; Zhang, Chao [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Wu, Guanglong; Ding, Qiong [Foreign Economic Cooperation Office, Ministry of Environmental Protection of China, Beijing, 100035 (China); Wang, Shijie [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Li, Fasheng, E-mail: Lifs@craes.org.cn [State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China)

    2013-04-15

    Dichlorodiphenyltrichloroethane (DDT) was a frequently occurring type of persistent organic environmental pollutant in China and DDT-containing antifouling paint could be the main contributor of DDT to shipyards and fishing harbors. A field survey was conducted in a shipyard in southern China to investigate the content and distribution of DDT in soil and sediments. Human health and screening-level ecological risk assessments were conducted for DDT contamination in soil and sediments and the results indicated that total DDT in all samples tested exceeded present advisory safe limits. Analysis of the composition and distribution implicated DDT-containing antifouling paint used for ship maintenance as an important source of DDT. Individual and cumulative health risks for residents exceeded the extra lifetime cancer risks of 10{sup −6} and 10{sup −5}, mainly from exposure to soil, ingestion and dermal contact. DDT in sediments is associated with a high level of toxicity for the benthic community when > 99% of samples exceed the threshold concentration likely to be responsible for effects and severe effects. Further risk control for DDT is required to ensure safety for human health, the benthic community and the environment. - Highlights: ► DDT ranked high concentration both in sediments and soil in a shipyard. ► Composition analysis indicated DDT antifouling paint was the main source. ► High loading DDT in sediments resulted in high probability of ecological risks. ► Potential health risks for residents were mainly from the exposure of ingestion.

  4. Health and ecological risk-based characterization of soil and sediment contamination in shipyard with long-term use of DDT-containing antifouling paint

    International Nuclear Information System (INIS)

    Guo, Guanlin; Zhang, Chao; Wu, Guanglong; Ding, Qiong; Wang, Shijie; Li, Fasheng

    2013-01-01

    Dichlorodiphenyltrichloroethane (DDT) was a frequently occurring type of persistent organic environmental pollutant in China and DDT-containing antifouling paint could be the main contributor of DDT to shipyards and fishing harbors. A field survey was conducted in a shipyard in southern China to investigate the content and distribution of DDT in soil and sediments. Human health and screening-level ecological risk assessments were conducted for DDT contamination in soil and sediments and the results indicated that total DDT in all samples tested exceeded present advisory safe limits. Analysis of the composition and distribution implicated DDT-containing antifouling paint used for ship maintenance as an important source of DDT. Individual and cumulative health risks for residents exceeded the extra lifetime cancer risks of 10 −6 and 10 −5 , mainly from exposure to soil, ingestion and dermal contact. DDT in sediments is associated with a high level of toxicity for the benthic community when > 99% of samples exceed the threshold concentration likely to be responsible for effects and severe effects. Further risk control for DDT is required to ensure safety for human health, the benthic community and the environment. - Highlights: ► DDT ranked high concentration both in sediments and soil in a shipyard. ► Composition analysis indicated DDT antifouling paint was the main source. ► High loading DDT in sediments resulted in high probability of ecological risks. ► Potential health risks for residents were mainly from the exposure of ingestion

  5. Modelling the risk of Pb and PAH intervention value exceedance in allotment soils by robust logistic regression

    International Nuclear Information System (INIS)

    Papritz, A.; Reichard, P.U.

    2009-01-01

    Soils of allotments are often contaminated by heavy metals and persistent organic pollutants. In particular, lead (Pb) and polycyclic aromatic hydrocarbons (PAHs) frequently exceed legal intervention values (IVs). Allotments are popular in European countries; cities may own and let several thousand allotment plots. Assessing soil contamination for all the plots would be very costly. Soil contamination in allotments is often linked to gardening practice and historic land use. Hence, we predict the risk of IV exceedance from attributes that characterize the history and management of allotment areas (age, nearby presence of pollutant sources, prior land use). Robust logistic regression analyses of data of Swiss allotments demonstrate that the risk of IV exceedance can be predicted quite precisely without costly soil analyses. Thus, the new method allows screening many allotments at small costs, and it helps to deploy the resources available for soil contamination surveying more efficiently. - The contamination of allotment soils, expressed as frequency of intervention value exceedance, depends on the age and further attributes of the allotments and can be predicted by logistic regression.

  6. [Self-rated health and educational level in Spain: trends by autonomous communities and gender (2001-2012)].

    Science.gov (United States)

    Aguilar-Palacio, Isabel; Carrera-Lasfuentes, Patricia; Rabanaque, M José

    2015-01-01

    To identify the trend in self-rated health in Spain by autonomous communities (AC) in the period 2001-2012, as well as differences by gender and age, and the influence of educational level. A cross sectional study was carried out using data from the National Health Surveys from 2001 to 2011-12 and the 2009 European Survey. A descriptive analysis was conducted that included gender, age, educational level, and the AC of residence. Logistic regression analyses were developed to explore the temporal trend and the association between educational level and self-rated health. The predictive capacity of the model was calculated using the C statistic. The prevalence of low self-rated health was higher in women with low educational level. Self-rated health improved in women with high educational level (2001:18.6% vs. 2012:14.6%). The highest prevalence of low self-rated health was observed in Andalusia, the Canary Islands, Galicia and Murcia, with differences by gender. Low educational level was associated with low self-rated health in most AC, with good predictive capacity. In all AC except Asturias, low self-rated health was more frequent in women than in men. In Spain, the prevalence of self-rated health showed no variations in the period analyzed and improved in the Balearic Islands, Catalonia, and Madrid. The prevalence of self-rated health in Spain differed by AC. Although health was unchanged during the period considered, inequalities were found in its temporal trend by educational level and gender, which could lead to an increase in health inequalities in women according educational level. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Prevalence of Children's Mental Health Problems and the Effectiveness of Population-Level Family Interventions.

    Science.gov (United States)

    Kato, Noriko; Yanagawa, Toshihiko; Fujiwara, Takeo; Morawska, Alina

    2015-01-01

    The prevalence of mental health problems among children and adolescents is of growing importance. Intervening in children's mental health early in life has been shown to be more effective than trying to resolve these problems when children are older. With respect to prevention activities in community settings, the prevalence of problems should be estimated, and the required level of services should be delivered. The prevalence of children's mental health disorders has been reported for many countries. Preventive intervention has emphasized optimizing the environment. Because parents are the primary influence on their children's development, considerable attention has been placed on the development of parent training to strengthen parenting skills. However, a public-health approach is necessary to confirm that the benefits of parent-training interventions lead to an impact at the societal level. This literature review clarifies that the prevalence of mental health problems is measured at the national level in many countries and that population-level parenting interventions can lower the prevalence of mental health problems among children in the community.

  8. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    Science.gov (United States)

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

  9. Efficiency of health care system at the sub-state level in Madhya Pradesh, India.

    Science.gov (United States)

    Purohit, Brijesh C

    2010-01-01

    This paper attempts a sub-state-level analysis of health system for a low-income Indian state, namely, Madhya Pradesh. The objective of our study is to establish efficiency parameters that may help health policy makers to improve district-level and thus state-level health system performance. It provides an idealized yardstick to evaluate the performance of the health sector by using stochastic frontier technique. The study was carried out in two stages of estimation, and our results suggest that life expectancy in the Indian state could be enhanced considerably by correcting the factors that are adversely influencing sub-state-level health system efficiency. Our results indicate that main factors within the health system for discrepancy in interdistrict performance are inequitable distribution of supplies, availability of skilled attention at birth, and inadequate staffing relative to patient load of rural population at primary health centers. Overcoming these factors through additional resources in the deficient districts, mobilized partly from grants in aid and partly from patient welfare societies, may help the state to improve life expectancy speedily and more equitably. Besides the direct inputs from the health sector, a more conducive environment for gender development, reducing inequality in opportunities for women in health, education and other rights may provide the necessary impetus towards reducing maternal morbidity and mortality and add to overall life expectancy in the state.

  10. Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data.

    Science.gov (United States)

    Saxena, Deepak; Vangani, Ruchi; Mavalankar, Dileep V; Thomsen, Sarah

    2013-03-06

    Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3) carried out during 2007-2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes - Institutional delivery, antenatal care (ANC), and use of modern contraception - and selected intermediary and structural determinants of health using multiple logistic regression. Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste) has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic education and infrastructural development to begin to remove the structural causes

  11. Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

    Directory of Open Access Journals (Sweden)

    Dileep V. Mavalankar

    2013-03-01

    Full Text Available Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Methods: Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3 carried out during 2007–2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes – Institutional delivery, antenatal care (ANC, and use of modern contraception – and selected intermediary and structural determinants of health using multiple logistic regression. Results: Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Discussion and conclusions: Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic

  12. Environmental levels of PCDD/Fs and metals around a cement plant in Catalonia, Spain, before and after alternative fuel implementation. Assessment of human health risks

    Energy Technology Data Exchange (ETDEWEB)

    Rovira, Joaquim [Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Environmental Engineering Laboratory, Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Nadal, Martí, E-mail: marti.nadal@urv.cat [Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Schuhmacher, Marta [Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Environmental Engineering Laboratory, Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Domingo, José L. [Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain)

    2014-07-01

    The concentrations of As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Sn, Tl, V, and Zn, and the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans were determined in samples of soil, vegetation, and air, collected in the vicinity of a cement plant (Catalonia, Spain), before (January 2011 and July 2011) and after (January 2012 and June 2013) alternative fuel partial substitution (fossil fuels by sewage sludge). Seven sampling points were selected at different directions and distances to the facility including two background sampling points. The results were used to assess the health risk assessment for the population living near the facility. Only few significant differences were found before and after alternative fuel partial substitution (Mn in soils and Cd in vegetation). Non-carcinogenic risks were below the safety threshold (HQ < 1), while carcinogenic risks were below 10{sup −5}, or exceeding slightly that value, always in the range considered as assumable (10{sup −6}–10{sup −4}). - Highlights: • The environmental impact of a cement plant using alternative fuel was monitored. • No significant differences in most pollutants were noted after the fuel change. • Traffic has a notable influence on the environmental levels of PCDD/Fs and metals. • Human health risks were below safety thresholds regardless of the used fuel.

  13. Association between school bullying levels/types and mental health problems among Taiwanese adolescents.

    Science.gov (United States)

    Yen, Cheng-Fang; Yang, Pinchen; Wang, Peng-Wei; Lin, Huang-Chi; Liu, Tai-Ling; Wu, Yu-Yu; Tang, Tze-Chun

    2014-04-01

    Few studies have compared the risks of mental health problems among the adolescents with different levels and different types of bullying involvement experiences. Bullying involvement in 6,406 adolescents was determined through use of the Chinese version of the School Bullying Experience Questionnaire. Data were collected regarding the mental health problems, including depression, suicidality, insomnia, general anxiety, social phobia, alcohol abuse, inattention, and hyperactivity/impulsivity. The association between experiences of bullying involvement and mental health problems was examined. The risk of mental health problems was compared among those with different levels/types of bullying involvement. The results found that being a victim of any type of bullying and being a perpetrator of passive bullying were significantly associated with all kinds of mental health problems, and being a perpetrator of active bullying was significantly associated with all kinds of mental health problems except for general anxiety. Victims or perpetrators of both passive and active bullying had a greater risk of some dimensions of mental health problems than those involved in only passive or active bullying. Differences in the risk of mental health problems were also found among adolescents involved in different types of bullying. This difference in comorbid mental health problems should be taken into consideration when assessing adolescents involved in different levels/types of bullying. © 2014.

  14. A critical discussion of the benefits of e-health in population-level dental research.

    Science.gov (United States)

    Lam, Raymond; Kruger, Estie; Tennant, Marc

    2013-01-01

    Population-level research is an essential area of health with the potential to affect quality of life and the broader economy. There are excellent epidemiological studies that have improved health services, but traditional research requires a considerable investment. Although electronic technology has changed the practice of many industries with improved efficiency, its application to health is relatively new. Termed 'e-health', this emerging area has been defined by the World Health Organization as the use of information technology to support many aspects of health such as in administration and scientific information. However, not all professionals are convinced of its use. This paper presents a novel application of this emerging area to describe the benefit in data collation and research to support one of the most pressing issues in public health: oral health and policy. Using the Chronic Disease Dental Scheme as an example, a critical discussion of its benefit to population-level research is presented. The Chronic Disease Dental Scheme method of electronic administration has been shown to enhance research and to complement existing progress in health data linkage. e-Health is an invaluable tool for population-level dental research.

  15. Efficiency of Health Care Sector at Sub-State Level in India: A Case of Punjab

    Directory of Open Access Journals (Sweden)

    Brijesh C. Purohit

    2009-11-01

    Full Text Available In recent years, WHO and other individual researchers have advocated estimation of health system performance through stochastic frontier models. It provides an idealized yardstick to evaluate economic performance of health system. So far attempts in India have remained focused at state level analysis. This paper attempts a sub-state level analysis for an affluent Indian state, namely Punjab, by using stochastic frontier technique. Our results provide pertinent insight into state health system and facilitate health facility planning at the sub-state level. Carried out in two stages of estimation, our results suggest that life expectancy in the Indian state could be enhanced considerably by correcting the factors that are adversely influencing the sub-state level health system efficiency. A higher budgetary allocation for health manpower is recommended by us to improve efficiency in poorly performing districts. This may be supported by policy initiatives outside the health system by empowering women through better education and work participation.

  16. Noise levels of a track-laying tractor during field operations in the vineyard

    Directory of Open Access Journals (Sweden)

    Pietro Catania

    2013-09-01

    Full Text Available Noise in agriculture is one of the risk factors to be taken into account in the assessment of the health and safety of workers; in particular, it is known that the tractor is a source of high noise. The Italian Low Decree 81/2008 defined the requirements for assessing and managing noise risk identifying a number of procedures to be adopted at different noise levels to limit workers exposure. This paper concerns the analysis of the noise risk arising from the use of a tracklaying tractor during field operations carried out in the vineyard. The objective of this study was to evaluate the noise level that comes close to the ear of the operator driving the tractor measuring the values of equivalent sound level (Leq(A and peak sound pressure (LCpk. We considered four options related to the same tractor coupled with the following tools to perform some farming operations: rototilling, chisel plough, flail mowers and vibro farmer. We considered three test conditions: T1 in flat (slope 0%, T2 uphill and T3 downhill (both 30% slope. The instrument used for the measurements is a precision integrating portable sound level meter, class 1, model HD2110L by Delta OHM, Italy. Each survey lasted 2 minutes, with an interval of measurement equal to 0.5 s. The tests were performed in compliance with the standards ISO 9612 and ISO 9432. The results show that the measured sound levels exceed the limits allowed by the regulations in almost all the test conditions; values exceeding the threshold limit of 80 dB(A were recorded coming up to a maximum value of 92.8 dB(A for flail mowers in test T1. When limits imposed by the regulations are exceeded, the operator is obliged to wear the appropriate Personal Protective Equipment.

  17. Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia.

    Science.gov (United States)

    Swarna Nantha, Yogarabindranath

    2014-10-01

    The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research. "Food addiction" could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory-based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete. Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country. Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities. © The Author(s) 2014.

  18. Optimal maintenance policy incorporating system level and unit level for mechanical systems

    Science.gov (United States)

    Duan, Chaoqun; Deng, Chao; Wang, Bingran

    2018-04-01

    The study works on a multi-level maintenance policy combining system level and unit level under soft and hard failure modes. The system experiences system-level preventive maintenance (SLPM) when the conditional reliability of entire system exceeds SLPM threshold, and also undergoes a two-level maintenance for each single unit, which is initiated when a single unit exceeds its preventive maintenance (PM) threshold, and the other is performed simultaneously the moment when any unit is going for maintenance. The units experience both periodic inspections and aperiodic inspections provided by failures of hard-type units. To model the practical situations, two types of economic dependence have been taken into account, which are set-up cost dependence and maintenance expertise dependence due to the same technology and tool/equipment can be utilised. The optimisation problem is formulated and solved in a semi-Markov decision process framework. The objective is to find the optimal system-level threshold and unit-level thresholds by minimising the long-run expected average cost per unit time. A formula for the mean residual life is derived for the proposed multi-level maintenance policy. The method is illustrated by a real case study of feed subsystem from a boring machine, and a comparison with other policies demonstrates the effectiveness of our approach.

  19. [Employees health education--challenges according to the educational level].

    Science.gov (United States)

    Korzeniowska, Elzbieta; Puchalski, Krzysztof

    2012-01-01

    Article addresses the problem of increasing Polish employees health education effectiveness according to the differences in educational level. Research model assume that effective method of developing recommendations improving the health education will synthesise scientific findings regarding methodology of conducting such education and knowledge about needs of two target groups: low and high educated employees. Educational solutions were searched in publications related to: health education, andragogy, propaganda and direct marketing. The empirical material used to characterize two target groups came from four research (qualitative and quantitative) conducted by the National Centre for Workplace Health Promotion (Nofer Institute of Occupational Medicine) in 2007-2010. Low educated employees' health education should be focused on increasing responsibility for health and strengthening their self-confidence according to the introduction of healthy lifestyle changes. To achieve these goals, important issue is to build their motivation to develop knowledge about taking care of health. In providing such information we should avoid the methods associated with school. Another important issue is creating an appropriate infrastructure and conditions facilitating the change of harmful behaviors undertaken at home and in the workplace. According to high-educated employees a challenge is to support taking health behaviors--although they are convinced it is important for their health, such behaviors are perceived as a difficult and freedom restriction. Promoting behavior change techniques, avoiding prohibitions in the educational messages and creating favorable climate for taking care of health in groups they participate are needed.

  20. Multi-Target Risk Assessment of Potentially Toxic Elements in Farmland Soil Based on the Environment-Ecological-Health Effect.

    Science.gov (United States)

    Wang, Zhongyang; Meng, Bo; Zhang, Wei; Bai, Jinheng; Ma, Yingxin; Liu, Mingda

    2018-05-28

    There are potential impacts of Potentially Toxic Elements (PTEs) (e.g., Cd, Cr, Ni, Cu, As, Zn, Hg, and Pb) in soil from the perspective of the ecological environment and human health, and assessing the pollution and risk level of soil will play an important role in formulating policies for soil pollution control. Lingyuan, in the west of Liaoning Province, China, is a typical low-relief terrain of a hilly area. The object of study in this research is the topsoil of farmland in this area, of which 71 soil samples are collected. In this study, research methods, such as the Nemerow Index, Potential Ecological Hazard Index, Ecological Risk Quotient, Environmental Exposure Hazard Analysis, Positive Matrix Factorization Model, and Land Statistical Analysis, are used for systematical assessment of the pollution scale, pollution level, and source of PTEs, as well as the ecological environmental risks and health risks in the study area. The main conclusions are: The average contents of As, Cd, Cr, Cu, Hg, Zn, Ni, and Pb of the soil are 5.32 mg/kg, 0.31 mg/kg, 50.44 mg/kg, 47.05 mg/kg, 0.03 mg/kg, 79.36 mg/kg, 26.01 mg/kg, and 35.65 mg/kg, respectively. The contents of Cd, Cu, Zn, and Pb exceed the background value of local soil; Cd content of some study plots exceeds the National Soil Environmental Quality Standard Value (0.6 mg/kg), and the exceeding standard rate of study plots is 5.63%; the comprehensive potential ecological hazard assessment in the study area indicates that the PTEs are at a slight ecological risk; probabilistic hazard quotient assessment indicates that the influence of PTEs on species caused by Cu is at a slight level ( p = 10.93%), and Zn, Pb, and Cd are at an acceptable level. For the ecological process, Zn is at a medium level ( p = 25.78%), Cu is at a slight level (19.77%), and the influence of Cd and Pb are acceptable; human health hazard assessment states that the Non-carcinogenic comprehensive health hazard index HI = 0.16 natural source are 13

  1. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  2. Pregnant women in Timis County, Romania are exposed primarily to low-level (<10 μg/L) arsenic through residential drinking water consumption

    OpenAIRE

    Neamtiu, Iulia; Bloom, Michael S.; Gati, Gabriel; Goessler, Walter; Surdu, Simona; Pop, Cristian; Braeuer, Simone; Fitzgerald, Edward F.; Baciu, Calin; Lupsa, Ioana Rodica; Anastasiu, Doru; Gurzau, Eugen

    2015-01-01

    Excessive arsenic content in drinking water poses health risks to millions of people worldwide. Inorganic arsenic (iAs) in groundwater exceeding the 10 μg/l maximum contaminant level (MCL) set by the World Health Organization (WHO) is characteristic for intermediate-depth aquifers over large areas of the Pannonian Basin in Central Europe. In western Romania, near the border with Hungary, Arad, Bihor, and Timis counties use drinking water coming partially or entirely from iAs contaminated aqui...

  3. Universal health coverage at the macro level: Synthetic control evidence from Thailand.

    Science.gov (United States)

    Rieger, Matthias; Wagner, Natascha; Bedi, Arjun S

    2017-01-01

    As more and more countries are moving towards Universal Health Coverage (UHC), it is important to understand the macro level or aggregate impacts of such a policy. We use synthetic control methods to study the impact of UHC, introduced in Thailand in 2001, on various macroeconomic and health outcomes. Thailand is compared to a weighted average of control countries in terms of aggregate health financing indicators, aggregate health outcomes and economic performance, over the period 1995 to 2012. Our results suggest that UHC helps alleviate the financial consequences of illnesses. The estimated treatment effect of UHC on out-of-pocket payments as a percentage of overall health expenditures is negative 13 percentage points and its effect on annual government per capita health spending is US$ 79. We detect a smaller effect of US$ 60.8 on total health spending per capita which appears with a lag. We document positive health effects as captured by reductions in infant and child mortality. We do not find any effect on GDP and the share of the government budget devoted to health. Overall, our results complement micro evidence based on within country variation. The counterfactual design implemented here may be used to inform other countries on the macro level repercussions of UHC. Copyright © 2016. Published by Elsevier Ltd.

  4. A critical review of recent US market level health care strategy literature.

    Science.gov (United States)

    Wells, R; Banaszak-Holl, J

    2000-09-01

    In this review, we argue that it would be profitable if the neoclassical economic theories that have dominated recent US market level health care strategy research could be complemented by greater use of sociological frameworks. Sociological theory can address three central questions that neoclassical economic theories have tended to slight: (1) how decision-makers' preferences are determined; (2) who the decision-makers are; and (3) how decision-makers' plans are translated into organizational action. We suggest five sociological frameworks that would enable researchers to address these issues better relative to market level strategy in health care. The frameworks are (1) institutional theory, (2) organizational ecology, (3) social movements, (4) social networks, and (5) internal organizational change. A recent global trend toward privatization of health care provision makes US market level strategy research increasingly applicable to non-US readers.

  5. Ballistic Transport Exceeding 28 μm in CVD Grown Graphene.

    Science.gov (United States)

    Banszerus, Luca; Schmitz, Michael; Engels, Stephan; Goldsche, Matthias; Watanabe, Kenji; Taniguchi, Takashi; Beschoten, Bernd; Stampfer, Christoph

    2016-02-10

    We report on ballistic transport over more than 28 μm in graphene grown by chemical vapor deposition (CVD) that is fully encapsulated in hexagonal boron nitride. The structures are fabricated by an advanced dry van-der-Waals transfer method and exhibit carrier mobilities of up to three million cm(2)/(Vs). The ballistic nature of charge transport is probed by measuring the bend resistance in cross- and square-shaped devices. Temperature-dependent measurements furthermore prove that ballistic transport is maintained exceeding 1 μm up to 200 K.

  6. Province-level income inequality and health outcomes in Canadian adolescents.

    Science.gov (United States)

    Quon, Elizabeth C; McGrath, Jennifer J

    2015-03-01

    To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Participants (aged 12-17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Evaluation of health and safety impacts of defense high-level waste in geologic repositories

    International Nuclear Information System (INIS)

    Smith, E.D.; Kocher, D.C.; Witherspoon, J.P.

    1985-02-01

    Pursuant to the requirement of the Nuclear Waste Policy Act of 1982 that the President evaluate the use of commercial high-level waste repositories for the disposal of defense high-level wastes, a comparative assessment has been performed of the potential health and safety impacts of disposal of defense wastes in commercial or defense-only repositories. Simplified models were used to make quantitative estimates of both long- and short-term health and safety impacts of several options for defense high-level waste disposal. The results indicate that potential health and safety impacts are not likely to vary significantly among the different disposal options for defense wastes. Estimated long-term health and safety impacts from all defense-waste disposal options are somewhat less than those from commercial waste disposal, while short-term health and safety impacts appear to be insensitive to the differences between defense and commercial wastes. In all cases, potential health and safety impacts are small because of the need to meet stringent standards promulgated by the US Environmental Protection Agency and the US Nuclear Regulatory Commission. We conclude that health and safety impacts should not be a significant factor in the choice of a disposal option for defense high-level wastes. 20 references, 14 tables

  8. Sodium levels in Canadian fast-food and sit-down restaurants.

    Science.gov (United States)

    Scourboutakos, Mary J; L'Abbé, Mary R

    2013-01-31

    To evaluate the sodium levels in Canadian restaurant and fast-food chain menu items. Nutrition information was collected from the websites of major sit-down (n=20) and fast-food (n=65) restaurants across Canada in 2010 and a database was constructed. Four thousand and forty-four meal items, baked goods, side dishes and children's items were analyzed. Sodium levels were compared to the recommended adequate intake level (AI), tolerable upper intake level (UL) and the US National Sodium Reduction Initiative (NSRI) targets. On average, individual sit-down restaurant menu items contained 1455 mg sodium/serving (or 97% of the AI level of 1500 mg/day). Forty percent of all sit-down restaurant items exceeded the AI for sodium and more than 22% of sit-down restaurant stir fry entrées, sandwiches/wraps, ribs, and pasta entrées with meat/seafood exceeded the daily UL for sodium (2300 mg). Fast-food restaurant meal items contained, on average, 1011 mg sodium (68% of the daily AI), while side dishes (from sit-down and fast-food restaurants) contained 736 mg (49%). Children's meal items contained, on average, 790 mg/serving (66% of the sodium AI for children of 1200 mg/day); a small number of children's items exceeded the children's daily UL. On average, 52% of establishments exceeded the 2012 NSRI density targets and 69% exceeded the 2014 targets. The sodium content in Canadian restaurant foods is alarmingly high. A population-wide sodium reduction strategy needs to address the high levels of sodium in restaurant foods.

  9. Impact of chirano gold mines operations on levels of As, Pb, Hg and Cd in the suraw river and the possible health implications on downstream communities

    International Nuclear Information System (INIS)

    Oppong, Kyekyeku

    2011-07-01

    Suraw River water quality awareness and preference survey conducted in five immediate downstream communities indicated that the residents were very much aware of the changes that have occurred since the commencement of active mining by CGML last quarter in 2004. Notwithstanding the residents overwhelming preference for the borehole water for their basic water needs including drinking, some people still rely on the River water when they go to their farms. Suraw River which principally drains the surface waters of Chirano Gold Mines operational area was investigated to assess the levels of As, Cd, Pb and Hg in the River water, bottom sediments and community borehole water using Atomic Absorption Spectrophotometer and Inductively Coupled Plasma - Optical Emission Spectroscopy (ICP – OES) for the water and sediments respectively. The results of the study generally showed low to below laboratory detection levels for the four heavy metals under investigation. The occurrence of Arsenic in more than half of the sampling sites in both the Suraw River and the community boreholes and particularly its detection at S1 in the surface water samples are most probably as a result of natural background levels. Except Cadmium which exceeded the Lowest Effect Level (LEL) in the sediment samples, the concentration of As, Pb and Hg were below the LEL of toxicity. The concentration of Cd also exceeded the Threshold Effect and the Probable Effect Levels but lower than the Severe Effect Level of sediment toxicity at five of the six sampling sites. The study has shown that the concentration of the four heavy metals investigated in both the Suraw River and the community borehole water were lower than expected compared with WHO/GWCL Drinking Water Standards and were within acceptable limits for potable water and therefore do not pose any immediate health risk to residents and settler farmers who still depend on the River water for their basic water needs. Apart from the concentration of Cd

  10. Adverse Health Effects Associated with Increased Activity at Kīlauea Volcano: A Repeated Population-Based Survey

    OpenAIRE

    Longo, Bernadette M.

    2013-01-01

    Eruptive activity at the Kīlauea volcano (Hawai`i, USA) has increased since 2008 resulting in volcanic air pollution (vog) at levels exceeding the national air quality standard for sulfur dioxide. Previous investigations during lower vog levels found adverse cardiorespiratory effects in the residents. The purpose of this 2012 survey was to reassess and compare the impact of the increased volcanic activity on population health. Prevalence of cardiorespiratory signs, symptoms, and diseases was ...

  11. The correlation between physical activity and grade point average for health science graduate students.

    Science.gov (United States)

    Gonzalez, Eugenia C; Hernandez, Erika C; Coltrane, Ambrosia K; Mancera, Jayme M

    2014-01-01

    Researchers have reported positive associations between physical activity and academic achievement. However, a common belief is that improving academic performance comes at the cost of reducing time for and resources spent on extracurricular activities that encourage physical activity. The purpose of this study was to examine the relationship between self-reported physical activity and grade point average (GPA) for health science graduate students. Graduate students in health science programs completed the International Physical Activity Questionnaire and reported their academic progress. Most participants (76%) reported moderate to vigorous physical activity levels that met or exceeded the recommended levels for adults. However, there was no significant correlation between GPA and level of physical activity. Negative findings for this study may be associated with the limited range of GPA scores for graduate students. Future studies need to consider more sensitive measures of cognitive function, as well as the impact of physical activity on occupational balance and health for graduate students in the health fields. Copyright 2014, SLACK Incorporated.

  12. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes.

    Science.gov (United States)

    Butte, Nancy F; Fox, Mary Kay; Briefel, Ronette R; Siega-Riz, Anna Maria; Dwyer, Johanna T; Deming, Denise M; Reidy, Kathleen C

    2010-12-01

    To assess the usual nutrient intakes of 3,273 US infants, toddlers, and preschoolers, aged 0 to 47 months, surveyed in the Feeding Infants and Toddlers Study (FITS) 2008; and to compare data on the usual nutrient intakes for the two waves of FITS conducted in 2002 and 2008. The FITS 2008 is a cross-sectional survey of a national random sample of US children from birth through age 47 months. Usual nutrient intakes derived from foods, beverages, and supplements were ascertained using a telephone-administered, multiple-pass 24-hour dietary recall. Infants aged birth to 5 months (n=382) and 6 to 11 months (n=505), toddlers aged 12 to 23 months (n=925), and preschoolers aged 24 to 47 months (n=1,461) were surveyed. All primary caregivers completed one 24-hour dietary recall and a random subsample (n=701) completed a second 24-hour dietary recall. The personal computer version of the Software for Intake Distribution Estimation was used to estimate the 10th, 25th, 50th, 75th, and 90th percentiles, as well as the proportions below and above cutoff values defined by the Dietary Reference Intakes or the 2005 Dietary Guidelines for Americans. Usual nutrient intakes met or exceeded energy and protein requirements with minimal risk of vitamin and mineral deficiencies. The usual intakes of antioxidants, B vitamins, bone-related nutrients, and other micronutrients were adequate relative to the Adequate Intakes or Estimated Average Requirements, except for iron and zinc in a small subset of older infants, and vitamin E and potassium in toddlers and preschoolers. Intakes of synthetic folate, preformed vitamin A, zinc, and sodium exceeded Tolerable Upper Intake Level in a significant proportion of toddlers and preschoolers. Macronutrient distributions were within acceptable macronutrient distribution ranges, except for dietary fat, in some toddlers and preschoolers. Dietary fiber was low in the vast majority of toddlers and preschoolers, and saturated fat intakes exceeded

  13. Greater-than-Class C low-level radioactive waste characterization. Appendix A-3: Basis for greater-than-Class C low-level radioactive waste light water reactor projections

    International Nuclear Information System (INIS)

    Mancini, A.; Tuite, P.; Tuite, K.; Woodberry, S.

    1994-09-01

    This study characterizes low-level radioactive waste types that may exceed Class C limits at light water reactors, estimates the amounts of waste generated, and estimates radionuclide content and distribution within the waste. Waste types that may exceed Class C limits include metal components that become activated during operations, process wastes such as cartridge filters and decontamination resins, and activated metals from decommissioning activities. Operating parameters and current management practices at operating plants are reviewed and used to estimate the amounts of low-level waste exceeding Class C limits that is generated per fuel cycle, including amounts of routinely generated activated metal components and process waste. Radionuclide content is calculated for specific activated metals components. Empirical data from actual low-level radioactive waste are used to estimate radionuclide content for process wastes. Volumes and activities are also estimated for decommissioning activated metals that exceed Class C limits. To estimate activation levels of decommissioning waste, six typical light water reactors are modeled and analyzed. This study does not consider concentration averaging

  14. Health status of elderly based on daily activities living, cholesterol and uric acid profile in Medan city

    Science.gov (United States)

    Amelia, R.; Harahap, J.; Wahyuni, A. S.; Pratama, A.

    2018-03-01

    Health problems in the elderly come from declining body cells, so the function and body endurance decreased along with increased risk factors for diseases. This study aimed to determine the elderly health status in Public Health Center of Tuntungan Medan. Health status includes measurement of daily activities living (DAL),and health parameter include blood pressure, blood sugar level (BSL), cholesterol level and uric acid level. The study design was descriptive with cross-sectional approach. The study population was the entire elderly population residing in the service area of public health center of Tuntungan Medan (55 subjects). The elderly who had a reasonable level of independence were 47 subjects (85.5%), the majority of elderly were in the category of hypertension stage I (20 subjects; 36.4%) with a mean systolic blood pressure level was 143mmHg. Most of them have BSL that exceeded the standard limit (42 subjects; 76.4%) with BSL mean value was 177mg/dL.Uric acid levels were in the high category (34 subjects; 61.98%) with a mean value of 7.0mm/dL, and most of them have normal cholesterol (43 subjects; 78.2%).

  15. 40 CFR 141.209 - Special notice for nitrate exceedances above MCL by non-community water systems (NCWS), where...

    Science.gov (United States)

    2010-07-01

    ... Water Violations § 141.209 Special notice for nitrate exceedances above MCL by non-community water... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Special notice for nitrate exceedances above MCL by non-community water systems (NCWS), where granted permission by the primacy agency under Â...

  16. [Urban air pollution with heavy metals and evaluating risk for public health].

    Science.gov (United States)

    Kazimov, M A; Alieva, R Kh; Alieva, N V

    2014-01-01

    The authors presented hygienic evaluation of ambient air in various districts of Baku city with heavy metals--lead, cadmium, chromium, nickel, copper and zinc. The metals contents of the air were assessed indirectly by their levels in soils of the areas under study. Findings are that soil levels of zinc, chromium and nickel exceeded those of the other metals by a degree. The highest levels were seen in the industrial area that can be assigned to a territory with highest risk for public health. The calculated daily doses of heavy metals inhaled by humans and levels of total daily doses inhaled by adult inhabitants could be risk factors in chronic exposure.

  17. Canada’s response to refugees at the primary health care level

    Directory of Open Access Journals (Sweden)

    Kevin Pottie

    2018-03-01

    Full Text Available Responsive primary health care systems and services must be at once complex and nimble. Policy makers may wish to believe that existing health systems effectively care for all populations equally, including refugees. However, we know that refugees may require a health equity approach: an approach where all levels of government, all types of health practitioners, and even the public sector, participate to ensure access to effective primary health care. This article outlines some of Canada’s healthcare responses for refugee populations. We provide field examples and guidelines that demonstrate responses, as well as ongoing inconsistencies and limitations. Refugee-receiving countries such as Australia, the US and Canada all have stories of success in resettlement and health systems. This article will focus on Canada.

  18. STUDY ON NOISE LEVEL GENERATED BY HUMAN ACTIVITIES IN SIBIU CITY, ROMANIA

    Directory of Open Access Journals (Sweden)

    Cristina STANCA-MOISE

    2014-10-01

    Full Text Available In this paper I have proposed an analysis and monitoring of the noise sources in the open spaces of air traffic, rail and car in Sibiu. From centralizing data obtained from the analysis of the measurements performed with equipment noise levels, we concluded that the noise and vibration produced by means of Transportation (air, road, rail can affect human health if they exceed limits. Noise is present and part of our lives and always a source of pollution as any of modern man is not conscious.

  19. Physical health condition and physical organism readiness levels of sports veteran wrestlers

    Directory of Open Access Journals (Sweden)

    Oleksiy Goncharov

    2017-10-01

    Full Text Available Purpose: study and an assessment of the physical state of health and the degree of physical fitness of the organism among active veteran wrestlers. Material & Methods: participants: 16 active veteran athletes, 7 of them judoka and 9 sambo wrestlers aged 36–45. Sports qualification of athletes: MS – 10 people, MSIC – 6 people. The stability of the organism to the conditions of hypoxia and hypercapnia was assessed by the results of the Stange and Genci tests. To determine the statistical balancing, the Bondarevsky trial was used. The degree of physical readiness was evaluated by the results of the distance traveled on the treadmill of Kettler, comparing it with the Cooper table. To assess the level of physical state, the formula was used by E. A. Pirogova. Results: investigation determined that the actions of the wrestlers – sports veterans of the body's resistance to the conditions of hypoxia and hypercapnia, as well as the indicator VC indices correspond young people. Indicators of statistical balancing among the acting veterans of judoists and sambo wrestlers corresponded to those of 20–30-year-old people. Level of physical condition (LPC of health in 71,4% of veteran-judoists at the average level and only 28,6% is of a high level. Sambo veterans observed the following: 44,4% of sportsmen of the LPC are above the average; 33,3% have an average level of physical health; in 11,1% of athletes the average LPC and 11,1% of the judo veterans have indicators corresponding to the level below the average. Conclusion: conducted step-by-step medical and pedagogical control allowed to reveal some violations of the adaptive mechanisms of the cardiovascular system, which once again confirms the possibility of using the data of heart rate, blood pressure, Cooper's test for studying and analyzing the physical state of health and the degree of physical preparedness, as well as forecasting the health status of veterans sports.

  20. Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees.

    Science.gov (United States)

    Krauss, Margot R; Garvin, Nadia U; Boivin, Michael R; Cowan, David N

    2017-02-01

    Musculoskeletal injuries are prevalent among military trainees and certain occupations. Fitness and body mass index (BMI) have been associated with musculoskeletal conditions, including stress fractures. The incidence of, and excess health care utilization for, stress fracture and non-stress fracture overuse musculoskeletal injuries during the first 6 months of service is higher among unfit female recruits. Those who exceeded body fat limits are at a greater risk of incident stress fractures, injuries, or health care utilization compared with weight-qualified recruits. Cohort study; Level of evidence, 3. All applicants to the United States Army were required to take a preaccession fitness test during the study period (February 2005-September 2006). The test included a 5-minute step test scored as pass or fail. BMI was recorded at application. There were 2 distinct comparisons made in this study: (1) between weight-qualified physically fit and unfit women and (2) between weight-qualified physically fit women and those who exceeded body fat limits. We compared the incidence of, and excess health care utilization for, musculoskeletal injuries, including stress fractures and physical therapy visits, during the first 183 days of military service. Among the weight-qualified women, unfit participants had a higher non-stress fracture injury incidence and related excess health care utilization rate compared with fit women, with rate ratios of 1.32 (95% CI, 1.14-1.53) and 1.18 (95% CI, 1.10-1.27), respectively. Among fit women, compared with the weight-qualified participants, those exceeding body fat limits had higher rate ratios for non-stress fracture injury incidence and related excess health care utilization of 1.27 (95% CI, 1.07-1.50) and 1.20 (95% CI, 1.11-1.31), respectively. Weight-qualified women who were unfit had a higher incidence of stress fractures and related excess health care utilization compared with fit women, with rate ratios of 1.62 (95% CI, 1

  1. Levels, sources and probabilistic health risks of polycyclic aromatic hydrocarbons in the agricultural soils from sites neighboring suburban industries in Shanghai.

    Science.gov (United States)

    Tong, Ruipeng; Yang, Xiaoyi; Su, Hanrui; Pan, Yue; Zhang, Qiuzhuo; Wang, Juan; Long, Mingce

    2018-03-01

    The levels, sources and quantitative probabilistic health risks for polycyclic aromatic hydrocarbons (PAHs) in agricultural soils in the vicinity of power, steel and petrochemical plants in the suburbs of Shanghai are discussed. The total concentration of 16 PAHs in the soils ranges from 223 to 8214ng g -1 . The sources of PAHs were analyzed by both isomeric ratios and a principal component analysis-multiple linear regression method. The results indicate that PAHs mainly originated from the incomplete combustion of coal and oil. The probabilistic risk assessments for both carcinogenic and non-carcinogenic risks posed by PAHs in soils with adult farmers as concerned receptors were quantitatively calculated by Monte Carlo simulation. The estimated total carcinogenic risks (TCR) for the agricultural soils has a 45% possibility of exceeding the acceptable threshold value (10 -6 ), indicating potential adverse health effects. However, all non-carcinogenic risks are below the threshold value. Oral intake is the dominant exposure pathway, accounting for 77.7% of TCR, while inhalation intake is negligible. The three PAHs with the highest contribution for TCR are BaP (64.35%), DBA (17.56%) and InP (9.06%). Sensitivity analyses indicate that exposure frequency has the greatest impact on the total risk uncertainty, followed by the exposure dose through oral intake and exposure duration. These results indicate that it is essential to manage the health risks of PAH-contaminated agricultural soils in the vicinity of typical industries in megacities. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Perception of leadership among health managers working in tertiary level hospitals.

    Science.gov (United States)

    Shahzad, Saadia; Zareen, Humaira

    2012-01-01

    Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.

  3. MAXIMIZING PROFIT - OPTICAL TRADITIONAL TRAVEL AGENCIES EXCEEDED

    Directory of Open Access Journals (Sweden)

    ENEA CONSTANŢA

    2013-12-01

    Full Text Available Recently concepts of globalized the services the advertising only that and substantial modifications, but that just radicals, in the structure net of touristic states. Is directed to of a new conceive the organic fashions of structures ale net of realized and of casting of guy colaborative, baze on interconexion, the interface and flexible interactions, from which his. I result the competitive advantages popularly the partners of business. The optics traditional agencies of tourings considered the production and the delivery touristic services except through the of a alone objective major prism scilicet maximizarea of the profits, falls to is exceeded. For the past decades ale the century XX, the impact technological changes in the industry services becomes all determine maul influenced the „traditional sectors” in charge, as for example the education, the trade, the touring, the informatics. Certainly, globalized can be interpretation in different senses. Referenced to the touristic services, the globalized is define as be a form an advanced still more complex maul of which nationalization involves a degrees of functional integration between the touristic activities disperse on plans transfrontalier.

  4. An Innovative Program in the Science of Health Care Delivery: Workforce Diversity in the Business of Health.

    Science.gov (United States)

    Essary, Alison C; Wade, Nathaniel L

    2016-01-01

    According to the most recent statistics from the National Center for Education Statistics, disparities in enrollment in undergraduate and graduate education are significant and not improving commensurate with the national population. Similarly, only 12% of graduating medical students and 13% of graduating physician assistant students are from underrepresented racial and ethnic groups. Established in 2012 to promote health care transformation at the organization and system levels, the School for the Science of Health Care Delivery is aligned with the university and college missions to create innovative, interdisciplinary curricula that meet the needs of our diverse patient and community populations. Three-year enrollment trends in the program exceed most national benchmarks, particularly among students who identify as Hispanic and American Indian/Alaska Native. The Science of Health Care Delivery program provides students a seamless learning experience that prepares them to be solutions-oriented leaders proficient in the business of health care, change management, innovation, and data-driven decision making. Defined as the study and design of systems, processes, leadership and management used to optimize health care delivery and health for all, the Science of Health Care Delivery will prepare the next generation of creative, diverse, pioneering leaders in health care.

  5. [Pollution characteristics and health risk assessment of atmospheric volatile organic compounds (VOCs) in pesticide factory].

    Science.gov (United States)

    Tan, Bing; Wang, Tie-Yu; Pang, Bo; Zhu, Zhao-Yun; Wang, Dao-Han; Lü, Yong-Long

    2013-12-01

    A method for determining volatile organic compounds (VOCs) in air by summa canister collecting and gas chromatography/ mass spectroscopy detecting was adopted. Pollution condition and characteristics of VOCs were discussed in three representative pesticide factories in Zhangjiakou City, Hebei Province. Meanwhile, an internationally recognized four-step evaluation model of health risk assessment was applied to preliminarily assess the health risk caused by atmospheric VOCs in different exposure ways, inhalation and dermal exposure. Results showed that serious total VOCs pollution existed in all factories. Concentrations of n-hexane (6161.90-6910.00 microg x m(-3)), benzene (126.00-179.30 microg x m(-3)) and 1,3-butadiene (115.00-177.30 microg x m(-3)) exceeded the Chronic Inhalation Reference Concentrations recommended by USEPA, corresponding to 700, 30 and 2 microg x m(-3), respectively. Concentration of dichloromethane (724.00 microg x m(-3)) in factory B was also higher than the reference concentration (600 microg x m(-3)). Results of health risk assessment indicated that non-carcinogenic risk indexes of VOCs ranged from 1.00E-04 to 1.00E + 00 by inhalation exposure, and 1.00E-09 to 1.00E-05 by dermal exposure. Risk indexes of n-hexane and dichloromethane by inhalation exposure in all factories exceeded 1, and risk index of benzene by inhalation in factory B was also higher than 1. Carcinogenic risk indexes exposed to VOCs ranged from 1.00E-08 to 1.00E-03 by inhalation exposure and 1. oo00E -13 to 1.00E-08 by dermal exposure. Cancer risk of 1,3-butadiene by inhalation exceeded 1.0E-04, which lead to definite risk, and those of benzene by inhalation also exceeded the maximum allowable level recommended by International Commission on Radiological Protection (5.0E-05). The risks of dermal exposure presented the same trend as inhalation exposure, but the level was much lower than that of inhalation exposure. Thus, inhalation exposure of atmospheric VOCs was the

  6. A framework for outcome-level evaluation of in-service training of health care workers.

    Science.gov (United States)

    O'Malley, Gabrielle; Perdue, Thomas; Petracca, Frances

    2013-10-01

    In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President's Emergency Plan for AIDS Relief's Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the ability of evaluators to

  7. Programme level implementation of malaria rapid diagnostic tests (RDTs) use: outcomes and cost of training health workers at lower level health care facilities in Uganda.

    Science.gov (United States)

    Kyabayinze, Daniel J; Asiimwe, Caroline; Nakanjako, Damalie; Nabakooza, Jane; Bajabaite, Moses; Strachan, Clare; Tibenderana, James K; Van Geetruyden, Jean Pierre

    2012-04-20

    The training of health workers in the use of malaria rapid diagnostic tests (RDTs) is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs) where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model). A cross-sectional evaluation of the health workers' competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD) prescriptions pre and post training. The direct costs relating to the training processes were also documented. Overall, 135 health workers were trained including 63 (47%) nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80%) of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16%) participants who were peer-trained by their trained colleagues. Only 9 (14%) did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112), with the main cost drivers being trainee travel and per

  8. Programme level implementation of malaria rapid diagnostic tests (RDTs use: outcomes and cost of training health workers at lower level health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Kyabayinze Daniel J

    2012-04-01

    Full Text Available Abstract Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model. A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47% nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80% of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16% participants who were peer-trained by their trained colleagues. Only 9 (14% did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112, with the

  9. Targeted health department expenditures benefit birth outcomes at the county level.

    Science.gov (United States)

    Bekemeier, Betty; Yang, Youngran; Dunbar, Matthew D; Pantazis, Athena; Grembowski, David E

    2014-06-01

    Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000-2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects. Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. What could have caused pre-industrial biomass burning emissions to exceed current rates?

    NARCIS (Netherlands)

    Werf, van der G.R.; Peters, W.; Leeuwen, van T.T.; Giglio, L.

    2013-01-01

    Recent studies based on trace gas mixing ratios in ice cores and charcoal data indicate that biomass burning emissions over the past millennium exceeded contemporary emissions by up to a factor of 4 for certain time periods. This is surprising because various sources of biomass burning are linked

  11. What could have caused pre-industrial biomass burning emissions to exceed current rates?

    NARCIS (Netherlands)

    van der Werf, G. R.; Peters, W.; van Leeuwen, T. T.; Giglio, L.

    2012-01-01

    Recent studies based on trace gas mixing ratios in ice cores and charcoal data indicate that biomass burning emissions over the past millennium exceeded contemporary emissions by up to a factor of 4 for certain time periods. This is surprising because various sources of biomass burning are linked

  12. Risk assessment of coumarin using the bench mark dose (BMD) approach: children in Norway which regularly eat oatmeal porridge with cinnamon may exceed the TDI for coumarin with several folds.

    Science.gov (United States)

    Fotland, T Ø; Paulsen, J E; Sanner, T; Alexander, J; Husøy, T

    2012-03-01

    Coumarin is a naturally occurring flavouring substance in cinnamon and many other plants. It is known that coumarin can cause liver toxicity in several species, and it is considered a non-genotoxic carcinogen in rodents. By using the bench mark dose approach we re-assessed coumarin toxicity and established a new TDI for coumarin of 0.07 mg/kg bw/day. Oral intake of coumarin is related to consumption of cinnamon-containing foods and food supplements. Cinnamon is a widely used spice in Norway, and can be used as topping on oatmeal porridge. Based on analyses of coumarin in Norwegian foods, intake calculations for children and adults were conducted, and a risk assessment of coumarin in the Norwegian population was performed. Intake estimates of coumarin show that small children eating oatmeal porridge several times a week sprinkled with cinnamon could have a coumarin intake of 1.63 mg/kg bw/day and may exceeding the TDI with several folds. Adults drinking cinnamon-based tea and consuming cinnamon supplements also can exceed TDI. The coumarin intake could exceed the TDI by 7- to 20-fold in some intake scenarios. Such large daily exceedances of TDI, even for a limited time period of 1-2 weeks, cause concern of adverse health effects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado

    2018-01-01

    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  14. Effects of level of social contact on dairy calf behavior and health

    DEFF Research Database (Denmark)

    Jensen, Margit Bak; Larsen, Lars Erik

    2014-01-01

    Housing preweaned dairy calves in pairs rather than individually has been found to positively affect behavioral responses in novel social and environmental situations, but concerns have been raised that close contact among very young animals may impair their health. In previous studies, the level...... of social contact permitted in individual housing has been auditory, visual, or physical contact. It is unclear how these various levels of social contact compare with each other and to pair housing, when their effects on behavior and health are considered, and whether the timing of pair housing has...

  15. 40 CFR 141.208 - Special notice for exceedance of the SMCL for fluoride.

    Science.gov (United States)

    2010-07-01

    ... exceed 2 mg/l because of this cosmetic dental problem. For more information, please call [name of water system contact] of [name of community water system] at [phone number]. Some home water treatment units... drinking water provided by your community water system [name] has a fluoride concentration of [insert value...

  16. Source Similarity and Social Media Health Messages: Extending Construal Level Theory to Message Sources.

    Science.gov (United States)

    Young, Rachel

    2015-09-01

    Social media users post messages about health goals and behaviors to online social networks. Compared with more traditional sources of health communication such as physicians or health journalists, peer sources are likely to be perceived as more socially close or similar, which influences how messages are processed. This experimental study uses construal level theory of psychological distance to predict how mediated health messages from peers influence health-related cognition and behavioral intention. Participants were exposed to source cues that identified peer sources as being either highly attitudinally and demographically similar to or different from participants. As predicted by construal level theory, participants who perceived sources of social media health messages as highly similar listed a greater proportion of beliefs about the feasibility of health behaviors and a greater proportion of negative beliefs, while participants who perceived sources as more dissimilar listed a greater proportion of positive beliefs about the health behaviors. Results of the study could be useful in determining how health messages from peers could encourage individuals to set realistic health goals.

  17. Health promotion and resilience in adolescents at school level

    Directory of Open Access Journals (Sweden)

    Griselda Cardozo

    2015-09-01

    Full Text Available This project arises from the need to sort out the different problems appearing in the process of growth and development of adolescents al school level. For this work we took into consideration four schools located in the Province of Córdoba. It refers to a transverse field work which was carried out in two stages during the year 2005. In the first stage, we made a diagnosis about the risk and protection factors in the young as well as the behaviors derived from them. We applied an anonymous survey based on the California Healthy Kids Survey - Bilingual version 2003. In order to select the subjects we made a stratified sample in each institution, with a total of 382 students of both sexes who attend the CBU (Unified Basic Level and the CE (Specialization Level. In the second stage, we worked with students of 4th and 5th year in workshops to train health promotion leaders and we also held workshops with teachers, proctors and principals. It is our goal to research about the factors and risk behaviors in the students. Our target is to improve the quality of life by reinforcing the health conditions and its determinants. The results conclude that the empowerment of the young and the educational community, trough their participation in the building of individual and collective capacities, brings about a higher knowledge of the risk and protection factors. These protection factors will generate resilience which influences in the maintenance, control and self-care of health. Through the dialogue, the educational institution supports the transference of subject matters together with the learning of problem solving strategies. Thus the school will promote critical thinking and creativity, the acknowledgment of the rights and duties as well as the recognition of the possibilities and limitations to promote a responsible autonomy. 

  18. Attitude and skill levels of graduate health professionals in performing cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Gebreegziabher Gebremedhn E

    2017-01-01

    Full Text Available Endale Gebreegziabher Gebremedhn,1 Gebremedhn Berhe Gebregergs,2 Bernard Bradley Anderson,3,† Vidhya Nagaratnam1 1Department of Anaesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, 2Department of Public Health, Bahir Dar College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, 3Department of Surgery, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia †Dr Bernard Bradley Anderson passed away on January 2, 2014 Background: Cardiopulmonary resuscitation (CPR is an emergency procedure used to treat victims following cardiopulmonary arrest. Graduate health professionals at the University of Gondar Teaching Hospital manage many trauma and critically ill patients. The chance of survival after cardiopulmonary arrest may be increased with sufficient attitude and skill levels. The study aimed to assess the attitude and skill levels of graduate health professionals in performing CPR.Methods: A hospital-based cross-sectional study was conducted from May 1 to 30, 2013, at the University of Gondar Teaching Hospital. The mean attitude and skill scores were compared for sex, original residence, and department of the participants using Student’s t-test and analysis of variance (Scheffe’s test. P-values <0.05 were considered to be statistically significant.Results: Of the 506 graduates, 461 were included in this study with a response rate of 91.1%. The mean attitude scores of nurse, interns, health officer, midwifery, anesthesia, and psychiatric nursing graduates were 1.15 (standard deviation [SD] =1.67, 8.21 (SD =1.24, 7.2 (SD =1.49, 6.69 (SD =1.83, 8.19 (SD =1.77, and 7.29 (SD =2.01, respectively, and the mean skill scores were 2.34 (SD =1.95, 3.77 (SD =1.58, 1.18 (SD =1.52, 2.16 (SD =1.93, 3.88 (SD =1.36, and 1.21 (SD =1.77, respectively.Conclusion and recommendations: Attitude and skill level of graduate health professionals with regard

  19. Health status convergence at the local level: empirical evidence from Austria

    Directory of Open Access Journals (Sweden)

    Gächter Martin

    2011-08-01

    Full Text Available Abstract Introduction Health is an important dimension of welfare comparisons across individuals, regions and states. Particularly from a long-term perspective, within-country convergence of the health status has rarely been investigated by applying methods well established in other scientific fields. In the following paper we study the relation between initial levels of the health status and its improvement at the local community level in Austria in the time period 1969-2004. Methods We use age standardized mortality rates from 2381 Austrian communities as an indicator for the health status and analyze the convergence/divergence of overall mortality for (i the whole population, (ii females, (iii males and (iv the gender mortality gap. Convergence/Divergence is studied by applying different concepts of cross-regional inequality (weighted standard deviation, coefficient of variation, Theil-Coefficient of inequality. Various econometric techniques (weighted OLS, Quantile Regression, Kendall's Rank Concordance are used to test for absolute and conditional beta-convergence in mortality. Results Regarding sigma-convergence, we find rather mixed results. While the weighted standard deviation indicates an increase in equality for all four variables, the picture appears less clear when correcting for the decreasing mean in the distribution. However, we find highly significant coefficients for absolute and conditional beta-convergence between the periods. While these results are confirmed by several robustness tests, we also find evidence for the existence of convergence clubs. Conclusions The highly significant beta-convergence across communities might be caused by (i the efforts to harmonize and centralize the health policy at the federal level in Austria since the 1970s, (ii the diminishing returns of the input factors in the health production function, which might lead to convergence, as the general conditions (e.g. income, education etc. improve

  20. Kyoto and beyond : A plan of action to meet and exceed Manitoba's Kyoto targets

    International Nuclear Information System (INIS)

    2002-10-01

    This document represents the next step in Manitoba's effort to mitigate the effects of climate change. A message from the Manitoba Premier and the Minister of Conservation of Manitoba are included in the introduction. The Action Plan is based in part on the discussion among climate experts and public input gathered in the course of the 2001 task force and the 2001 public forum on climate change. A rise in average global temperatures is affecting most of the planet, which is due in part to the upsetting of the balance of greenhouse gases in the atmosphere as a result of human activities. It is affecting weather patterns, water, agriculture, forests, health and welfare, and life in the North. The Manitoba government is committed to meeting and exceeding the reduction targets set under the Kyoto Protocol through renewable electricity, Selkirk conversion, ethanol, methane capture, and other measures targeted toward industry. Energy efficiency also plays a big part in the process of reducing greenhouse gas emissions. The government is leading by example, and also investing in knowledge. It is promoting technology development and innovation while enhancing awareness and understanding. All sectors are being encouraged to implement appropriate measures. The various initiatives undertaken by each department and organization under each of those headings are described. figs

  1. Preliminary results of mercury levels in raw and cooked seafood and their public health impact.

    Science.gov (United States)

    Costa, Fernanda do N; Korn, Maria Graças A; Brito, Geysa B; Ferlin, Stacy; Fostier, Anne H

    2016-02-01

    Mercury is toxic for human health and one of the main routes of exposure is through consumption of contaminated fish and shellfish. The objective of this work was to assess the possible mercury contamination of bivalves (Anomalocardia brasiliana, Lucina pectinata, Callinectes sapidus), crustacean (C. sapidus) and fish (Bagre marinus and Diapterus rhombeus) collected on Salinas da Margarida, BA (Brazil), a region which carciniculture, fishing and shellfish extraction are the most important economic activities. The effect of cooking on Hg concentration in the samples was also studied. The results showed that Hg concentration was generally higher in the cooked samples than in raw samples. This increase can be related to the effect of Hg pre-concentration, formation of complexes involving mercury species and sulfhydryl groups present in tissues and/or loss of water and fat. The highest concentrations were found in B. marinus samples ranging 837.0-1585.3 μg kg(-1), which exceeded those recommended by Brazilian Health Surveillance Agency (ANVISA). In addition, Hg values found in the other samples also suggest the monitoring of the Hg concentrations in seafood consumed from the region. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Reduction in health risk induced by semi-volatile organic compounds and metals in a drinking water treatment plant

    International Nuclear Information System (INIS)

    Zhao, F.; Yin, J.; Zhang, X. X.; Chen, Y.; Zhang, Y.; Wu, B.; Li, M.

    2015-01-01

    This study investigated health risk reduction in a drinking water treatment plant of Nanjing City (China) based on chemical detection of 22 semi-volatile organic compounds (SVOCs) and 24 metallic elements in source water and drinking water during 2009–2011. Chemical analysis showed that 15 SVOCs and 9 metals were present in the water. Health risk assessment revealed that hazard quotient of each pollutant and hazard index (HI) of all the detectable pollutants were below 1.00, indicating that the chemicals posed negligible non-carcinogenic risk to local residents. Benzo(a)pyrene may induce carcinogenic risk since its risk index via both oral and dermal exposure exceeded the safety level (1.00E-6), but other SVOCs induced no carcinogenic risk. Total HI of the SVOCs was 1.08E-3 for the source water and 1.56E-3 for the drinking water, suggesting that the used conventional treatment processes (coagulation/sedimentation, sand filtration and chlorine disinfection) cannot effectively reduce the non-carcinogenic risk. The source water had higher carcinogenic risk than the drinking water, but risk index of the drinking water still exceeded 1.00E-6. This study might serve as a basis for health risk assessment of drinking water and also as a benchmark for the authorities to reduce health risk arising from trace-level hazardous pollutants.

  3. Emissions from Electronic Cigarettes: Assessing Vapers' Intake of Toxic Compounds, Secondhand Exposures, and the Associated Health Impacts.

    Science.gov (United States)

    Logue, Jennifer M; Sleiman, Mohamad; Montesinos, V Nahuel; Russell, Marion L; Litter, Marta I; Benowitz, Neal L; Gundel, Lara A; Destaillats, Hugo

    2017-08-15

    E-cigarettes likely represent a lower risk to health than traditional combustion cigarettes, but they are not innocuous. Recently reported emission rates of potentially harmful compounds were used to assess intake and predict health impacts for vapers and bystanders exposed passively. Vapers' toxicant intake was calculated for scenarios in which different e-liquids were used with various vaporizers, battery power settings and vaping regimes. For a high rate of 250 puff day -1 using a typical vaping regime and popular tank devices with battery voltages from 3.8 to 4.8 V, users were predicted to inhale formaldehyde (up to 49 mg day -1 ), acrolein (up to 10 mg day -1 ) and diacetyl (up to 0.5 mg day -1 ), at levels that exceeded U.S. occupational limits. Formaldehyde intake from 100 daily puffs was higher than the amount inhaled by a smoker consuming 10 conventional cigarettes per day. Secondhand exposures were predicted for two typical indoor scenarios: a home and a bar. Contributions from vaping to air pollutant concentrations in the home did not exceed the California OEHHA 8-h reference exposure levels (RELs), except when a high emitting device was used at 4.8 V. In that extreme scenario, the contributions from vaping amounted to as much as 12 μg m -3 formaldehyde and 2.6 μg m -3 acrolein. Pollutant concentrations in bars were modeled using indoor volumes, air exchange rates and the number of hourly users reported in the literature for U.S. bars in which smoking was allowed. Predicted contributions to indoor air levels were higher than those in the residential scenario. Formaldehyde (on average 135 μg m -3 ) and acrolein (28 μg m -3 ) exceeded the acute 1-h exposure REL for the highest emitting vaporizer/voltage combination. Predictions for these compounds also exceeded the 8-h REL in several bars when less intense vaping conditions were considered. Benzene concentrations in a few bars approached the 8-h REL, and diacetyl levels were close to the lower limit

  4. Respiratory health effects of exposure to low levels of airborne endotoxin - a systematic review.

    Science.gov (United States)

    Farokhi, Azadèh; Heederik, Dick; Smit, Lidwien A M

    2018-02-08

    Elevated endotoxin levels have been measured in ambient air around livestock farms, which is a cause of concern for neighbouring residents. There is clear evidence that occupational exposure to high concentrations of airborne endotoxin causes respiratory inflammation, respiratory symptoms and lung function decline. However, health effects of exposure to low levels of endotoxin are less well described. The aim of this systematic review is to summarize published associations between exposure to relatively low levels of airborne endotoxin and respiratory health endpoints. Studies investigating respiratory effects of measured or modelled exposure to low levels of airborne endotoxin (average effects of exposure to low levels of endotoxin on respiratory symptoms and lung function. However, considerable heterogeneity existed in the outcomes of the included studies and no overall estimate could be provided by meta-analysis to quantify the possible relationship. Instead, a best evidence synthesis was performed among studies examining the exposure-response relationship between endotoxin and respiratory outcomes. Significant exposure-response relationships between endotoxin and symptoms and FEV 1 were shown in several studies, with no conflicting findings in the studies included in the best evidence synthesis. Significantly different effects of endotoxin exposure were also seen in vulnerable subgroups (atopics and patients with broncho-obstructive disease) and smokers. Respiratory health effects of exposure to low levels of airborne endotoxin (health effects, especially in vulnerable subgroups of the population.

  5. Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey.

    Science.gov (United States)

    Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-02-20

    Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (pfacility-level factors were significantly associated with case management quality. Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for fever, and then test and treat accordingly, otherwise, malaria control programmes might miss an opportunity to dramatically improve malaria case management, despite better diagnostic tools.

  6. Mental health and levels of physical activity in children: a systematic review

    Directory of Open Access Journals (Sweden)

    Gabrielle Cerqueira da Silva

    2017-09-01

    Full Text Available Introduction: the regular practice of physical activity has been cited as a mental health protection factor during childhood and adulthood. However, few investigations were carried out on the associations between mental disorder and levels of physical activity in children. Objective: To analyze, by systematic review, the association the association between mental health and physical activity levels in children. Method: Search for articles published in the CAPES Journal Portal databases, LILACS, PubMed, SciELO and Scopus. We adopted the following inclusion criteria: original articles in English or Portuguese, performed with humans, with free full-text. We initially found a total of 2,467 articles, which were analyzed by titles, abstracts, followed by reading of the full article. We selected 05 papers for the final result. Results: The results of the articles show that more active children, participating in physical activity, had better mental health compared children who had no physical activities and were sedentary. Conclusion: Further studies are needed related to the mental health of children, addressing mainly the importance of practicing physical activity to treat and prevent mental illness and promote mental health of these individuals.

  7. 30 CFR 62.120 - Action level.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Action level. 62.120 Section 62.120 Mineral... OCCUPATIONAL NOISE EXPOSURE § 62.120 Action level. If during any work shift a miner's noise exposure equals or exceeds the action level the mine operator must enroll the miner in a hearing conservation program that...

  8. Meeting the International Health Regulations (2005) surveillance core capacity requirements at the subnational level in Europe

    DEFF Research Database (Denmark)

    Ziemann, Alexandra; Rosenkötter, Nicole; Riesgo, Luis Garcia-Castrillo

    2015-01-01

    BACKGROUND: The revised World Health Organization's International Health Regulations (2005) request a timely and all-hazard approach towards surveillance, especially at the subnational level. We discuss three questions of syndromic surveillance application in the European context for assessing...... public health emergencies of international concern: (i) can syndromic surveillance support countries, especially the subnational level, to meet the International Health Regulations (2005) core surveillance capacity requirements, (ii) are European syndromic surveillance systems comparable to enable cross...... effect of different types of public health emergencies in a timely manner as required by the International Health Regulations (2005)....

  9. A dyadic analysis of relationships and health: does couple-level context condition partner effects?

    Science.gov (United States)

    Barr, Ashley B; Simons, Ronald L

    2014-08-01

    Adding to the growing literature explicating the links between romantic relationships and health, this study examined how both couple-level characteristics, particularly union type (e.g., dating, cohabiting, or marriage) and interracial pairing, and interpersonal characteristics (e.g., partner strain and support), predicted young adults' physical and mental health. Using dyadic data from a sample of 249 young, primarily Black couples, we hypothesized and found support for the importance of couple-level context, partner behavior, and their interaction in predicting health. Interracial couples (all Black/non-Black pairings) reported worse health than monoracial Black couples. Union type, however, did not directly predict health but was a significant moderator of partner strain. That is, the negative association between partner strain and self-reported health was stronger for cohabiting and married couples versus their dating counterparts, suggesting that coresidence, more so than marital status, may be important for understanding partner effects on physical health. For psychological distress, however, partner support proved equally beneficial across union types.

  10. A Dyadic Analysis of Relationships and Health: Does Couple-Level Context Condition Partner Effects?

    Science.gov (United States)

    Barr, Ashley B.; Simons, Ronald L.

    2014-01-01

    Adding to the growing literature explicating the links between romantic relationships and health, this study examined how both couple-level characteristics, particularly union type (e.g. dating, cohabiting, or marriage) and interracial pairing, and interpersonal characteristics (e.g. partner strain and support) predicted young adults’ physical and mental health. Using dyadic data from a sample of 249 young, primarily African American couples, we hypothesized and found support for the importance of couple-level context, partner behavior, and their interaction in predicting health. Interracial couples (all Black/non-Black pairings) reported worse health than monoracial Black couples. Union type, however, did not directly predict health but was a significant moderator of partner strain. That is, the negative association between partner strain and self-reported health was stronger for cohabiting and married couples versus their dating counterparts, suggesting that coresidence more so than marital status may be important for understanding partner effects on physical health. For psychological distress, however, partner support proved equally beneficial across union types. PMID:25090254

  11. Strengthening health-related rehabilitation services at national levels.

    Science.gov (United States)

    Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

    2018-04-18

    One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  12. Strengthening health-related rehabilitation services at national levels

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2017-04-01

    Full Text Available Objective: One of the aims of the World Health Organization’s Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up rehabilitation services. This paper describes the measures required and how (advisory missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. Recommendations: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. Conclusion: This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  13. Wind turbines and health: a critical review of the scientific literature.

    Science.gov (United States)

    McCunney, Robert J; Mundt, Kenneth A; Colby, W David; Dobie, Robert; Kaliski, Kenneth; Blais, Mark

    2014-11-01

    This review examines the literature related to health effects of wind turbines. We reviewed literature related to sound measurements near turbines, epidemiological and experimental studies, and factors associated with annoyance. (1) Infrasound sound near wind turbines does not exceed audibility thresholds. (2) Epidemiological studies have shown associations between living near wind turbines and annoyance. (3) Infrasound and low-frequency sound do not present unique health risks. (4) Annoyance seems more strongly related to individual characteristics than noise from turbines. Further areas of inquiry include enhanced noise characterization, analysis of predicted noise values contrasted with measured levels postinstallation, longitudinal assessments of health pre- and postinstallation, experimental studies in which subjects are "blinded" to the presence or absence of infrasound, and enhanced measurement techniques to evaluate annoyance.

  14. Meeting Recommended Levels of Physical Activity and Health-Related Quality of Life in Rural Adults.

    Science.gov (United States)

    Hart, Peter D

    2016-03-01

    Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population. This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT). Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.

  15. Primary health services at district level in South Africa: a critique of the primary health care approach

    Directory of Open Access Journals (Sweden)

    Dookie Sunitha

    2012-07-01

    Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

  16. Risk Analysis for Environmental Health Triage

    International Nuclear Information System (INIS)

    Bogen, K T

    2005-01-01

    The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage

  17. Personality trait level and change as predictors of health outcomes: findings from a national study of Americans (MIDUS).

    Science.gov (United States)

    Turiano, Nicholas A; Pitzer, Lindsay; Armour, Cherie; Karlamangla, Arun; Ryff, Carol D; Mroczek, Daniel K

    2012-01-01

    Personality traits predict numerous health outcomes, but previous studies have rarely used personality change to predict health. The current investigation utilized a large national sample of 3,990 participants from the Midlife in the U.S. study (MIDUS) to examine if both personality trait level and personality change longitudinally predict 3 different health outcomes (i.e., self-rated physical health, self-reported blood pressure, and number of days limited at work or home due to physical health reasons) over a 10-year span. Each of the Big Five traits, except openness, predicted self-rated health. Change in agreeableness, conscientiousness, and extraversion also predicted self-rated health. Trait levels of conscientiousness and neuroticism level predicted self-reported blood pressure. All trait levels except agreeableness predicted number of work days limited. Only change in conscientiousness predicted the number of work days limited. Findings demonstrate that a full understanding of the link between personality and health requires consideration of trait change as well as trait level.

  18. Identification of Causes of the Occupational Stress for Health Providers at Different Levels of Health Care.

    Science.gov (United States)

    Trifunovic, Natasa; Jatic, Zaim; Kulenovic, Alma Dzubur

    2017-06-01

    To identify and compare the stressors in the work environment experienced by employees in primary health care and secondary health care, amongphysiciansand nurses. The survey was conducted to identify types of stressors by assessing health care workers employed in the primary and secondary health care services of the Public Institution, the Health Centre of the Sarajevo Canton, using a questionnaire about stress in the workplace. Among all study participants stressors connected to the organization of work, finance and communication were found to affect their mental health most strongly. The results show a significant difference between primary and secondary health care in experience of stressors related to the organization of work, communication, and stressors related to the emotional and physical risks. Primary health care physicians report a significantly higher experience of stress and impact on mental health compared with other physicians related to emotional difficulties when working in the field of palliative care. Our results also indicate a significant difference between primary and secondary health providers in experiencing stressors related to the organization of work, such as: on-call duty shifts, an inadequate working environment and in the assessment of administrative work overload. The survey identified the most intense stressors for doctors and nurses at primary and secondary levels of health care services. The results of the study indicate that doctors and nurses have a different hierarchy of stressors, as well as subjects at Primary and Secondary Health Care. The results of the study indicate that subjects et Primary Health Care perceive more stressful organizational, emotional and communicational problems.

  19. Temporal and Spatial Variation in, and Population Exposure to, Summertime Ground-Level Ozone in Beijing.

    Science.gov (United States)

    Zhao, Hui; Zheng, Youfei; Li, Ting; Wei, Li; Guan, Qing

    2018-03-29

    Ground-level ozone pollution in Beijing has been causing concern among the public due to the risks posed to human health. This study analyzed the temporal and spatial distribution of, and investigated population exposure to, ground-level ozone. We analyzed hourly ground-level ozone data from 35 ambient air quality monitoring sites, including urban, suburban, background, and traffic monitoring sites, during the summer in Beijing from 2014 to 2017. The results showed that the four-year mean ozone concentrations for urban, suburban, background, and traffic monitoring sites were 95.1, 99.8, 95.9, and 74.2 μg/m³, respectively. A total of 44, 43, 45, and 43 days exceeded the Chinese National Ambient Air Quality Standards (NAAQS) threshold for ground-level ozone in 2014, 2015, 2016, and 2017, respectively. The mean ozone concentration was higher in suburban sites than in urban sites, and the traffic monitoring sites had the lowest concentration. The diurnal variation in ground-level ozone concentration at the four types of monitoring sites displayed a single-peak curve. The peak and valley values occurred at 3:00-4:00 p.m. and 7:00 a.m., respectively. Spatially, ground-level ozone concentrations decreased in gradient from the north to the south. Population exposure levels were calculated based on ground-level ozone concentrations and population data. Approximately 50.38%, 44.85%, and 48.49% of the total population of Beijing were exposed to ground-level ozone concentrations exceeding the Chinese NAAQS threshold in 2014, 2015, and 2016, respectively.

  20. Temporal and Spatial Variation in, and Population Exposure to, Summertime Ground-Level Ozone in Beijing

    Science.gov (United States)

    Zheng, Youfei; Li, Ting; Wei, Li; Guan, Qing

    2018-01-01

    Ground-level ozone pollution in Beijing has been causing concern among the public due to the risks posed to human health. This study analyzed the temporal and spatial distribution of, and investigated population exposure to, ground-level ozone. We analyzed hourly ground-level ozone data from 35 ambient air quality monitoring sites, including urban, suburban, background, and traffic monitoring sites, during the summer in Beijing from 2014 to 2017. The results showed that the four-year mean ozone concentrations for urban, suburban, background, and traffic monitoring sites were 95.1, 99.8, 95.9, and 74.2 μg/m3, respectively. A total of 44, 43, 45, and 43 days exceeded the Chinese National Ambient Air Quality Standards (NAAQS) threshold for ground-level ozone in 2014, 2015, 2016, and 2017, respectively. The mean ozone concentration was higher in suburban sites than in urban sites, and the traffic monitoring sites had the lowest concentration. The diurnal variation in ground-level ozone concentration at the four types of monitoring sites displayed a single-peak curve. The peak and valley values occurred at 3:00–4:00 p.m. and 7:00 a.m., respectively. Spatially, ground-level ozone concentrations decreased in gradient from the north to the south. Population exposure levels were calculated based on ground-level ozone concentrations and population data. Approximately 50.38%, 44.85%, and 48.49% of the total population of Beijing were exposed to ground-level ozone concentrations exceeding the Chinese NAAQS threshold in 2014, 2015, and 2016, respectively. PMID:29596366

  1. Temporal and Spatial Variation in, and Population Exposure to, Summertime Ground-Level Ozone in Beijing

    Directory of Open Access Journals (Sweden)

    Hui Zhao

    2018-03-01

    Full Text Available Ground-level ozone pollution in Beijing has been causing concern among the public due to the risks posed to human health. This study analyzed the temporal and spatial distribution of, and investigated population exposure to, ground-level ozone. We analyzed hourly ground-level ozone data from 35 ambient air quality monitoring sites, including urban, suburban, background, and traffic monitoring sites, during the summer in Beijing from 2014 to 2017. The results showed that the four-year mean ozone concentrations for urban, suburban, background, and traffic monitoring sites were 95.1, 99.8, 95.9, and 74.2 μg/m3, respectively. A total of 44, 43, 45, and 43 days exceeded the Chinese National Ambient Air Quality Standards (NAAQS threshold for ground-level ozone in 2014, 2015, 2016, and 2017, respectively. The mean ozone concentration was higher in suburban sites than in urban sites, and the traffic monitoring sites had the lowest concentration. The diurnal variation in ground-level ozone concentration at the four types of monitoring sites displayed a single-peak curve. The peak and valley values occurred at 3:00–4:00 p.m. and 7:00 a.m., respectively. Spatially, ground-level ozone concentrations decreased in gradient from the north to the south. Population exposure levels were calculated based on ground-level ozone concentrations and population data. Approximately 50.38%, 44.85%, and 48.49% of the total population of Beijing were exposed to ground-level ozone concentrations exceeding the Chinese NAAQS threshold in 2014, 2015, and 2016, respectively.

  2. Urinary metabolite levels and symptoms in Filipino workers using organic solvents.

    Science.gov (United States)

    Cucueco, M T; Espinosa, N C; Villanueva, M B; Castro, F T; Sison, S Y; Ortega, V S; Hisanaga, N

    1993-01-01

    To compare symptoms with urinary metabolite levels, 900 workers from 7 organic solvent-using industries were studied. Urinary metabolites were determined using a high performance liquid chromatograph. Urinary hippuric acid concentrations exceeding the reference value (2.5 g/g creatinine) were found in 78 (8.7%) workers. However, only 3 (0.3%) and 1 (0.1%) of the participants exceeded the reference value for mandelic (0.8 g/g creatinine) and total methylhippuric acid (1.5 g/g creatinine), respectively. The sum of the values of the ratio of measured urinary metabolite concentration to the corresponding ACGIH's biological exposure indices (BEI) [(HA/BEI of HA + MHA/BEI of MHA + MA/BEI of MA)] exceeded 1.0 in 166 (18.4%) workers. Majority of them were from the footwear manufacturing industry (63/129 or 49.2%). Questionnaire interviews were also administered to determine the prevalence of symptoms while at work (acute symptoms) or within the past 6 months (chronic symptoms). Urinary metabolite levels of individual and mixed solvents were compared with the symptoms of all workers. Analysis using Spearman's rank correlation showed in workers whose urinary hippuric acid exceeded 3.75 g/g creatine (1.5 x BEI), significant correlation between their hippuric acid levels and subjective complaints. Workers whose sum of the values of the ratio of measured urinary metabolite concentration to corresponding BEI exceeded 1.5 were selected and comparing this level with their symptoms, significant correlation was also noted in some complaints.

  3. Socioeconomic Status and the Health of Youth: A Multi-level, Multi-domain Approach to Conceptualizing Pathways

    Science.gov (United States)

    Schreier, Hannah M. C.; Chen, Edith

    2012-01-01

    Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on two of the most prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (1) multiple levels of influence, including the neighborhood, family and person level, (2) both social and physical domains in the environment, and finally (3) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth’s neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth’s risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth’s physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth’s long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities. PMID:22845752

  4. Are community-level financial data adequate to assess population health investments?

    Science.gov (United States)

    Casper, Tim; Kindig, David A

    2012-01-01

    The variation in health outcomes among communities results largely from different levels of financial and nonfinancial policy investments over time; these natural experiments should offer investment and policy guidance for a business model on population health. However, little such guidance exists. We examined the availability of data in a sample of Wisconsin counties for expenditures in selected categories of health care, public health, human services, income support, job development, and education. We found, as predicted by the National Committee on Vital and Health Statistics in 2002, that availability is often limited by the challenges of difficulty in locating useable data, a lack of resources among public agencies to upgrade information technology systems for making data more usable and accessible to the public, and a lack of enterprise-wide coordination and geographic detail in data collection efforts. These challenges must be overcome to provide policy-relevant information for optimal population health resource allocation.

  5. Human health risk associated with brominated flame-retardants (BFRs).

    Science.gov (United States)

    Lyche, Jan L; Rosseland, Carola; Berge, Gunnar; Polder, Anuschka

    2015-01-01

    The purposes of this review are to assess the human exposure and human and experimental evidence for adverse effects of brominated flame-retardants (BFRs) with specific focus on intake from seafood. The leakage of BFRs from consumer products leads to exposure of humans from fetal life to adulthood. Fish and fish products contain the highest levels of BFRs and dominate the dietary intake of frequent fish eaters in Europe, while meat, followed by seafood and dairy products accounted for the highest US dietary intake. House dust is also reported as an important source of exposure for children as well as adults. The levels of BFRs in the general North American populations are higher than those in Europe and Japan and the highest levels are detected in infants and toddlers. The daily intake via breast milk exceeds the RfD in 10% of US infants. BFRs including PBDEs, HBCDs and TBBP-A have induced endocrine-, reproductive- and behavior effects in laboratory animals. Furthermore, recent human epidemiological data demonstrated association between exposure to BFRs and similar adverse effects as observed in animal studies. Fish including farmed fish and crude fish oil for human consumption may contain substantial levels of BFRs and infants and toddlers consuming these products on a daily basis may exceed the tolerable daily intake suggesting that fish and fish oil alone represent a risk to human health. This intake comes in addition to exposure from other sources (breast milk, other food, house dust). Because potential harmful concentrations of BFRs and other toxicants occur in fish and fish products, research on a wider range of products is warranted, to assess health hazard related to the contamination of fish and fish products for human consumption. Copyright © 2014. Published by Elsevier Ltd.

  6. Access to eye health services among indigenous Australians: an area level analysis

    Directory of Open Access Journals (Sweden)

    Kelaher Margaret

    2012-09-01

    Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.

  7. Salt marsh persistence is threatened by predicted sea-level rise

    Science.gov (United States)

    Crosby, Sarah C.; Sax, Dov F.; Palmer, Megan E.; Booth, Harriet S.; Deegan, Linda A.; Bertness, Mark D.; Leslie, Heather M.

    2016-11-01

    Salt marshes buffer coastlines and provide critical ecosystem services from storm protection to food provision. Worldwide, these ecosystems are in danger of disappearing if they cannot increase elevation at rates that match sea-level rise. However, the magnitude of loss to be expected is not known. A synthesis of existing records of salt marsh elevation change was conducted in order to consider the likelihood of their future persistence. This analysis indicates that many salt marshes did not keep pace with sea-level rise in the past century and kept pace even less well over the past two decades. Salt marshes experiencing higher local sea-level rise rates were less likely to be keeping pace. These results suggest that sea-level rise will overwhelm most salt marshes' capacity to maintain elevation. Under the most optimistic IPCC emissions pathway, 60% of the salt marshes studied will be gaining elevation at a rate insufficient to keep pace with sea-level rise by 2100. Without mitigation of greenhouse gas emissions this potential loss could exceed 90%, which will have substantial ecological, economic, and human health consequences.

  8. Trabajadores de salud de nivel intermedio: un recurso prometedor Mid-level health providers: a promising resource

    Directory of Open Access Journals (Sweden)

    Andrew Brown

    2011-06-01

    Full Text Available Los trabajadores de salud de nivel intermedio (TSNI son trabajadores capacitados en una institución de educación superior durante al menos dos a tres años, quienes son autorizados y regulados para trabajar de forma autónoma para el diagnóstico, control y tratamiento de dolencias, enfermedades y discapacidades, así como participar en la prevención y promoción de la salud. Su papel se ha ampliado progresivamente y ha recibido atención en particular en países de ingresos bajos y medios, como parte de una estrategia para superar los desafíos del personal sanitario, mejorar el acceso a servicios básicos de salud y lograr objetivos relacionados con los Objetivos del Desarrollo del Milenio. La evidencia, aunque limitada e imperfecta, muestra que donde los TSNI están debidamente capacitados, apoyados y coherentemente integrados en el sistema de salud, tienen el potencial para mejorar la distribución de los trabajadores de la salud y el acceso equitativo a los servicios de salud, manteniendo -si no sobrepasando- los estándares de calidad comparables a los servicios prestados por el personal médico. Sin embargo, existen desafíos importantes en términos de la marginación y el limitado apoyo a la gestión de los TSNI en los sistemas de salud. La expansión de los TSNI debe tener prioridad entre las opciones de política consideradas por países que enfrentan problemas de escasez y desigualdad en la distribución de recursos humanos. Una mejor educación, supervisión, administración y regulación de las prácticas y la integración en el sistema de salud tienen el potencial de maximizar los beneficios de la utilización de este personal.Mid-level health providers (MLP are health workers trained at a higher education institution for at least a total of 2-3 years, and authorized and regulated to work autonomously to diagnose, manage and treat illness, disease and impairments, as well as engage in preventive and promotive care. Their role

  9. Observations and estimates of wave-driven water level extremes at the Marshall Islands

    Science.gov (United States)

    Merrifield, M. A.; Becker, J. M.; Ford, M.; Yao, Y.

    2014-10-01

    Wave-driven extreme water levels are examined for coastlines protected by fringing reefs using field observations obtained in the Republic of the Marshall Islands. The 2% exceedence water level near the shoreline due to waves is estimated empirically for the study sites from breaking wave height at the outer reef and by combining separate contributions from setup, sea and swell, and infragravity waves, which are estimated based on breaking wave height and water level over the reef flat. Although each component exhibits a tidal dependence, they sum to yield a 2% exceedence level that does not. A hindcast based on the breaking wave height parameterization is used to assess factors leading to flooding at Roi-Namur caused by an energetic swell event during December 2008. Extreme water levels similar to December 2008 are projected to increase significantly with rising sea level as more wave and tide events combine to exceed inundation threshold levels.

  10. Development of Thresholds and Exceedance Probabilities for Influent Water Quality to Meet Drinking Water Regulations

    Science.gov (United States)

    Reeves, K. L.; Samson, C.; Summers, R. S.; Balaji, R.

    2017-12-01

    Drinking water treatment utilities (DWTU) are tasked with the challenge of meeting disinfection and disinfection byproduct (DBP) regulations to provide safe, reliable drinking water under changing climate and land surface characteristics. DBPs form in drinking water when disinfectants, commonly chlorine, react with organic matter as measured by total organic carbon (TOC), and physical removal of pathogen microorganisms are achieved by filtration and monitored by turbidity removal. Turbidity and TOC in influent waters to DWTUs are expected to increase due to variable climate and more frequent fires and droughts. Traditional methods for forecasting turbidity and TOC require catchment specific data (i.e. streamflow) and have difficulties predicting them under non-stationary climate. A modelling framework was developed to assist DWTUs with assessing their risk for future compliance with disinfection and DBP regulations under changing climate. A local polynomial method was developed to predict surface water TOC using climate data collected from NOAA, Normalized Difference Vegetation Index (NDVI) data from the IRI Data Library, and historical TOC data from three DWTUs in diverse geographic locations. Characteristics from the DWTUs were used in the EPA Water Treatment Plant model to determine thresholds for influent TOC that resulted in DBP concentrations within compliance. Lastly, extreme value theory was used to predict probabilities of threshold exceedances under the current climate. Results from the utilities were used to produce a generalized TOC threshold approach that only requires water temperature and bromide concentration. The threshold exceedance model will be used to estimate probabilities of exceedances under projected climate scenarios. Initial results show that TOC can be forecasted using widely available data via statistical methods, where temperature, precipitation, Palmer Drought Severity Index, and NDVI with various lags were shown to be important

  11. Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala.

    Science.gov (United States)

    Hernández, Alison R; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

    2015-10-08

    Mid-level health workers are on the front-lines in underserved areas in many LMICs, and their performance is critical for improving the health of vulnerable populations. However, improving performance in low-resource settings is complex and highly dependent on the organizational context of local health systems. This study aims to examine the views of actors from different levels of a regional health system in Guatemala on actions to support the performance of auxiliary nurses, a cadre of mid-level health workers with a prominent role in public sector service delivery. A concept mapping study was carried out to develop an integrated view on organizational support and identify locally relevant strategies for strengthening performance. A total of 93 regional and district managers, and primary and secondary care health workers participated in generating ideas on actions needed to support auxiliary nurses' performance. Ideas were consolidated into 30 action items, which were structured through sorting and rating exercises, involving a total of 135 of managers and health workers. Maps depicting participants' integrated views on domains of action and dynamics in sub-groups' interests were generated using a sequence of multivariate statistical analyses, and interpreted by regional managers. The combined input of health system actors provided a multi-faceted view of actions needed to support performance, which were organized in six domains, including: Communication and coordination, Tools to orient work, Organizational climate of support, Motivation through recognition, Professional development and Skills development. The nature of relationships across hierarchical levels was identified as a cross-cutting theme. Pattern matching and go-zone maps indicated directions for action based on areas of consensus and difference across sub-groups of actors. This study indicates that auxiliary nurses' performance is interconnected with the performance of other health system actors who

  12. Low-Level Evidence Suggests that Perceived Ability to Evaluate and Trust Online Health Information is Associated with Low Health Literacy

    Directory of Open Access Journals (Sweden)

    Lindsay Alcock

    2016-04-01

    Full Text Available Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1 the ability to evaluate online health information based on (2 perceived reliability and accuracy, (3 trust in the Internet as an information source, and (4 the application of established evaluation criteria. Design – Systematic review and narrative synthesis. Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method. Subjects – 38 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. The most prevalent

  13. Can air pollution negate the health benefits of cycling and walking?

    Science.gov (United States)

    Tainio, Marko; de Nazelle, Audrey J; Götschi, Thomas; Kahlmeier, Sonja; Rojas-Rueda, David; Nieuwenhuijsen, Mark J; de Sá, Thiago Hérick; Kelly, Paul; Woodcock, James

    2016-06-01

    Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk-benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios. The health effects of active travel and air pollution were estimated through changes in all-cause mortality for different levels of active travel and air pollution. Air pollution exposure was estimated through changes in background concentrations of fine particulate matter (PM2.5), ranging from 5 to 200μg/m3. For active travel exposure, we estimated cycling and walking from 0 up to 16h per day, respectively. These refer to long-term average levels of active travel and PM2.5 exposure. For the global average urban background PM2.5 concentration (22μg/m3) benefits of PA by far outweigh risks from air pollution even under the most extreme levels of active travel. In areas with PM2.5 concentrations of 100μg/m3, harms would exceed benefits after 1h 30min of cycling per day or more than 10h of walking per day. If the counterfactual was driving, rather than staying at home, the benefits of PA would exceed harms from air pollution up to 3h 30min of cycling per day. The results were sensitive to dose-response function (DRF) assumptions for PM2.5 and PA. PA benefits of active travel outweighed the harm caused by air pollution in all but the most extreme air pollution concentrations. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level.

    Science.gov (United States)

    Ottová-Jordan, Veronika; Smith, Otto R F; Augustine, Lilly; Gobina, Inese; Rathmann, Katharina; Torsheim, Torbjørn; Mazur, Joanna; Välimaa, Raili; Cavallo, Franco; Jericek Klanscek, Helena; Vollebergh, Wilma; Meilstrup, Charlotte; Richter, Matthias; Moor, Irene; Ravens-Sieberer, Ulrike

    2015-04-01

    This article describes trends and stability over time in health complaints in adolescents from 2002 to 2010 and investigates associations between health complaints, behavioural and social contextual factors at individual level and economic factors at macro-level. Comprising N = 510 876 11-, 13- and 15-year-old children and adolescents in Europe, North America and Israel, data came from three survey cycles of the international Health Behaviour in School-aged Children (HBSC) study. Age- and gender-adjusted trends in health complaints were examined in each country by means of linear regression. By using the country as the random effects variable, we tested to what extent individual and contextual variables were associated with health complaints. Significant associations are stronger for individual level determinants (e.g. being bullied, smoking) than for determinants at macro-level (e.g. GDP, Gini), as can be seen by the small effect sizes (less than 5% for different trends). Health complaints are fairly stable over time in most countries, and no clear international trend in health complaints can be observed between 2002 and 2010. The most prominent stable determinants were being female, being bullied, school pressure and smoking. Factors associated with health complaints are more related to the proximal environment than to distal macro-level factors. This points towards intensifying targeted interventions, (e.g. for bullying) and also targeting specific risk groups. The comparably small effect size at country-level indicates that country-level factors have an impact on health and should not be ignored. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  15. Measuring the quality of child health care at first-level facilities.

    Science.gov (United States)

    Gouws, Eleanor; Bryce, Jennifer; Pariyo, George; Armstrong Schellenberg, Joanna; Amaral, João; Habicht, Jean-Pierre

    2005-08-01

    Sound policy and program decisions require timely information based on valid and relevant measures. Recent findings suggest that despite the availability of effective and affordable guidelines for the management of sick children in first-level health facilities in developing countries, the quality and coverage of these services remains low. We report on the development and evaluation of a set of summary indices reflecting the quality of care received by sick children in first-level facilities. The indices were first developed through a consultative process to achieve face validity by involving technical experts and policymakers. The definition of evaluation measures for many public health programs stops at this point. We added a second phase in which standard statistical techniques were used to evaluate the content and construct validity of the indices and their reliability, drawing on data sets from the multi-country evaluation of integrated management of childhood illness (MCE) in Brazil, Tanzania and Uganda. The statistical evaluation identified important conceptual errors in the indices arising from the theory-driven expert review. The experts had combined items into inappropriate indicators resulting in summary indices that were difficult to interpret and had limited validity for program decision making. We propose a revised set of summary indices for the measurement of child health care in developing countries that is supported by both expert and statistical reviews and that led to similar programmatic insights across the three countries. We advocate increased cross-disciplinary research within public health to improve measurement approaches. Child survival policymakers, program planners and implementers can use these tools to improve their monitoring and so increase the health impact of investments in health facility care.

  16. Conceptualising health services in terms of level and location of care

    African Journals Online (AJOL)

    location of care, are complex combinations of services. They encompass all levels of care ... expression in the recently published ANC health plan. This more comprehensive ..... business of training PHC providers and basic specialists as.

  17. Effects of organisational-level interventions at work on employees’ health: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Methods Systematic review. Organisational-level workplace interventions aiming at improving employees’ health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. Results 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Conclusions Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the

  18. Effects of organisational-level interventions at work on employees' health: a systematic review.

    Science.gov (United States)

    Montano, Diego; Hoven, Hanno; Siegrist, Johannes

    2014-02-08

    Organisational-level workplace interventions are thought to produce more sustainable effects on the health of employees than interventions targeting individual behaviours. However, scientific evidence from intervention studies does not fully support this notion. It is therefore important to explore conditions of positive health effects by systematically reviewing available studies. We set out to evaluate the effectiveness of 39 health-related intervention studies targeting a variety of working conditions. Systematic review. Organisational-level workplace interventions aiming at improving employees' health were identified in electronic databases and manual searches. The appraisal of studies was adapted from the Cochrane Back Review Group guidelines. To improve comparability of the widely varying studies we classified the interventions according to the main approaches towards modifying working conditions. Based on this classification we applied a logistic regression model to estimate significant intervention effects. 39 intervention studies published between 1993 and 2012 were included. In terms of methodology the majority of interventions were of medium quality, and four studies only had a high level of evidence. About half of the studies (19) reported significant effects. There was a marginally significant probability of reporting effects among interventions targeting several organisational-level modifications simultaneously (Odds ratio (OR) 2.71; 95% CI 0.94-11.12), compared to those targeting one dimension only. Despite the heterogeneity of the 39 organisational-level workplace interventions underlying this review, we were able to compare their effects by applying broad classification categories. Success rates were higher among more comprehensive interventions tackling material, organisational and work-time related conditions simultaneously. To increase the number of successful organisational-level interventions in the future, commonly reported obstacles against

  19. Workplace Social Capital and Mental Health among Chinese Employees: A Multi-Level, Cross-Sectional Study

    Science.gov (United States)

    Gao, Junling; Weaver, Scott R.; Dai, Junming; Jia, Yingnan; Liu, Xingdi; Jin, Kezhi; Fu, Hua

    2014-01-01

    Background Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. Methods By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. Results In total, 34.9% of workers reported poor mental health (WHO-5workplace-level social capital were 0.95 (95% CI: 0.61–1.49), 1.14 (95% CI: 0.72–1.81) and 1.63 (95% CI: 1.05–2.53) for the third, second, and lowest quartiles, respectively. Conclusions Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees’ mental health in China. PMID:24404199

  20. Impact analysis of TOTEM data at the LHC: black disk limit exceeded

    CERN Document Server

    Alkin, A; Kovalenko, O; Troshin, S M

    2015-01-01

    We discuss the profile of the impact--parameter dependent elastic scattering amplitude. Extraction of impact-parameter dependence from the dataset with inclusion of the experimental data on elastic scattering at the LHC energies helps to reveal the asymptotics of hadron interactions. Analysis of the data clearly indicates that the impact-parameter elastic scattering amplitude exceed the black disk limit at the LHC energy 7TeV and the inelastic overlap function reaches its maximum value at $b>0$

  1. assessment of the english literacy level of patients in primary health ...

    African Journals Online (AJOL)

    2010-09-07

    Sep 7, 2010 ... The English literacy level of primary health care patients in Tshwane .... It is therefore important to use appropriate literacy assessment tools to .... Participants were given the following instruction: ..... One of the disadvantages.

  2. Mercury in breast milk - a health hazard for infants in gold mining areas?

    Science.gov (United States)

    Bose-O'Reilly, Stephan; Lettmeier, Beate; Roider, Gabriele; Siebert, Uwe; Drasch, Gustav

    2008-10-01

    Breast-feeding can be a source of mercury exposure for infants. The main concern up to now is methyl-mercury exposure of women at child-bearing age. Certain fish species have high levels of methyl-mercury leading to consumer's advisory guidelines in regard of fish consumption to protect infants from mercury exposure passing through breast milk. Little is known about the transfer of inorganic mercury passing through breast milk to infants. Epidemiological studies showed negative health effects of inorganic mercury in gold mining areas. Small-scale gold miners use mercury to extract the gold from the ore. Environmental and health assessments of gold mining areas in Indonesia, Tanzania and Zimbabwe showed a high exposure with inorganic mercury in these gold mining areas, and a negative health impact of the exposure to the miners and the communities. This paper reports about the analysis and the results of 46 breast milk samples collected from mercury-exposed mothers. The median level of 1.87mug/l is fairly high compared to other results from literature. Some breast milk samples showed very high levels of mercury (up to 149mug/l). Fourteen of the 46 breast milk samples exceed 4mug/l which is considered to be a "high" level. US EPA recommends a "Reference Dose" of 0.3mug inorganic mercury/kg body weight/day [United States Environmental Protection Agency, 1997. Volume V: Health Effects of Mercury and Mercury Compounds. Study Report EPA-452/R-97-007: US EPA]. Twenty-two of the 46 children from these gold mining areas had a higher calculated total mercury uptake. The highest calculated daily mercury uptake of 127mug exceeds by far the recommended maximum uptake of inorganic mercury. Further systematic research of mercury in breast milk from small-scale gold mining areas is needed to increase the knowledge about the bio-transfer of mercury from mercury vapour-exposed mothers passing through breast milk to the breast-fed infant.

  3. Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

    Directory of Open Access Journals (Sweden)

    Surekha Garimella

    2016-01-01

    Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the

  4. The changes of plasma adrenomedullin level in Han and tibetan health adult men in plateau area

    International Nuclear Information System (INIS)

    Chen Shaolin

    2011-01-01

    To investigate the changes and clinical significance of plasma adrenomedullin in Han and Tibetan health adult men at the state of chronic hypoxia. The Han health adult who migrated and lived above sea level 4200 meter for 1∼3 years and the native Tibetan were involved in this study. The plasma adrenomedullin levels in both Han and Tibetan health adult men were measured by RIA. The results showed that the plasma adrenomedullin levels of native Tibetan were significantly higher than that of migrated Han worker (P<0.05). The plasma adrenomedullin might play a regulatory role on the physiological function in the health adult men who live in high altitude hypoxic state. (authors)

  5. 30 CFR 62.130 - Permissible exposure level.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Permissible exposure level. 62.130 Section 62... REGULATIONS OCCUPATIONAL NOISE EXPOSURE § 62.130 Permissible exposure level. (a) The mine operator must assure that no miner is exposed during any work shift to noise that exceeds the permissible exposure level. If...

  6. ACADEMIC STRESS IN STUDENTS FROM HEALTH DEPARTMENTS IN A PUBLIC UNIVERSITY OF CARTAGENA-COLOMBIA

    OpenAIRE

    Montalvo-Prieto Amparo; Blanco-Blanco Katerin; Cantillo-Martínez Neyi; Castro-González Yuldor; Downs-Bryan Agatha; Romero-Villadiego Eliana

    2015-01-01

    Introduction: stress is a factor that influences in the quality of life and performance of the individual. It appears when a person identifies dangerous situations that exceeds its own resources and endanger its own being-well. Objective: to describe the stress level in university students from health departments in Cartagena-Colombia. Methods: a descriptive study was carried out in 266 female students chosen by random probabilistic sampling from departments of Nursing, Dent...

  7. Workplace social capital and mental health among Chinese employees: a multi-level, cross-sectional study.

    Science.gov (United States)

    Gao, Junling; Weaver, Scott R; Dai, Junming; Jia, Yingnan; Liu, Xingdi; Jin, Kezhi; Fu, Hua

    2014-01-01

    Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. In total, 34.9% of workers reported poor mental health (WHO-5health, 1.39 (95% CI: 1.10-1.75), 1.85 (95% CI: 1.38-2.46) and 3.54 (95% CI: 2.73-4.59), respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61-1.49), 1.14 (95% CI: 0.72-1.81) and 1.63 (95% CI: 1.05-2.53) for the third, second, and lowest quartiles, respectively. Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees' mental health in China.

  8. Health equity issues at the local level: Socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti

    Directory of Open Access Journals (Sweden)

    Aftab Asma S

    2007-08-01

    Full Text Available Abstract Background Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. Methods We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. Results We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. Conclusion These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not

  9. Health equity issues at the local level: socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti.

    Science.gov (United States)

    Perry, Henry B; King-Schultz, Leslie W; Aftab, Asma S; Bryant, John H

    2007-08-01

    Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not even greater, levels of health inequities exist. These inequities

  10. Can exergaming contribute to improving physical activity levels and health outcomes in children?

    Science.gov (United States)

    Daley, Amanda J

    2009-08-01

    Physical inactivity among children is a serious public health problem. It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people. As physical inactivity and obesity levels continue to rise in young people, it has been proposed that new-generation active computer- and video-console games (otherwise known as "exergaming") may offer the opportunity to contribute to young people's energy expenditure during their free time. Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games, the energy costs of playing the authentic versions of activity-based video games are substantially larger, highlighting that active gaming is no substitute for real sports and activities. A small number of exergaming activities engage children in moderate-intensity activity, but most do not. Only 3 very small trials have considered the effects of exergaming on physical activity levels and/or other health outcomes in children. Evidence from these trials has been mixed; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials. No adequately powered randomized, controlled trial has been published to date, and no trial has assessed the long-term impact of exergaming on children's health. We now need high-quality randomized, controlled trials to evaluate the effectiveness and sustainability of exergaming, as well as its clinical relevance; until such studies take place, we should remain cautious about its ability to positively affect children's health.

  11. Comparison of the health benefits and health risks of energy development

    International Nuclear Information System (INIS)

    Myers, D.K.; Gentner, N.E.; Werner, M.M.

    1984-01-01

    Health risks associated with the production of energy from various sources tend towards 1-10 potential premature deaths per GW.a. Technological development has increased average life expectancy by about 35 years. Cheap and safe supplies of energy support the social infrastructure and prosperity that make this possible. About 3.5 years increased life expectancy may be attributed to energy development. In contrast, for a societal risk of one premature death/GW.a and utilization of 10 GW.a per million persons, the average loss of life expectancy is 0.02 years. Under these conditions, the average health benefit would thus exceed the average health cost by at least two orders of magnitude. The risk, however, is disproportionately borne by relatively small, occupational sub-groups in the population, e.g. uranium and coal miners. The expected average loss of life expectancy in 50 years at work in one of these occupations in North America is currently about 1-2 years. Occupational hazards in most other portions of the energy supply industries are closer to those anticipated in a safe industry, where average loss of life expectancy due to occupational hazards would not exceed 0.15 years. The shared societal health benefit of increased life span associated with technological development outweighs average health hazards associated with occupation in both the more hazardous and the safer stages of energy production. (author)

  12. White dwarf stars exceeding the Chandrasekhar mass limit

    Science.gov (United States)

    Tomaschitz, Roman

    2018-01-01

    The effect of nonlinear ultra-relativistic electron dispersion on the mass-radius relation of high-mass white dwarfs is studied. The dispersion is described by a permeability tensor in the Dirac equation, generated by the ionized high-density stellar matter, which constitutes the neutralizing background of the nearly degenerate electron plasma. The electron dispersion results in a stable mass-radius relation for high-mass white dwarfs, in contrast to a mass limit in the case of vacuum permeabilities. In the ultra-relativistic regime, the dispersion relation is a power law whose amplitude and scaling exponent is inferred from mass and radius estimates of two high-mass white dwarfs, Sirius B and LHS 4033. Evidence for the existence of super-Chandrasekhar mass white dwarfs is provided by several Type Ia supernovae (e.g., SN 2013cv, SN 2003fg, SN 2007if and SN 2009dc), whose mass ejecta exceed the Chandrasekhar limit by up to a factor of two. The dispersive mass-radius relation is used to estimate the radii, central densities, Fermi temperatures, bulk and compression moduli and sound velocities of their white dwarf progenitors.

  13. Recommended level of physical activity and health-related quality of life among Japanese adults

    OpenAIRE

    Nakamura Yoshio; Oka Koichiro; Shibata Ai; Muraoka Isao

    2007-01-01

    Abstract Background The benefits of a recommended level of physical activity on physiological health indicators such as morbidity and mortality are well-accepted, but less research has addressed whether or not the association between the recommended level of physical activity and a health-related quality of life (HRQOL) exists in the Japanese population. Thus, the present study examined whether the recommended physical activity would be associated with HRQOL in the general Japanese middle-age...

  14. Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level

    DEFF Research Database (Denmark)

    Ottová-Jordan, Veronika; Smith, Otto R F; Augustine, Lilly

    2015-01-01

    BACKGROUND: This article describes trends and stability over time in health complaints in adolescents from 2002 to 2010 and investigates associations between health complaints, behavioural and social contextual factors at individual level and economic factors at macro-level. METHODS: Comprising N...... at macro-level (e.g. GDP, Gini), as can be seen by the small effect sizes (less than 5% for different trends). Health complaints are fairly stable over time in most countries, and no clear international trend in health complaints can be observed between 2002 and 2010. The most prominent stable determinants...... were being female, being bullied, school pressure and smoking. CONCLUSION: Factors associated with health complaints are more related to the proximal environment than to distal macro-level factors. This points towards intensifying targeted interventions, (e.g. for bullying) and also targeting specific...

  15. Health effects of low level radiation

    International Nuclear Information System (INIS)

    Hattori, Sadao

    1998-01-01

    In 1982, Prof. Thomas Don Luckey of Missouri Univ. asserted 'Radiation Hormesis' on the Journal of Health Physics and he published two books. CRIEPI initiated the research program on Radiation Hormesis following his assertion to confirm 'is it true or not?' After nearly ten year research activities on data surveys and animal tests with many Universities, we are realizing scientific truth of bio-positive effects by low level radiation exposures. The interesting bio-positive effects we found could be categorized in following five groups. 1) Rejuvenation of cells such as increase of SOD and cell membrane permeability, 2) Moderation of psychological stress through response of key enzymes, 3) Suppression and therapy of adult-diseases such as diabetes and hypertension, 4) Suppression of cancer through enhancement of immune systems such as lymphocytes, 5) Suppression of cancer and ratio-adaptive response by activation of DNA repair and apoptosis. In the responses of many specialists to our initiation of radiation hormesis research program following T.D. Luckey's claim about low level radiation, I have to pick up for the first, the great success of Prof. Sakamoto. Prof. Sakamoto had been already applying whole body low dose irradiation for ten years before our radiation hormesis research started on the therapy to suppress the cancer reappearing after treatment. He reported about his successful trial to real patients and showed an enhancement of immune system. (author)

  16. Health effects of low level radiation

    Energy Technology Data Exchange (ETDEWEB)

    Hattori, Sadao [Central Research Inst. of Electric Power Industry, Tokyo (Japan)

    1998-12-31

    In 1982, Prof. Thomas Don Luckey of Missouri Univ. asserted `Radiation Hormesis` on the Journal of Health Physics and he published two books. CRIEPI initiated the research program on Radiation Hormesis following his assertion to confirm `is it true or not?` After nearly ten year research activities on data surveys and animal tests with many Universities, we are realizing scientific truth of bio-positive effects by low level radiation exposures. The interesting bio-positive effects we found could be categorized in following five groups. 1) Rejuvenation of cells such as increase of SOD and cell membrane permeability, 2) Moderation of psychological stress through response of key enzymes, 3) Suppression and therapy of adult-diseases such as diabetes and hypertension, 4) Suppression of cancer through enhancement of immune systems such as lymphocytes, 5) Suppression of cancer and ratio-adaptive response by activation of DNA repair and apoptosis. In the responses of many specialists to our initiation of radiation hormesis research program following T.D. Luckey`s claim about low level radiation, I have to pick up for the first, the great success of Prof. Sakamoto. Prof. Sakamoto had been already applying whole body low dose irradiation for ten years before our radiation hormesis research started on the therapy to suppress the cancer reappearing after treatment. He reported about his successful trial to real patients and showed an enhancement of immune system. (author)

  17. Anomaly in the education–health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels

    Directory of Open Access Journals (Sweden)

    Anna Zajacova

    2016-12-01

    Full Text Available This Short Communication builds on recent findings that documented an anomaly in the education–health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group reported an equal or higher level of health problems than adults with high school (HS diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups.Using the restricted 1999–2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: “some college”, vocational associate degree (AA, and academic AA.The data show that adults with “some college” or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile.This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling. Keywords: Education, Subbaccalaureate, Biomarkers, Health, Gradient, US adults

  18. Structural and contextual dimensions of Iranian primary health care system at local level.

    Science.gov (United States)

    Zanganeh Baygi, Mehdi; Seyedin, Hesam; Salehi, Masoud; Jafari Sirizi, Mehdi

    2015-01-01

    In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago. This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level. A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests. Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value structural dimensions. Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system.

  19. Workplace social capital and mental health among Chinese employees: a multi-level, cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Junling Gao

    Full Text Available BACKGROUND: Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. METHODS: By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5 was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. RESULTS: In total, 34.9% of workers reported poor mental health (WHO-5<13. After controlling for individual-level socio-demographic and lifestyle variables, compared to workers with the highest quartile of personal social capital, workers with the third, second, and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health, 1.39 (95% CI: 1.10-1.75, 1.85 (95% CI: 1.38-2.46 and 3.54 (95% CI: 2.73-4.59, respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61-1.49, 1.14 (95% CI: 0.72-1.81 and 1.63 (95% CI: 1.05-2.53 for the third, second, and lowest quartiles, respectively. CONCLUSIONS: Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees' mental health in China.

  20. OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT IN ROMANIA IN VIEW OF THE ECONOMIC DEVELOPMENT OF SOCIETY

    Directory of Open Access Journals (Sweden)

    Rusu-Zagar Gilda

    2013-07-01

    Full Text Available Health and safety at work has become one of the most substantial and important sectors in the EU social policy over the last years.In Romania, the implementation of health and safety management systems is performed by: a systematic approach to problems, training and awareness, effective and efficient tools for managing a company's specific issues as well as involvement at all its organizational levels.The article deals with the implementation of the management systems for health and safety at work, which complements the enterprises' existing organizational system and promotes enforcement of the legislation regarding health and safety at work.Creating a healthier and safer working environment is a goal that exceeds the resources and expertise of a single institution or a single country.

  1. Assessing public health policy approaches to level-up the gradient in health inequalities: the Gradient Evaluation Framework.

    Science.gov (United States)

    Davies, J K; Sherriff, N S

    2014-03-01

    This paper seeks to introduce and analyse the development of the Gradient Evaluation Framework (GEF) to facilitate evaluation of policy actions for their current or future use in terms of their 'gradient friendliness'. In particular, this means their potential to level-up the gradient in health inequalities by addressing the social determinants of health and thereby reducing decision-makers' chances of error when developing such policy actions. A qualitative developmental study to produce a policy-based evaluation framework. The scientific basis of GEF was developed using a comprehensive consensus-building process. This process followed an initial narrative review, based on realist review principles, which highlighted the need for production of a dedicated evaluation framework. The consensus-building process included expert workshops, a pretesting phase, and external peer review, together with support from the Gradient project Scientific Advisory Group and all Gradient project partners, including its Project Steering Committee. GEF is presented as a flexible policy tool resulting from a consensus-building process involving experts from 13 European countries. The theoretical foundations which underpin GEF are discussed, together with a range of practical challenges. The importance of systematic evaluation at each stage of the policy development and implementation cycle is highlighted, as well as the socio-political context in which policy actions are located. GEF offers potentially a major contribution to the public health field in the form of a practical, policy-relevant and common frame of reference for the evaluation of public health interventions that aim to level-up the social gradient in health inequalities. Further research, including the need for practical field testing of GEF and the exploration of alternative presentational formats, is recommended. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. What could have caused pre-industrial biomass burning emissions to exceed current rates?

    Directory of Open Access Journals (Sweden)

    G. R. van der Werf

    2013-01-01

    Full Text Available Recent studies based on trace gas mixing ratios in ice cores and charcoal data indicate that biomass burning emissions over the past millennium exceeded contemporary emissions by up to a factor of 4 for certain time periods. This is surprising because various sources of biomass burning are linked with population density, which has increased over the past centuries. We have analysed how emissions from several landscape biomass burning sources could have fluctuated to yield emissions that are in correspondence with recent results based on ice core mixing ratios of carbon monoxide (CO and its isotopic signature measured at South Pole station (SPO. Based on estimates of contemporary landscape fire emissions and the TM5 chemical transport model driven by present-day atmospheric transport and OH concentrations, we found that CO mixing ratios at SPO are more sensitive to emissions from South America and Australia than from Africa, and are relatively insensitive to emissions from the Northern Hemisphere. We then explored how various landscape biomass burning sources may have varied over the past centuries and what the resulting emissions and corresponding CO mixing ratio at SPO would be, using population density variations to reconstruct sources driven by humans (e.g., fuelwood burning and a new model to relate savanna emissions to changes in fire return times. We found that to match the observed ice core CO data, all savannas in the Southern Hemisphere had to burn annually, or bi-annually in combination with deforestation and slash and burn agriculture exceeding current levels, despite much lower population densities and lack of machinery to aid the deforestation process. While possible, these scenarios are unlikely and in conflict with current literature. However, we do show the large potential for increased emissions from savannas in a pre-industrial world. This is mainly because in the past, fuel beds were probably less fragmented compared to the

  3. Organotin levels in seafood

    NARCIS (Netherlands)

    Belfroid, A.C.; Purperhart, M.; Ariese, F.

    2000-01-01

    Tolerable average residue levels (TARL) for tributylin (TBT) in seafood products were calculated based on the tolerable daily intake (TDI) of TBT and the seafood consumption of the average consumer in various countries. Data from the literature show that these TARLs in seafood are exceeded in one or

  4. Individual-level factors related to better mental health outcomes following child maltreatment among adolescents.

    Science.gov (United States)

    Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Fortier, Janique; Sareen, Jitender; MacMillan, Harriet L; Boyle, Michael H; Afifi, Tracie O

    2018-05-01

    Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. Comparison of Serum Adipocytokine Levels according to Metabolic Health and Obesity Status

    Directory of Open Access Journals (Sweden)

    Tae Hoon Lee

    2015-06-01

    Full Text Available BackgroundMetabolic health is an emerging concept that is highly correlated with various metabolic complications, and adipocytokines have been causally linked to a wide range of metabolic diseases. Thus, this study compared serum adipocytokine levels according to metabolic health and obesity status.MethodsFour hundred and fifty-six nondiabetic subjects (mean age, 40.5 years were categorized into four groups according to metabolic health and obesity status: metabolically healthy nonobese (MHNO, metabolically healthy obese (MHO, metabolically unhealthy nonobese (MUHNO, and metabolically unhealthy obese (MUHO. Being metabolically healthy was defined as the presence of fewer than two of the following five metabolic abnormalities: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostatic model assessment of insulin resistance index. Obesity status was assessed using body mass index (BMI, with obesity defined as a BMI higher than 25 kg/m2. Levels of serum interleukin-6 (IL-6, monocyte chemoattractant protein-1 (MCP-1, tumor necrosis factor α (TNF-α, and adipocyte fatty acid binding protein (A-FABP were also evaluated.ResultsOf the 456 subjects, 247 (54.2% were in the MHNO group, 66 (14.5% were in the MHO group, 66 (14.5% were in the MUHNO group, and 77 (16.9% were in the MUHO group. There were no significant differences in IL-6 or MCP-1 levels among the groups, but levels of TNF-α and A-FABP were significantly higher in the MUHNO group compared to the MHNO group.ConclusionHigh TNF-α and A-FABP levels are significantly associated with metabolically unhealthiness in nonobese Korean individuals.

  6. Human radiation experimentation: a health physics perspective

    International Nuclear Information System (INIS)

    Kathren, R.L.

    1996-01-01

    This paper observes ethical human experimentation can be considered in terms of two basic principles or tests: informed, willing and knowledgeable subjects; and expectation of benefits. A number of human experiments are evaluated in terms of these principles, including a sixteenth century toxicology experiment, the deliberate exposure by an x-ray pioneer, and the plutonium injection cases of the 1940's. The following rational ethic is proposed for the practice of health physics with respect to human radiation experimentation: At all levels, the health physicist has a professional as well as personal obligation to ensure that proper human requirements, including proper informed consent and willing subjects, arc carried out with respect to human radiation experimentation, and must be convinced that the real or potential benefits to be derived from the experiment clearly exceed the potential detriment and risk. (author)

  7. Anomaly in the education–health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels

    OpenAIRE

    Zajacova, Anna; Johnson-Lawrence, Vicki

    2016-01-01

    This Short Communication builds on recent findings that documented an anomaly in the education-health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group) reported an equal or higher level of health problems than adults with high school (HS) diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups. Using the restricted 1999?2012 NHANES, we est...

  8. Investigating variations in implementation fidelity of an organizational-level occupational health intervention.

    Science.gov (United States)

    Augustsson, Hanna; von Thiele Schwarz, Ulrica; Stenfors-Hayes, Terese; Hasson, Henna

    2015-06-01

    The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.

  9. High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 7

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    This Requirements Identification Document (RID) describes an Occupational Health and Safety Program as defined through the Relevant DOE Orders, regulations, industry codes/standards, industry guidance documents and, as appropriate, good industry practice. The definition of an Occupational Health and Safety Program as specified by this document is intended to address Defense Nuclear Facilities Safety Board Recommendations 90-2 and 91-1, which call for the strengthening of DOE complex activities through the identification and application of relevant standards which supplement or exceed requirements mandated by DOE Orders. This RID applies to the activities, personnel, structures, systems, components, and programs involved in maintaining the facility and executing the mission of the High-Level Waste Storage Tank Farms.

  10. High-level waste storage tank farms/242-A evaporator standards/requirements identification document (S/RID), Vol. 7

    International Nuclear Information System (INIS)

    1994-04-01

    This Requirements Identification Document (RID) describes an Occupational Health and Safety Program as defined through the Relevant DOE Orders, regulations, industry codes/standards, industry guidance documents and, as appropriate, good industry practice. The definition of an Occupational Health and Safety Program as specified by this document is intended to address Defense Nuclear Facilities Safety Board Recommendations 90-2 and 91-1, which call for the strengthening of DOE complex activities through the identification and application of relevant standards which supplement or exceed requirements mandated by DOE Orders. This RID applies to the activities, personnel, structures, systems, components, and programs involved in maintaining the facility and executing the mission of the High-Level Waste Storage Tank Farms

  11. Steady-state sulfur critical loads and exceedances for protection of aquatic ecosystems in the U.S. Southern Appalachian Mountains.

    Science.gov (United States)

    McDonnell, Todd C; Sullivan, Timothy J; Hessburg, Paul F; Reynolds, Keith M; Povak, Nicholas A; Cosby, Bernard J; Jackson, William; Salter, R Brion

    2014-12-15

    Atmospherically deposited sulfur (S) causes stream water acidification throughout the eastern U.S. Southern Appalachian Mountain (SAM) region. Acidification has been linked with reduced fitness and richness of aquatic species and changes to benthic communities. Maintaining acid-base chemistry that supports native biota depends largely on balancing acidic deposition with the natural resupply of base cations. Stream water acid neutralizing capacity (ANC) is maintained by base cations that mostly originate from weathering of surrounding lithologies. When ambient atmospheric S deposition exceeds the critical load (CL) an ecosystem can tolerate, stream water chemistry may become lethal to biota. This work links statistical predictions of ANC and base cation weathering for streams and watersheds of the SAM region with a steady-state model to estimate CLs and exceedances. Results showed that 20.1% of the total length of study region streams displayed ANC high elevation, and cool and moist forested conditions, the percentage of stream length in exceedance was highest for mountain wilderness areas and in national parks, and lowest for privately owned valley bottom land. Exceedance results were summarized by 12-digit hydrologic unit code (subwatershed) for use in developing management goals and policy objectives, and for long-term monitoring. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Alternative interpretations of statistics on health effects of low-level radiation

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1983-01-01

    Four examples of the interpretation of statistics of data on low-level radiation are reviewed: (a) genetic effects of the atomic bombs at Hiroshima and Nagasaki, (b) cancer at Rocky Flats, (c) childhood leukemia and fallout in Utah, and (d) cancer among workers at the Portsmouth Naval Shipyard. Aggregation of data, adjustment for age, and other problems related to the determination of health effects of low-level radiation are discussed. Troublesome issues related to post hoc analysis are considered

  13. BEIR-III report and the health effects of low-level radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1980-01-01

    The present BEIR-III Committee has not highlighted any controversy over the health effects of low-level radiation. In its evaluation of the experimental data and epidemiological surveys, the Committee has carefully reviewed and assessed the value of all the available scientific evidence for estimating numerical risk coefficients for the health hazards to human populations exposed to low levels of ionizing radiation. Responsible public awareness of the possible health effects of ionizing radiations from medical and industrial radiation exposure, centers on three important matters of societal concern: (1) to place into perspective the extent of harm to the health of man and his descendants to be expected in the present and in the future from those societal activities involving ionizing radiation; (2) to develop quantitative indices of harm based on dose-effect relationships; such indices could then be used with prudent caution to introduce concepts of the regulation of population doses on the basis of somatic and genetic risks; and (3) to identify the magnitude and extent of radiation activities which could cause harm, to assess their relative significance, and to provide a framework for recommendations on how to reduce unnecessary radiation exposure to human populations. The main difference of the BEIR Committee Report is not so much from new data or new interpretations of existing data, but rather from a philosophical approach and appraisal of existing and future radiation protection resulting from an atmosphere of constantly changing societal conditions and public attitudes

  14. Perception of the health risks resulting from health, lifestyle and professional strain of teachers of various school levels

    OpenAIRE

    Papršteinová, Markéta

    2014-01-01

    Perception of health risks from lifestyle and work psychic load of teachers from different school levels Introduction: It is well known that the teaching profession is associated with numerous health risks. Teachers are exposed to excessive mental work and sensory stress, long working in a forced position at increased risk of noise, infections and voice disorders. Compared with the general population, there are more frequently found diseases related to occupational stress. Aim: To determine t...

  15. Practice-level approaches for behavioral counseling and patient health behaviors.

    Science.gov (United States)

    Balasubramanian, Bijal A; Cohen, Deborah J; Clark, Elizabeth C; Isaacson, Nicole F; Hung, Dorothy Y; Dickinson, L Miriam; Fernald, Douglas H; Green, Larry A; Crabtree, Benjamin F

    2008-11-01

    There is little empirical evidence to show that a practice-level approach that includes identifying patients in need of health behavior advice and linking them to counseling resources either in the practice or in the community results in improvements in patients' behaviors. This study examined whether patients in primary care practices that had practice-level approaches for physical activity and healthy-diet counseling were more likely to have healthier behaviors than patients in practices without practice-level approaches. A cross-sectional study of 54 primary care practices was conducted from July 2005 to January 2007. Practices were categorized into four groups depending on whether they had both identification tools (health risk assessment, registry) and linking strategies (within practice or to community resources); identification tools but no linking strategies; linking strategies but no identification tools; or neither identification tools nor linking strategies. Controlling for patient and practice characteristics, practices that had both identification tools and linking strategies for physical activity counseling were 80% more likely (95% CI=1.25, 2.59) to have patients who reported exercising regularly compared to practices that lacked both. Also, practices that had either identification tools or linking strategies but not both were approximately 50% more likely to have patients who reported exercising regularly. The use of a greater number of practice-level approaches for physical activity counseling was associated with higher odds of patients' reporting exercising regularly (p for trend=0.0002). Use of identification tools and linking strategies for healthy-eating counseling was not associated with patients' reports of healthy diets. This study suggests that practice-level approaches may enable primary care practices to help patients improve physical activity. However, these approaches may have different effects on different behaviors, and merit further

  16. Water Hardness Level and ItAND#8217;s Health Effects

    Directory of Open Access Journals (Sweden)

    Necmettin Kocak

    2011-04-01

    Full Text Available Water hardness is a term used to define the number of ions contained in the water, especially quantity sulphate, carbonate salts of calcium and magnesium. This characteristis of water is a important quality in it’s use as drinking water, industrial water and service water. The temporary hardness level of water cames from bicarbonate salts of calcium and magnesium whereas chloride, sulphate, nitrate, phosphate, silicate salts of calcium and magnesium. In order to indicate the hardness level of water samples French Hardness Level is used in our country. There is a larger amounth of calcium and magnesium salts in hard water samples. These minerals have very important functions in the human body. In this study, the importance of hard water in terms of human health has been assessed under light of current information. The studies about the preventive role of hard water in cardiovascular diseases, cerebrovascular diseases, stroke and many types of cancer areviewed. These studies Express that higher levels of calcium and magnesium hard water provide a higher reduction in these disease. Water, which must be consumed as 2 liters per dayis very important for human life. Hard water contains a lot of the minerals that must be taker daily, especially calcium and magnesium. It’s advised that water for consumption to have medium hardness. The hardness level of water is an aesthetic quality. Thus, in populations having a taste for soft water, the effort of individuals to softer the network water provided by municipalities using different equipments, in addition to their preference of soft water in plastic or glass bottles for consumption could imply lack of benefit of hard water for population health and also bring out some risks in terms of water hygiene. [TAF Prev Med Bull 2011; 10(2.000: 187-192

  17. The Relationship between Health Literacy and Physical Activity Level of Elderly Women in the City of Urmia

    Directory of Open Access Journals (Sweden)

    Friborz Fathi

    2017-06-01

    Full Text Available Background and objective: Health Literacy refers to cognitive and social skills which determine the motivation and knowledge intended for people to obtain information and access to understand and using them to promote and keeping fitness. Regular physical activity is necessary for human. The purpose of this study was to investigate the relationship between Health Literacy and physical activity level of elderly women in the of Urmia city. Methods: In this descriptive – correlation study of 120 elderly women of Urmia were selected. In Order to collect data, two questionnaire Functional Health Literacy of TOFHLA adults   and a physical activity questionnaire of Baekce was used. It was used SPSS software and one-sample T- test, and it was also conducted Pearson correlation and stepwise regression. Results: of 30% of the elderly had adequate Health Literacy 38/34 had inadequate health literacy and 31/64 had cross-border Health Literacy. Correlations were positive and significant correlation between adequate Health Literacy and physical activity were cross-border health physical activity in respectively. One-sample T-Tak results showed that the level Health Literacy in both access and reading in elderly women is higher than the average level in Urmia. Stepwise regression analysis showed that adequate health and cross-border Health Literacy can account for more than 80 percent of their sporting activities. Conclusion:  In order to promote physical activity levels of elderly women it should be improved their health literacy. By planning and designing useful training in the field of Health Literacy programs tailored to the elderly it can be done effective step to develop literacy skills in community health and physical health of elderly. Paper Type: Research Article

  18. Investigation of the Sound Pressure Level (SPL) of earphones during music listening with the use of physical ear canal models

    Science.gov (United States)

    Aying, K. P.; Otadoy, R. E.; Violanda, R.

    2015-06-01

    This study investigates on the sound pressure level (SPL) of insert-type earphones that are commonly used for music listening of the general populace. Measurements of SPL from earphones of different respondents were measured by plugging the earphone to a physical ear canal model. Durations of the earphone used for music listening were also gathered through short interviews. Results show that 21% of the respondents exceed the standard loudness/duration relation recommended by the World Health Organization (WHO).

  19. Generalized cost-effectiveness analysis for national-level priority-setting in the health sector

    Directory of Open Access Journals (Sweden)

    Edejer Tessa

    2003-12-01

    Full Text Available Abstract Cost-effectiveness analysis (CEA is potentially an important aid to public health decision-making but, with some notable exceptions, its use and impact at the level of individual countries is limited. A number of potential reasons may account for this, among them technical shortcomings associated with the generation of current economic evidence, political expediency, social preferences and systemic barriers to implementation. As a form of sectoral CEA, Generalized CEA sets out to overcome a number of these barriers to the appropriate use of cost-effectiveness information at the regional and country level. Its application via WHO-CHOICE provides a new economic evidence base, as well as underlying methodological developments, concerning the cost-effectiveness of a range of health interventions for leading causes of, and risk factors for, disease. The estimated sub-regional costs and effects of different interventions provided by WHO-CHOICE can readily be tailored to the specific context of individual countries, for example by adjustment to the quantity and unit prices of intervention inputs (costs or the coverage, efficacy and adherence rates of interventions (effectiveness. The potential usefulness of this information for health policy and planning is in assessing if current intervention strategies represent an efficient use of scarce resources, and which of the potential additional interventions that are not yet implemented, or not implemented fully, should be given priority on the grounds of cost-effectiveness. Health policy-makers and programme managers can use results from WHO-CHOICE as a valuable input into the planning and prioritization of services at national level, as well as a starting point for additional analyses of the trade-off between the efficiency of interventions in producing health and their impact on other key outcomes such as reducing inequalities and improving the health of the poor.

  20. Mapping risk of cadmium and lead contamination to human health in soils of Central Iran

    International Nuclear Information System (INIS)

    Amini, M.; Afyuni, M.; Khademi, H.; Abbaspour, K.C.; Schulin, R.

    2005-01-01

    In order to map Cd and Pb contamination in the soils of the region of Isfahan, Central Iran, we performed indicator kriging on a set of 255 topsoil samples (0-20 cm) gathered irregularly from an area of 6800 km 2 . The measured Cd concentrations exceeded the Swiss guide value in more than 80% of the samples whereas Pb concentrations exceeded the respective guide value only in 2% of the samples. Based on the simulated conditional distribution functions, the probability of exceeding the concentration of Cd and Pb from the specific threshold was computed. The results indicated that in most parts of the region the probability of contamination by Cd is very large (>0.95) whereas it is small (<0.5) for Pb. Based on a misclassification analysis, we chose the probability of 0.45 as optimum probability threshold to delineate the polluted from unpolluted areas for Cd. In addition, we performed a loss analysis to separate risks to human health from potential losses due to remediation costs. Based on this analysis a probability threshold of 0.8 was found to be the optimum threshold for the classification of polluted and unpolluted areas in the case of Cd. Health risks were found to be larger in the western parts of the region. Misclassification analysis was sufficient for risk mapping for Pb as its concentration did not reach risk levels for human health. A probability of 0.7 for Pb was found to be the optimum threshold for the delineation of polluted and unpolluted lands

  1. County-level poverty is equally associated with unmet health care needs in rural and urban settings.

    Science.gov (United States)

    Peterson, Lars E; Litaker, David G

    2010-01-01

    Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Compare the association between regional poverty with self-reported unmet need, a marker of health care access, by rural/urban setting. Multilevel, cross-sectional analysis of a state-representative sample of 39,953 adults stratified by rural/urban status, linked at the county level to data describing contextual characteristics. Weighted random intercept models examined the independent association of regional poverty with unmet needs, controlling for a range of contextual and individual-level characteristics. The unadjusted association between regional poverty levels and unmet needs was similar in both rural (OR = 1.06 [95% CI, 1.04-1.08]) and urban (OR = 1.03 [1.02-1.05]) settings. Adjusting for other contextual characteristics increased the size of the association in both rural (OR = 1.11 [1.04-1.19]) and urban (OR = 1.11 [1.05-1.18]) settings. Further adjustment for individual characteristics had little additional effect in rural (OR = 1.10 [1.00-1.20]) or urban (OR = 1.11 [1.01-1.22]) settings. To better meet the health care needs of all Americans, health care systems in areas with high regional poverty should acknowledge the relationship between poverty and unmet health care needs. Investments, or other interventions, that reduce regional poverty may be useful strategies for improving health through better access to health care. © 2010 National Rural Health Association.

  2. Effects of sleep deprivation on serum cortisol level and mental health in servicemen.

    Science.gov (United States)

    Song, Hong-Tao; Sun, Xin-Yang; Yang, Ting-Shu; Zhang, Li-Yi; Yang, Jia-Lin; Bai, Jing

    2015-06-01

    This study aimed to investigate the effects of sleep deprivation on serum cortisol level and mental health and explore the correlations between them in servicemen. A total of 149 out of the 207 Chinese servicemen were randomly selected to go through 24hour sleep deprivation, leaving the rest (58) as the control group, before and after which their blood samples were drawn for cortisol measurement. Following the procedure, all the participants were administered the Military Personnel Mental Disorder Prediction Scale, taking the military norm as baseline. The results revealed that the post-deprivation serum cortisol level was positively correlated with the factor score of mania in the sleep deprivation group (rSp=0.415, pSleep deprivation could significantly increase serum cortisol level and may affect mental health in servicemen. The increase of serum cortisol level is significantly related to mania disorder during sleep deprivation. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. National level maternal health decisions

    NARCIS (Netherlands)

    Koduah, A.

    2016-01-01

    Maternal and neonatal deaths and morbidity still pose an enormous challenge for health authorities in Ghana, a lower middle income country. Despite massive investments in maternal and neonatal health and special attention through Millennium Development Goals (MDG) 4

  4. A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks

    Directory of Open Access Journals (Sweden)

    Jerome J. Schleier III

    2015-01-01

    Full Text Available Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin used for adult mosquito management to generate an overall estimate of risk quotient (RQ. The utility of the Bayesian inference for risk management is that the estimated risk represents a probability distribution from which the probability of exceeding a threshold can be estimated. The mean RQs after all studies were incorporated were 0.4386, with a variance of 0.0163 for malathion and 0.3281 with a variance of 0.0083 for permethrin. After taking into account all of the evidence available on the risks of ULV insecticides, the probability that malathion or permethrin would exceed a level of concern was less than 0.0001. Bayesian estimates can substantially improve decisions by allowing decision makers to estimate the probability that a risk will exceed a level of concern by considering seemingly disparate lines of evidence.

  5. Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors.

    Science.gov (United States)

    Hughes, Alison; Condon, Louise

    2016-11-01

    Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

  6. The role of perceived air pollution and health risk perception in health symptoms and disease: a population-based study combined with modelled levels of PM10.

    Science.gov (United States)

    Orru, Kati; Nordin, Steven; Harzia, Hedi; Orru, Hans

    2018-03-31

    Adverse health impact of air pollution on health may not only be associated with the level of exposure, but rather mediated by perception of the pollution and by top-down processing (e.g. beliefs of the exposure being hazardous), especially in areas with relatively low levels of pollutants. The aim of this study was to test a model that describes interrelations between air pollution (particles pollution, health risk perception, health symptoms and diseases. A population-based questionnaire study was conducted among 1000 Estonian residents (sample was stratified by age, sex, and geographical location) about health risk perception and coping. The PM 10 levels were modelled in 1 × 1 km grids using a Eulerian air quality dispersion model. Respondents were ascribed their annual mean PM 10 exposure according to their home address. Path analysis was performed to test the validity of the model. The data refute the model proposing that exposure level significantly influences symptoms and disease. Instead, the perceived exposure influences symptoms and the effect of perceived exposure on disease is mediated by health risk perception. This relationship is more pronounced in large cities compared to smaller towns or rural areas. Perceived pollution and health risk perception, in particular in large cities, play important roles in understanding and predicting environmentally induced symptoms and diseases at relatively low levels of air pollution.

  7. Health hazards of China's lead-acid battery industry: a review of its market drivers, production processes, and health impacts.

    Science.gov (United States)

    van der Kuijp, Tsering Jan; Huang, Lei; Cherry, Christopher R

    2013-08-03

    Despite China's leaded gasoline phase out in 2000, the continued high rates of lead poisoning found in children's blood lead levels reflect the need for identifying and controlling other sources of lead pollution. From 2001 to 2007, 24% of children in China studied (N = 94,778) were lead poisoned with levels exceeding 100 μg/L. These levels stand well above the global average of 16%. These trends reveal that China still faces significant public health challenges, with millions of children currently at risk of lead poisoning. The unprecedented growth of China's lead-acid battery industry from the electric bike, automotive, and photovoltaic industries may explain these persistently high levels, as China remains the world's leading producer, refiner, and consumer of both lead and lead-acid batteries.This review assesses the role of China's rising lead-acid battery industry on lead pollution and exposure. It starts with a synthesis of biological mechanisms of lead exposure followed by an analysis of the key technologies driving the rapid growth of this industry. It then details the four main stages of lead battery production, explaining how each stage results in significant lead loss and pollution. A province-level accounting of each of these industrial operations is also included. Next, reviews of the literature describe how this industry may have contributed to mass lead poisonings throughout China. Finally, the paper closes with a discussion of new policies that address the lead-acid battery industry and identifies policy frameworks to mitigate exposure.This paper is the first to integrate the market factors, production processes, and health impacts of China's growing lead-acid battery industry to illustrate its vast public health consequences. The implications of this review are two-fold: it validates calls for a nationwide assessment of lead exposure pathways and levels in China as well as for a more comprehensive investigation into the health impacts of the lead

  8. Infrasound and low frequency noise from wind turbines: exposure and health effects

    Energy Technology Data Exchange (ETDEWEB)

    Bolin, Karl [Marcus Wallenberg Laboratory, Department of Aeronautical and Vehicle Engineering, Kungliga Tekniska Hoegskolan (Sweden); Bluhm, Goesta; Nilsson, Mats E [Institute of Environmental Medicine, Karolinska Institutet (Sweden); Eriksson, Gabriella, E-mail: kbolin@kth.se [Swedish National Road and Transport Research Institute and Linkoeping University (Sweden)

    2011-07-15

    Wind turbines emit low frequency noise (LFN) and large turbines generally generate more LFN than small turbines. The dominant source of LFN is the interaction between incoming turbulence and the blades. Measurements suggest that indoor levels of LFN in dwellings typically are within recommended guideline values, provided that the outdoor level does not exceed corresponding guidelines for facade exposure. Three cross-sectional questionnaire studies show that annoyance from wind turbine noise is related to the immission level, but several explanations other than low frequency noise are probable. A statistically significant association between noise levels and self-reported sleep disturbance was found in two of the three studies. It has been suggested that LFN from wind turbines causes other, and more serious, health problems, but empirical support for these claims is lacking.

  9. The role of social participation in municipal-level health systems: the case of Palencia, Guatemala

    Science.gov (United States)

    Ruano, Ana Lorena

    2013-01-01

    Background Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy but participation in health is still seen as a means to make the health system more responsive to local health needs and as a way to bring the health sector and the community closer together. Objective To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs. Design Documentary analysis was used to study the context of participation in Guatemala. To do this, written records and accounts of Guatemalan history during the 20th century were reviewed. The fieldwork was carried out over 8 months and three field visits were conducted between early January of 2009 and late March of 2010. A total of 38 in-depth interviews with regional health authorities, district health authorities, community representatives, and community health workers (CHWs) were conducted. Data were analyzed using thematic analysis. Results Guatemala's armed civil struggle was framed in the cold war and the fight against communism. Locally, the war was fed by the growing social, political, and ethnic inequalities that existed in the country. The process of reconstructing the country's social fabric started with the signing of the peace agreements of 1996, and continued with the passing of the 2002 legal framework designed to promote decentralization through social participation. Today, Guatemala is a post-war society that is trying to foster participation in a context full of challenges for the population and for the institutions that promote it. In the municipality of Palencia, there are three different spaces for participation in health: the municipal-level health commission, in community-level social development councils, and in the CHW program. Each of these

  10. The role of social participation in municipal-level health systems: the case of Palencia, Guatemala.

    Science.gov (United States)

    Ruano, Ana Lorena

    2013-09-10

    Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy but participation in health is still seen as a means to make the health system more responsive to local health needs and as a way to bring the health sector and the community closer together. To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs. Documentary analysis was used to study the context of participation in Guatemala. To do this, written records and accounts of Guatemalan history during the 20th century were reviewed. The fieldwork was carried out over 8 months and three field visits were conducted between early January of 2009 and late March of 2010. A total of 38 in-depth interviews with regional health authorities, district health authorities, community representatives, and community health workers (CHWs) were conducted. Data were analyzed using thematic analysis. Guatemala's armed civil struggle was framed in the cold war and the fight against communism. Locally, the war was fed by the growing social, political, and ethnic inequalities that existed in the country. The process of reconstructing the country's social fabric started with the signing of the peace agreements of 1996, and continued with the passing of the 2002 legal framework designed to promote decentralization through social participation. Today, Guatemala is a post-war society that is trying to foster participation in a context full of challenges for the population and for the institutions that promote it. In the municipality of Palencia, there are three different spaces for participation in health: the municipal-level health commission, in community-level social development councils, and in the CHW program. Each of these spaces has participants with

  11. The role of social participation in municipal-level health systems: the case of Palencia, Guatemala

    Directory of Open Access Journals (Sweden)

    Ana Lorena Ruano

    2013-09-01

    Full Text Available Background: Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy but participation in health is still seen as a means to make the health system more responsive to local health needs and as a way to bring the health sector and the community closer together. Objective: To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs. Design: Documentary analysis was used to study the context of participation in Guatemala. To do this, written records and accounts of Guatemalan history during the 20th century were reviewed. The fieldwork was carried out over 8 months and three field visits were conducted between early January of 2009 and late March of 2010. A total of 38 in-depth interviews with regional health authorities, district health authorities, community representatives, and community health workers (CHWs were conducted. Data were analyzed using thematic analysis. Results: Guatemala's armed civil struggle was framed in the cold war and the fight against communism. Locally, the war was fed by the growing social, political, and ethnic inequalities that existed in the country. The process of reconstructing the country's social fabric started with the signing of the peace agreements of 1996, and continued with the passing of the 2002 legal framework designed to promote decentralization through social participation. Today, Guatemala is a post-war society that is trying to foster participation in a context full of challenges for the population and for the institutions that promote it. In the municipality of Palencia, there are three different spaces for participation in health: the municipal-level health commission, in community-level social development councils, and in the CHW

  12. Are Your Custodians Exposed to Excessive Lead Levels?

    Science.gov (United States)

    School Business Affairs, 1997

    1997-01-01

    Data from a 1994 University of Maryland study suggest that typical janitorial tasks (sweeping, vacuuming, emptying trash receptacles, cleaning fixtures, and other related housekeeping activities) would not result in an airborne lead exposure that exceeded Occupational Safety and Health Administration (OSHA) standards. Lead abatement work should…

  13. Chapel Hill bisphenol A expert panel consensus statement: Integration of mechanisms, effects in animals and potential to impact human health at current levels of exposure

    Science.gov (United States)

    vom Saal, Frederick S.; Akingbemi, Benson T.; Belcher, Scott M.; Birnbaum, Linda S.; Crain, D. Andrew; Eriksen, Marcus; Farabollini, Francesca; Guillette, Louis J.; Hauser, Russ; Heindel, Jerrold J.; Ho, Shuk-Mei; Hunt, Patricia A.; Iguchi, Taisen; Jobling, Susan; Kanno, Jun; Keri, Ruth A.; Knudsen, Karen E.; Laufer, Hans; LeBlanc, Gerald A.; Marcus, Michele; McLachlan, John A.; Myers, John Peterson; Nadal, Angel; Newbold, Retha R.; Olea, Nicolas; Prins, Gail S.; Richter, Catherine A.; Rubin, Beverly S.; Sonnenschein, Carlos; Soto, Ana M.; Talsness, Chris E.; Vandenbergh, John G.; Vanderberg, Laura N.; Walser-Kuntz, Debby R.; Watson, Cheryl S.; Welshons, Wade V.; Wetherill, Yelena; Zoeller, R. Thomas

    2007-01-01

    This document is a summary statement of the outcome from the meeting: “Bisphenol A: An Examination of the Relevance of Ecological, In vitro and Laboratory Animal Studies for Assessing Risks to Human Health” sponsored by both the NIEHS and NIDCR at NIH/DHHS, as well as the US-EPA and Commonweal on the estrogenic environmental chemical bisphenol A (BPA, 2,2-bis(4-hydroxyphenyl)propane; CAS# 80-05-7). The meeting was held in Chapel Hill, NC, 28–30 November 2006 due to concerns about the potential for a relationship between BPA and negative trends in human health that have occurred in recent decades. Examples include increases in abnormal penile/urethra development in males, early sexual maturation in females, an increase in neurobehavioral problems such as attention deficit hyperactivity disorder (ADHD) and autism, an increase in childhood and adult obesity and type 2 diabetes, a regional decrease in sperm count, and an increase in hormonally mediated cancers, such as prostate and breast cancers. Concern has been elevated by published studies reporting a relationship between treatment with “low doses” of BPA and many of theses negative health outcomes in experimental studies in laboratory animals as well as in vitro studies identifying plausible molecular mechanisms that could mediate such effects. Importantly, much evidence suggests that these adverse effects are occurring in animals within the range of exposure to BPA of the typical human living in a developed country, where virtually everyone has measurable blood, tissue and urine levels of BPA that exceed the levels produced by doses used in the “low dose” animal experiments.

  14. Individual-level social capital and self-rated health in Japan: an application of the Resource Generator.

    Science.gov (United States)

    Kobayashi, Tomoko; Kawachi, Ichiro; Iwase, Toshihide; Suzuki, Etsuji; Takao, Soshi

    2013-05-01

    Despite accumulating evidence of associations between social capital and health in public health research, a criticism of the field has been that researchers have exclusively focused on concepts of social cohesion to the exclusion of individual-level approaches. In the present study, we evaluated the association between social capital measured by the Resource Generator (an individual-level assessment of access to social capital) and self-rated health among Japanese population in a cross-sectional study. A postal survey of 4000 randomly selected residents in Okayama City (western Japan) was conducted in February 2009. We divided the overall scores from the Resource Generator Japan scale into quartiles. Odds ratios (ORs) and 95% confidence intervals (CIs) for self-rated health were calculated separately by sex. Individuals with the highest quartile of scores had significantly lower odds of poor health compared to the lowest group after covariate adjustment among both men and women (men; OR: 0.45, 95% CI: 0.24-0.86, women; OR: 0.44, 95% CI: 0.25-0.79, respectively) and there were also significant dose-response relationships. In the sub-domains of Resource Generator Japan scale, a differential pattern was observed by sex. Women showed a clear dose-response relationship with health across all four sub-scales (domestic resources, expert advice, personal skills, and problem solving resources). In contrast, only the domain of expert advice exhibited a strong association with men's health. Among both men and women individual-level social capital measured by the Resource Generator was related to reduced odds of poor health even after taking into account individual confounders. Although we cannot exclude reverse causation due to the cross-sectional design, our study adds to the accumulating evidence of the potential utility of the Resource Generator for evaluating the relationship between individual-level access to social capital and health. Copyright © 2013 Elsevier Ltd

  15. Physical activity levels and health profiles of adult women living in ...

    African Journals Online (AJOL)

    This study investigated the physical activity levels and health profiles of adult women living in the Mmasechaba informal settlement in Gauteng. Apart from the questionnaire, anthropometric measurements were recorded and body mass index and waist-to-hip ratios were calculated. The results indicated that the incidence of ...

  16. Simplification improves understanding of informed consent information in clinical trials regardless of health literacy level.

    Science.gov (United States)

    Kim, Eun Jin; Kim, Su Hyun

    2015-06-01

    This study evaluated the effect of a simplified informed consent form for clinical trials on the understanding and efficacy of informed consent information across health literacy levels. A total of 150 participants were randomly assigned to one of two groups and provided with either standard or simplified consent forms for a cancer clinical trial. The features of the simplified informed consent form included plain language, short sentences, diagrams, pictures, and bullet points. Levels of objective and subjective understanding were significantly higher in participants provided with simplified informed consent forms relative to those provided with standard informed consent forms. The interaction effects between type of consent form and health literacy level on objective and subjective understanding were nonsignificant. Simplified informed consent was effective in enhancing participant's subjective and objective understanding regardless of health literacy. © The Author(s) 2015.

  17. Evidence from district level inputs to improve quality of care for maternal and newborn health: interventions and findings.

    Science.gov (United States)

    Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Bhutta, Zulfiqar A

    2014-09-04

    District level healthcare serves as a nexus between community and district level facilities. Inputs at the district level can be broadly divided into governance and accountability mechanisms; leadership and supervision; financial platforms; and information systems. This paper aims to evaluate the effectivness of district level inputs for imporving maternal and newborn health. We considered all available systematic reviews published before May 2013 on the pre-defined district level interventions and included 47 systematic reviews. Evidence suggests that supervision positively influenced provider's practice, knowledge and client/provider satisfaction. Involving local opinion leaders to promote evidence-based practice improved compliance to the desired practice. Audit and feedback mechanisms and tele-medicine were found to be associated with improved immunization rates and mammogram uptake. User-directed financial schemes including maternal vouchers, user fee exemption and community based health insurance showed significant impact on maternal health service utilization with voucher schemes showing the most significant positive impact across all range of outcomes including antenatal care, skilled birth attendant, institutional delivery, complicated delivery and postnatal care. We found insufficient evidence to support or refute the use of electronic health record systems and telemedicine technology to improve maternal and newborn health specific outcomes. There is dearth of evidence on the effectiveness of district level inputs to improve maternal newborn health outcomes. Future studies should evaluate the impact of supervision and monitoring; electronic health record and tele-communication interventions in low-middle-income countries.

  18. Anomaly in the education-health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels.

    Science.gov (United States)

    Zajacova, Anna; Johnson-Lawrence, Vicki

    2016-12-01

    This Short Communication builds on recent findings that documented an anomaly in the education-health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group) reported an equal or higher level of health problems than adults with high school (HS) diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups. Using the restricted 1999-2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: "some college", vocational associate degree (AA), and academic AA. The data show that adults with "some college" or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile. This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling.

  19. Management of health and safety in the organization of worktime at the local level.

    Science.gov (United States)

    Jeppesen, H J; Bøggild, H

    1998-01-01

    This study examined the consideration of health and safety issues in the local process of organizing worktime within the framework of regulations. The study encompassed all 7 hospitals in one region of Denmark. Twenty-three semi-structured interviews were carried out with 2 representatives from the different parties involved (management, cooperation committees, health and safety committees from each hospital, and 2 local unions). Furthermore, a questionnaire was sent to all 114 wards with day and night duty. The response rate was 84%. Data were collected on alterations in worktime schedules, responsibilities, reasons for the present design of schedules, and use of inspection reports. The organization of worktime takes place in single wards without external interference and without guidelines other than the minimum standards set in regulations. At the ward level, management and employees were united in a mutual desire for flexibility, despite the fact that regulations were not always followed. No interaction was found in the management of health and safety factors between the parties concerned at different levels. The demands for flexibility in combination with the absence of guidelines and the missing dynamics between the parties involved imply that the handling of health and safety issues in the organization of worktime may be accidental and unsystematic. In order to consider the health and safety of night and shift workers within the framework of regulations, a clarification of responsibilities, operational levels, and cooperation is required between the parties concerned.

  20. How much of Toyota's philosophy is embedded in health care at the organisational level? A review.

    Science.gov (United States)

    Antierens, Alain; Beeckman, Dimitri; Verhaeghe, Sofie; Myny, Dries; Van Hecke, Ann

    2018-05-01

    Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies. No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care. Sixty studies were identified for the final analysis. Some Toyota Way principles appear more deeply embedded in health care institutions than others are. Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse. This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level. © 2018 John Wiley & Sons Ltd.

  1. Changes in Area-level Socioeconomic Status and Oral Health of Indigenous Australian Children.

    Science.gov (United States)

    Ha, Diep H; Do, Loc G; Luzzi, Liana; Mejia, Gloria C; Jamieson, Lisa

    2016-01-01

    Dental diseases have shown to be influenced by area-level socioeconomic status. This study aims to assess the effects of change in area-level SES on the oral health of Australian Indigenous children. Data were collected from a national surveillance survey for children's dental health at two points of time (2000-2002/2007-2010). The study examines caries experienced by area-level SES and whether changes in area-level SES (stable-high, upwardly-mobile, downwardly-mobile and stable low) affects caries experience. Dental caries in both the deciduous and permanent dentition increased significantly among Indigenous children during the study period. In stable low-SES areas, the experience of decayed, missing and overall dmft/DMFT in both dentitions was highest compared with other groups at both Time 1(2.15 vs 1.61, 1.77, 1.87 and 0.86 vs 0.55, 0.67, 0.70 respectively) and Time 2 (3.23 vs 2.08, 2.17, 2.02 and 1.49 vs 1.18, 1.21 respectively). A change in area-level SES was associated with experience of dental disease among Indigenous Australian children.

  2. The health benefits of reducing air pollution in Sydney, Australia.

    Science.gov (United States)

    Broome, Richard A; Fann, Neal; Cristina, Tina J Navin; Fulcher, Charles; Duc, Hiep; Morgan, Geoffrey G

    2015-11-01

    Among industrialised countries, fine particle (PM2.5) and ozone levels in the Sydney metropolitan area of Australia are relatively low. Annual mean PM2.5 levels have historically remained below 8 μg/m(3) while warm season (November-March) ozone levels occasionally exceed the Australian guideline value of 0.10 ppm (daily 1 h max). Yet, these levels are still below those seen in the United States and Europe. This analysis focuses on two related questions: (1) what is the public health burden associated with air pollution in Sydney; and (2) to what extent would reducing air pollution reduce the number of hospital admissions, premature deaths and number of years of life lost (YLL)? We addressed these questions by applying a damage function approach to Sydney population, health, PM2.5 and ozone data for 2007 within the BenMAP-CE software tool to estimate health impacts and economic benefits. We found that 430 premature deaths (90% CI: 310-540) and 5800 YLL (95% CI: 3900-7600) are attributable to 2007 levels of PM2.5 (about 2% of total deaths and 1.8% of YLL in 2007). We also estimate about 630 (95% CI: 410-840) respiratory and cardiovascular hospital admissions attributable to 2007 PM2.5 and ozone exposures. Reducing air pollution levels by even a small amount will yield a range of health benefits. Reducing 2007 PM2.5 exposure in Sydney by 10% would, over 10 years, result in about 650 (95% CI: 430-850) fewer premature deaths, a gain of 3500 (95% CI: 2300-4600) life-years and about 700 (95% CI: 450-930) fewer respiratory and cardiovascular hospital visits. These results suggest that substantial health benefits are attainable in Sydney with even modest reductions in air pollution. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Environmental Health Risk Communication: Assessing Levels of Fish-Consumption Literacy among Selected Southeast Asians

    Science.gov (United States)

    Ratnapradipa, Dhitinut; Getz, Thomas D.; Zarcadoolas, Christina; Panzara, Anthony D.; Esposito, Valerie; Wodika, Alicia B.; Caron, Colleen; Migliore, Beverly; Quilliam, Daniela N.

    2010-01-01

    Limited resources have led to a lack of comprehensive state outreach strategies that are geared for non-English speaking constituencies. The investigators worked with Southeast Asian communities in Rhode Island to determine perceptions and levels of trust with various health authorities providing health messaging about fish-consumption practices.…

  4. Social and productive activities and health among partnered older adults: A couple-level analysis.

    Science.gov (United States)

    Lam, Jack; Bolano, Danilo

    2018-04-16

    We theorize and test the health of older adults as a result of their activity engagement, as well as a product of their spouse's engagement. We draw on 15 waves of couple-level data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Using responses of time engaged in nine different activities, we estimate Latent Class Models to describe activity profiles of partnered older adults. Given potential health selections into activity engagement, we lag older adults' activity engagement by one wave to examine its association with subsequent health. We then investigate associations between the lag of the spouse's activities with respondents' health, controlling for their own activity engagement at the previous wave. We find four activity profiles for men, and three for women. Respondents who were predominantly engaged in community activities generally report better subsequent health. Beyond their own activity engagement, for both older men and women, having a partner who was also community engaged associate with better subsequent health, though for older women, there were little differences between having a husband who was community engaged or inactive. Our findings highlight the value of considering activities of partnered older adults at the couple level. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Physical Activity and Sedentary Behaviors Levels of Kuwaiti Adolescents: The Study of Health and Activity Among Adolescents in Kuwait.

    Science.gov (United States)

    Hashem, Rawan; Rey-López, Juan P; Hamer, Mark; McMunn, Anne; Whincup, Peter H; Owen, Christopher G; Rowlands, Alex; Stamatakis, Emmanuel

    2018-04-01

    There is only scarce number of studies available describing the lifestyle of adolescents living in Arab countries. Hence, we described physical activity (PA) and sedentary behaviors patterns among Kuwaiti adolescents and the associations with parental education. Cross-sectional data from 435 adolescents (201 boys and 234 girls) were collected from the Study of Health and Activity among Adolescents in Kuwait conducted between 2012 and 2013. Outcome variables included PA (ActiGraph GT1M accelerometers) and sedentary behaviors. Exposure variable was parental education. Descriptive and multiple logistic regression analyses were used to examine the association between parental education and outcome variables. Total sedentary time (minutes per day) was higher in girls [568.2 (111.6)] than in boys [500.0 (102.0)], whereas boys accumulated more minutes in light, moderate, and vigorous PA (all Ps ≤ .001). In total, 3.4% of adolescents spent ≥60 minutes per day of moderate to vigorous PA (by accelerometry), while only 21% met the screen time guidelines. Low/medium maternal education was associated with a higher odds of exceeding screen time guidelines (odds ratio = 2.09; 95% confidence interval, 1.09-4.02). Most Kuwaiti adolescents in this sample were physically inactive and exceeded screen time guidelines. Objective PA was not socially patterned, yet an inverse association between maternal education and screen time behaviors was found.

  6. Radiation safety and health effects related to low-level radioactive wastes

    International Nuclear Information System (INIS)

    King, W.C.

    1979-01-01

    The hazards associated with low-level radioactive waste, one of the nation's greatest concerns, are discussed from a health physicist's perspective. Potential biological hazards, four stages of the low-level radioactive waste disposal process, and suggested methods of reducing the risks of handling and disposal, based on previous studies, are defined. Also discussed are potential pathways of human exposure and two scenarios designed to demonstrate the complexity of modeling exposure pathways. The risks of developing a fatal cancer from exposure to the radioactive material, should it occur, is compared to other more commonly accepted risks

  7. Does public insurance provide better financial protection against rising health care costs for families of children with special health care needs?

    Science.gov (United States)

    Yu, Hao; Dick, Andrew W; Szilagyi, Peter G

    2008-10-01

    Health care costs grew rapidly since 2001, generating substantial economic pressures on families, especially those with children with special health care needs (CSHCN). To examine how the growth of health care costs affected financial burden for families of CSHCN between 2001 and 2004 and to determine the extent to which health insurance coverage protected families of CSHCN against financial burden. In 2001-2004, 5196 families of CSHCN were surveyed by the national Medical Expenditure Panel Survey (MEPS). The main outcome was financial burden, defined as the proportion of family income spent on out-of-pocket (OOP) health care expenditures for all family members, including OOP costs and premiums. Family insurance coverage was classified as: (1) all members publicly insured, (2) all members privately insured, (3) all members uninsured, (4) partial coverage, and (5) a mix of public and private with no uninsured periods. An upward trend in financial burden for families of CSHCN occurred and was associated with growth of economy-wide health care costs. A multivariate analysis indicated that, given the economy-wide increase in medical costs between 2001 and 2004, a family with CSHCN was at increased risk in 2004 for having financial burden exceeding 10% of family income [odds ratio (OR) = 1.39; P financial burden exceeding 20% of family income. Over 15% of families with public insurance had financial burden exceeding 10% of family income compared with 20% of families with private insurance (P financial burden of >10% or 20% of family income than privately-insured families. Rising health care costs increased financial burden on families of CSHCN in 2001-2004. Public insurance coverage provided better financial protection than private insurance against the rapidly rising health care costs for families of CSHCN.

  8. Airborne exposure and soil levels associated with lead abatement of a steel tank.

    Science.gov (United States)

    Lange, John H

    2002-02-01

    This study reports on airborne exposure levels and soil concentrations of lead in regard to abatement of a steel structure (water tank). The tank was de-leaded by abrasive sand blasting. The ball of the tank had a lead surface level that exceeded the Environmental Protection Agency (EPA) definition of lead-based paint (LBP) (0.5% lead), but paint on stem and base was below this criterion. Personal and area airborne samples were collected during different activities of lead abatement of the tank. Summary results suggest during abrasive blasting of ball and stem/base personal exposure levels, as reported with arithmetic and geometric means, exceed the Occupational Safety and Health Administration (OSHA) permissible exposure limit (50 microg/m3). Highest personal exposure (occupational exposure) was associated with blasting of ball. Distribution of airborne and soil samples suggest non-normality and is best represented by a logarithmic form. Geometric standard deviations for air and soil lead support a non-normal distribution. Outlying values were found for personal and area air samples. Exposure levels associated with blasting stem/base section of tank support OSHA's policy requiring air monitoring of work at levels below the criterion established by EPA in identifying LBP. Area samples were statistically lower than personal samples associated with blasting ball and stem/base of tank. Exposure data suggest that workers performing abatement on steel structures have elevated lead exposure from surface lead. Respirator protection requirements are discussed. Soil lead concentration was suggested to decrease as distance increased from tank. Soil lead is suggested to be a result of deposition from LBP on tank surface. Minimal efforts were required to reduce average lead soil levels below EPA's upper acceptable criterion (1200 ppm Pb).

  9. Photochemical model evaluation of the ground-level ozone impacts on ambient air quality and vegetation health in the Alberta oil sands region: Using present and future emission scenarios

    Science.gov (United States)

    Vijayaraghavan, Krish; Cho, Sunny; Morris, Ralph; Spink, David; Jung, Jaegun; Pauls, Ron; Duffett, Katherine

    2016-09-01

    One of the potential environmental issues associated with oil sands development is increased ozone formation resulting from NOX and volatile organic compound emissions from bitumen extraction, processing and upgrading. To manage this issue in the Athabasca Oil Sands Region (AOSR) in northeast Alberta, a regional multi-stakeholder group, the Cumulative Environmental Management Association (CEMA), developed an Ozone Management Framework that includes a modelling based assessment component. In this paper, we describe how the Community Multi-scale Air Quality (CMAQ) model was applied to assess potential ground-level ozone formation and impacts on ambient air quality and vegetation health for three different ozone precursor cases in the AOSR. Statistical analysis methods were applied, and the CMAQ performance results met the U.S. EPA model performance goal at all sites. The modelled 4th highest daily maximum 8-h average ozone concentrations in the base and two future year scenarios did not exceed the Canada-wide standard of 65 ppb or the newer Canadian Ambient Air Quality Standards of 63 ppb in 2015 and 62 ppb in 2020. Modelled maximum 1-h ozone concentrations in the study were well below the Alberta Ambient Air Quality Objective of 82 ppb in all three cases. Several ozone vegetation exposure metrics were also evaluated to investigate the potential impact of ground-level ozone on vegetation. The chronic 3-months SUM60 exposure metric is within the CEMA baseline range (0-2000 ppb-hr) everywhere in the AOSR. The AOT40 ozone exposure metric predicted by CMAQ did not exceed the United Nations Economic Commission for Europe (UN/ECE) threshold of concern of 3000 ppb-hr in any of the cases but is just below the threshold in high-end future emissions scenario. In all three emission scenarios, the CMAQ predicted W126 ozone exposure metric is within the CEMA baseline threshold of 4000 ppb-hr. This study outlines the use of photochemical modelling of the impact of an industry (oil

  10. Development of California Public Health Goals (PHGs) for chemicals in drinking water.

    Science.gov (United States)

    Howd, R A; Brown, J P; Morry, D W; Wang, Y Y; Bankowska, J; Budroe, J D; Campbell, M; DiBartolomeis, M J; Faust, J; Jowa, L; Lewis, D; Parker, T; Polakoff, J; Rice, D W; Salmon, A G; Tomar, R S; Fan, A M

    2000-01-01

    As part of a program for evaluation of environmental contaminants in drinking water, risk assessments are being conducted to develop Public Health Goals (PHGs) for chemicals in drinking water, based solely on public health considerations. California's Safe Drinking Water Act of 1996 mandated the development of PHGs for over 80 chemicals by 31 December 1999. The law allowed these levels to be set higher or lower than federal maximum contaminant levels (MCLs), including a level of zero if data are insufficient to determine a specific level. The estimated safe levels and toxicological rationale for the first 26 of these chemicals are described here. The chemicals include alachlor, antimony, benzo[a]pyrene, chlordane, copper, cyanide, dalapon, 1,2-dichlorobenzene, 1,4-dichlorobenzene, 2,4-D, diethylhexylphthalate, dinoseb, endothall, ethylbenzene, fluoride, glyphosate, lead, nitrate, nitrite, oxamyl, pentachlorophenol, picloram, trichlorofluoromethane, trichlorotrifluoroethane, uranium and xylene(s). These risk assessments are to be considered by the State of California in revising and developing state MCLs for chemicals in drinking water (which must not exceed federal MCLs). The estimates are also notable for incorporation or consideration of newer guidelines and principles for risk assessment extrapolations.

  11. Water splitting-biosynthetic system with CO₂ reduction efficiencies exceeding photosynthesis.

    Science.gov (United States)

    Liu, Chong; Colón, Brendan C; Ziesack, Marika; Silver, Pamela A; Nocera, Daniel G

    2016-06-03

    Artificial photosynthetic systems can store solar energy and chemically reduce CO2 We developed a hybrid water splitting-biosynthetic system based on a biocompatible Earth-abundant inorganic catalyst system to split water into molecular hydrogen and oxygen (H2 and O2) at low driving voltages. When grown in contact with these catalysts, Ralstonia eutropha consumed the produced H2 to synthesize biomass and fuels or chemical products from low CO2 concentration in the presence of O2 This scalable system has a CO2 reduction energy efficiency of ~50% when producing bacterial biomass and liquid fusel alcohols, scrubbing 180 grams of CO2 per kilowatt-hour of electricity. Coupling this hybrid device to existing photovoltaic systems would yield a CO2 reduction energy efficiency of ~10%, exceeding that of natural photosynthetic systems. Copyright © 2016, American Association for the Advancement of Science.

  12. Four-Terminal All-Perovskite Tandem Solar Cells Achieving Power Conversion Efficiencies Exceeding 23%

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Kai [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zhao, Dewei [University of Toledo; Wang, Changlei [University of Toledo; Wuhan University; Song, Zhaoning [University of Toledo; Yu, Yue [University of Toledo; Chen, Cong [University of Toledo; Zhao, Xingzhong [Wuhan University; Yan, Yanfa [University of Toledo

    2018-02-09

    We report on fabrication of 4-terminal all-perovskite tandem solar cells with power conversion efficiencies exceeding 23% by mechanically stacking semitransparent 1.75 eV wide-bandgap FA0.8Cs0.2Pb(I0.7Br0.3)3 perovskite top cells with 1.25 eV low-bandgap (FASnI3)0.6(MAPbI3)0.4 bottom cells. The top cells use MoOx/ITO transparent electrodes and achieve transmittance up to 70% beyond 700 nm.

  13. Are higher blood mercury levels associated with dry eye symptoms in adult Koreans? A population-based cross-sectional study

    Science.gov (United States)

    Chung, So-Hyang

    2016-01-01

    Objectives The purpose of this study was to investigate whether blood mercury concentrations associated with the presence of dry eye symptoms in a nationally representative Korean population. Methods Population-based prospective cross-sectional study using the heavy metal data set of the 2010–2012 Korean National Health and Nutrition Examination Survey (KNHANES). A total of 4761 adult Koreans were the eligible population in this study. Of the 7162 survey participants, 2401 were excluded because they were mercury levels were measured on the day the participants completed a questionnaire regarding the presence of dry eye symptoms (persistent dryness or eye irritation). The population was divided into low and high groups by median level (4.26 and 2.89 µg/L for males and females, respectively). Results Self-reported dry eye symptoms were present in 13.0% of the cohort. Participants with dry eye symptoms were significantly more likely to have blood mercury levels exceeding the median than those without dry eye symptoms (45.7% vs 51.7%, p=0.021). Logistic regression analysis showed that, after adjusting for age, gender, education, total household income, smoking status, heavy alcohol use, sleep time, perceived stress status, total cholesterol levels and atopy history, dry eye symptoms were significantly associated with blood mercury levels that exceeded the median (reference: lower mercury group; OR, 1.324; 95% CI 1.059 to 1.655; pmercury levels were associated with dry eye symptoms in a nationally representative Korean population. PMID:27121705

  14. 'The public is too subjective': public involvement at different levels of health-care decision making.

    Science.gov (United States)

    Litva, Andrea; Coast, Joanna; Donovan, Jenny; Eyles, John; Shepherd, Michael; Tacchi, Jo; Abelson, Julia; Morgan, Kieran

    2002-06-01

    There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants from health and non-health related organisations. Nineteen interviews were conducted to allow the elaboration of focus group comments, to probe views more deeply and to pursue emerging themes. The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels, with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions, but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels, to supplement the inputs of health care professionals.

  15. A STUDY ON THE DETERMINATION OF WORK ENGAGEMENT LEVELS OF HEALTH EMPLOYEES

    Directory of Open Access Journals (Sweden)

    Özlem Özer

    2016-01-01

    Full Text Available The aim of this study is to determine work engagement levels of health employees and to reveal whether the individual and demographic features of the employees have an effect on the level of work engagement or not. The population of study included all employees in Aydin Atatürk State Hospital. The sample is selected in the study, tried to reach the whole universe and a total of 414 usable responses were obtained. According to result of this study, there are statistically significant differences between employees’ evaluations related to work engagement level by level of education, occupational status and gender whereas total work years, age and marital status do not create a difference in terms of work engagement levels of employees.

  16. A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India.

    Science.gov (United States)

    Dixit, Jyoti; Goel, Sonu; Sharma, Vijaylakshmi

    2017-01-01

    Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. A cross-sectional quantitative study was conducted from January to June 2015 among health care workers ( n = 354) at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Majority of the regular health-care staff was highly satisfied (86.9%) as compared to contractual staff (10.5%), which however was moderately satisfied (55.9%). Stepwise regression model showed that work-related matters (β = 1.370, P job (β = 0.530, P satisfaction level. Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

  17. Mental health and school dropout across educational levels and genders: a 4.8-year follow-up study.

    Science.gov (United States)

    Hjorth, Cathrine F; Bilgrav, Line; Frandsen, Louise Sjørslev; Overgaard, Charlotte; Torp-Pedersen, Christian; Nielsen, Berit; Bøggild, Henrik

    2016-09-15

    Education is a key determinant of future employment and income prospects of young people. Poor mental health is common among young people and is related to risk of dropping out of school (dropout). Educational level and gender might play a role in the association, which remains to be studied. Mental health was measured in 3146 Danish inhabitants aged 16-29 years using the 12-Item Short-Form Health Survey and examined across genders and educational levels. For students, educational level at baseline was used; for young people who were not enrolled in school at baseline (non-students), the highest achieved educational level was used. The risk of dropout in students was investigated in administrative registers over a 4.8-year period (1(st) March 2010-31(th) December 2014). Odds ratios (OR) and 95 % confidence intervals (CI) were calculated for mental health and in relation to dropout in logistic regression models, adjusting for age, gender, educational level, parental education, parental income and ethnicity. Poor mental health was present in 24 % (n = 753) of the participants, 29 % (n = 468) in females and 19 % (n = 285) in males (p mental health than males (OR = 1.8, CI = 1.5-2.2). Among the students the lowest risk was found at the elementary level (OR = 1.3, CI = 0.8-2.3), while students in higher education had a statistically significantly higher risk (OR = 1.9, CI = 1.2-2.9). The lowest-educated non-students had the highest OR of poor mental health (OR = 3.3, CI = 2.1-5.4). Dropout occurred in 8 % (n = 124) of the students. Poor mental health was associated to dropout in vocational (OR = 1.8, CI = 1.0-3.2) and higher education (OR = 2.0, CI = 1.0-4.2). For males in higher education, poor mental health was a predictor of dropout (OR = 5.2, CI = 1.6-17.3), which was not seen females in higher education (OR = 1.2, CI = 0.5-3.1). Poor mental health was significantly associated to

  18. Wave energy level and geographic setting correlate with Florida beach water quality.

    Science.gov (United States)

    Feng, Zhixuan; Reniers, Ad; Haus, Brian K; Solo-Gabriele, Helena M; Kelly, Elizabeth A

    2016-03-15

    Many recreational beaches suffer from elevated levels of microorganisms, resulting in beach advisories and closures due to lack of compliance with Environmental Protection Agency guidelines. We conducted the first statewide beach water quality assessment by analyzing decadal records of fecal indicator bacteria (enterococci and fecal coliform) levels at 262 Florida beaches. The objectives were to depict synoptic patterns of beach water quality exceedance along the entire Florida shoreline and to evaluate their relationships with wave condition and geographic location. Percent exceedances based on enterococci and fecal coliform were negatively correlated with both long-term mean wave energy and beach slope. Also, Gulf of Mexico beaches exceeded the thresholds significantly more than Atlantic Ocean ones, perhaps partially due to the lower wave energy. A possible linkage between wave energy level and water quality is beach sand, a pervasive nonpoint source that tends to harbor more bacteria in the low-wave-energy environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. 42 CFR 84.181 - Non-powered air-purifying particulate filter efficiency level determination.

    Science.gov (United States)

    2010-10-01

    ... distribution with count median diameter of 0.075 ±0.020 micrometer and a standard geometric deviation not....020 micrometer and a standard geometric deviation not exceeding 1.60 at the specified test conditions... HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

  20. Study on polychlorobiphenyl serum levels in French consumers of freshwater fish

    International Nuclear Information System (INIS)

    Desvignes, Virginie; Volatier, Jean-Luc; Bels, Frédéric de; Zeghnoun, Abdelkrim; Favrot, Marie-Christine; Marchand, Philippe; Le Bizec, Bruno; Rivière, Gilles; Leblanc, Jean-Charles; Merlo, Mathilde

    2015-01-01

    Introduction: Polychlorobiphenyls (PCBs) are persistent pollutants that are widespread in the environment and in foodstuffs, particularly in freshwater fish, which frequently exceed the maximum levels set by European regulations. Objectives: First, we describe the consumption of freshwater fish and serum PCB levels in French anglers, a population expected to have the highest level of dietary PCB exposure. Second, we investigated whether there is a statistical relationship between serum PCB levels and the angler consumption of freshwater fish with high PCB bioaccumulation potential (PCB-BP + freshwater fish) in order to make recommendations with regard to safe consumption of freshwater fish. Methods: We conducted a survey of anglers from six sites with contrasting PCB contamination levels. The survey included a food consumption frequency questionnaire and blood samples were taken to assess serum PCB levels. We used a regression model to determine the main factors contributing to serum PCB levels. Results: Consumption of PCB-BP + freshwater fish was relatively infrequent. Serum PCB levels of the study population and of women of childbearing age were in the same range as those observed in the French population and in neighbouring European countries, but higher than in the North American population. The two factors with the highest positive association with serum PCB levels were age (R 2 = 61%) and the consumption of PCB-BP + freshwater fish (R 2 = 2%). Using the regression model, we calculated, for several scenarios depending on the age and gender of the population, the maximum annual frequencies for PCB-BP + freshwater fish consumption that do not exceed the critical body burden threshold. Conclusion: Following the results of this study, the French agency for food, environmental and occupational health and safety (ANSES) issued an opinion and recommended some specific maximum freshwater fish consumption frequencies to protect the French general population

  1. Study on polychlorobiphenyl serum levels in French consumers of freshwater fish

    Energy Technology Data Exchange (ETDEWEB)

    Desvignes, Virginie, E-mail: virginie.desvignes@anses.fr [Risk Assessment Department, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), 27–31, avenue du Général Leclerc, Maisons-Alfort, F-94701 (France); Volatier, Jean-Luc [Risk Assessment Department, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), 27–31, avenue du Général Leclerc, Maisons-Alfort, F-94701 (France); Bels, Frédéric de [Division for Public Health and Care, French National Cancer Institute (INCa), 52, avenue André Morizet, Boulogne Billancourt Cedex, F-92513 (France); Zeghnoun, Abdelkrim [Department of Environmental Health, French Institute for Public Health Surveillance (InVS), 12, rue du Val d' Osne, Saint-Maurice, F-94415 (France); Favrot, Marie-Christine [Ministry of Health, 14, avenue Duquesne, Paris, F-75350 (France); Marchand, Philippe; Le Bizec, Bruno [LUNAM Université, Oniris, Laboratoire d' Etude des Résidus et Contaminants dans les Aliments (LABERCA), USC INRA 1329, Nantes, F-44307 (France); Rivière, Gilles; Leblanc, Jean-Charles; Merlo, Mathilde [Risk Assessment Department, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), 27–31, avenue du Général Leclerc, Maisons-Alfort, F-94701 (France)

    2015-02-01

    Introduction: Polychlorobiphenyls (PCBs) are persistent pollutants that are widespread in the environment and in foodstuffs, particularly in freshwater fish, which frequently exceed the maximum levels set by European regulations. Objectives: First, we describe the consumption of freshwater fish and serum PCB levels in French anglers, a population expected to have the highest level of dietary PCB exposure. Second, we investigated whether there is a statistical relationship between serum PCB levels and the angler consumption of freshwater fish with high PCB bioaccumulation potential (PCB-BP{sup +} freshwater fish) in order to make recommendations with regard to safe consumption of freshwater fish. Methods: We conducted a survey of anglers from six sites with contrasting PCB contamination levels. The survey included a food consumption frequency questionnaire and blood samples were taken to assess serum PCB levels. We used a regression model to determine the main factors contributing to serum PCB levels. Results: Consumption of PCB-BP{sup +} freshwater fish was relatively infrequent. Serum PCB levels of the study population and of women of childbearing age were in the same range as those observed in the French population and in neighbouring European countries, but higher than in the North American population. The two factors with the highest positive association with serum PCB levels were age (R{sup 2} = 61%) and the consumption of PCB-BP{sup +} freshwater fish (R{sup 2} = 2%). Using the regression model, we calculated, for several scenarios depending on the age and gender of the population, the maximum annual frequencies for PCB-BP{sup +} freshwater fish consumption that do not exceed the critical body burden threshold. Conclusion: Following the results of this study, the French agency for food, environmental and occupational health and safety (ANSES) issued an opinion and recommended some specific maximum freshwater fish consumption frequencies to protect the French

  2. Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

    Science.gov (United States)

    Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

    2004-12-01

    Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

  3. Investigation of the possibility of exceeding the Greenwald density limit during ECRH in T-10

    International Nuclear Information System (INIS)

    Alikaev, V.V.; Borshchegovskii, A.A.; Volkov, V.V.; Dremin, M.M.; Esipchuk, Yu.V.; Kakurin, A.M.; Kirneva, N.A.; Kislov, A.Ya.; Kislov, D.A.; Klimanov, I.V.; Kochin, V.A.; Krupin, V.A.; Krylov, S.V.; Myalton, T.B.; Novikov, A.Yu.; Notkin, G.E.; Pavlov, Yu.D.; Piterskii, V.V.; Poznyak, V.I.; Roi, I.N.

    2000-01-01

    In T-10 experiments, attempts were made to significantly exceed the Greenwald limit n-bar Gr during high-power (P ab = 750 kW) electron-cyclotron resonance heating (ECRH) and gas puffing. Formally, the density limit (n-bar e ) lim exceeding the Greenwald limit ((n-bar) e ) lim /n-bar Gr = 1.8) was achieved for q L = 8.2. However, as q L decreased, the ratio (n-bar e ) lim /n-bar Gr also decreased, approaching unity at q L ≅ 3. It was suggested that the 'current radius' (i.e., the radius of the magnetic surface enclosing the bulk of the plasma current I p ), rather than the limiter radius, was the parameter governing the value of (n-bar e ) lim . In the ECRH experiments, no substantial degradation of plasma confinement was observed up to n-bar e ∼ 0.9(n-bar e ) lim regardless of the ratio (n(bar sign) e ) lim /n-bar Gr . In different scenarios of the density growth up to (n-bar e ) lim , two types of disruptions related to the density limit were observed

  4. Lake-level frequency analysis for Devils Lake, North Dakota

    Science.gov (United States)

    Wiche, Gregg J.; Vecchia, Aldo V.

    1996-01-01

    for generating precipitation, evaporation, and inflow indicates that the upper lake-level exceedance levels from the water mass-balance model are particularly sensitive to parameter uncertainty. The sensitivity in the upper exceedance levels was caused almost entirely by uncertainty in the fitted probability distributions of the quarterly inflows. A method was developed for using long-term streamflow data for the Red River of the North at Grand Forks to reduce the variance in the estimated mean.Comparison of the annual lake-volume model and the water mass-balance model indicates the upper exceedance levels of the water mass-balance model increase much more rapidly than those of the annual lake-volume model. As an example, for simulation year 5, the 99-percent exceedance for the lake level is 1,417.6 feet above sea level for the annual lake-volume model and 1,423.2 feet above sea level for the water mass-balance model. The rapid increase is caused largely by the record precipitation and inflow in the summer and fall of 1993. Because the water mass-balance model produces lake-level traces that closely match the hydrology of Devils Lake, the water mass-balance model is superior to the annual lake-volume model for computing exceedance levels for the 50-year planning horizon.

  5. Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

    Science.gov (United States)

    Heywood, Peter; Harahap, Nida P

    2009-04-16

    During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been

  6. Exploring the Influence of Social Determinants, Social Capital, and Health Expertise on Health and the Rural Church.

    Science.gov (United States)

    Plunkett, Robyn; Leipert, Beverly; Olson, Joanne

    2016-09-01

    In rural communities, religious places can significantly shape health for individuals, families, and communities. Rural churches are prominent community centers in rural communities and are deeply woven into rural culture. Thus, health influences arising from the rural church likely have health implications for the greater community. This article explores health influences emerging from rural churches using social determinants of health, social capital, and health expertise. Although nurses are important health resources for all populations, their value in rural areas may be exceedingly significant. The contribution of nurses to church-based health capital in rural communities may be quite significant and underestimated, although it remains poorly understood. © The Author(s) 2015.

  7. The Relationship Between Sociodemographic Characteristics, Work Conditions, and Level of "Mobbing" of Health Workers in Primary Health Care.

    Science.gov (United States)

    Picakciefe, Metin; Acar, Gulcihan; Colak, Zehra; Kilic, Ibrahim

    2015-06-19

    Mobbing is a type of violence which occurs in workplaces and is classified under the community violence subgroup of interpersonal violence. The aim of this study is to examine health care workers who work in primary health care in the city of Mugla and to determine whether there is a relationship between sociodemographic characteristics, work conditions, and their level of mobbing. A cross-sectional analysis has been conducted in which 130 primary health care workers were selected. Of the 130, 119 health workers participated, yielding a response rate of 91.5%; 83.2% of health workers are female, 42.9% are midwives, 27.7% are nurses, and 14.3% are doctors. In all, 31.1% of health workers have faced with "mobbing" in the last 1 year, and the frequency of experiencing "mobbing" of those 48.6% of them is 1 to 3 times per year. A total of 70.3% of those who apply "mobbing" are senior health workers, and 91.9% are female. The frequency of encountering with "mobbing" was found significantly in married health workers, in those 16 years and above according to examined total working time, in those who have psychosocial reactions, and in those who have counterproductive behaviors. It has been discovered that primary health care workers have high prevalence of "mobbing" exposure. To avoid "mobbing" at workplace, authorities and responsibilities of all employees have to be clearly determined. © The Author(s) 2015.

  8. Levels of Mercury in Persian Gulf Frozen Fish Species

    Directory of Open Access Journals (Sweden)

    Parisa Ziarati

    2017-03-01

    Full Text Available Severe discharge of sewage and industrial effluents into the Persian Gulf leads to the deposition of various types of heavy metals, especially lead and mercury, in the muscles of fish. Total mercury and methylmercury contents were determined in the edible parts (muscle tissue, fillet of two different most popular frozen fish species from the Persian Gulf to ascertain whether the concentrations exceeded the maximum level fixed by the European Commission or not. During the period from October 2015 to June 2016, a total of 150 frozen fish packaged samples were randomly collected from the recognized supermarkets in Tehran province, Iran. The mercury (Hg concentration of samples was determined by atomic absorption spectrophotometer using a mercuric hydride system (MHS 10 and also by direct mercury analyzer (DMA. High concentration of total Hg was found in a Carcharhinus dussumie brand (0.91 ± 0.12 μg/g while the lowest level was detected in Pomadasys furcatus (0.29 ± 0.02 μg/g. In current study the mean concentrations of Mercury in all studied frozen fish samples were 0.79 ± 0.11 µg/g that means Hg levels were above 0.5 μg/g, which is the maximum standard level recommended by Joint FAO/WHO/Expert Committee on Food Additives (JECFA. In 13% of Pomadasys and in 47.2 % of Carcharhinus fish samples total mercury concentrations exceeded the maximum level fixed by the European Commission. All samples had also mean Hg concentrations that exceeded EPA's established safety level of 0.3 μg/g.

  9. Mental health problems of Dutch adolescents: the association with adolescents' and their parents' educational level.

    Science.gov (United States)

    Havas, Jano; Bosma, Hans; Spreeuwenberg, Cor; Feron, Frans J

    2010-06-01

    We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred. Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings. A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents. There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.

  10. Heavy metal pollution assessment, source identification, and health risk evaluation in Aibi Lake of northwest China.

    Science.gov (United States)

    Zhaoyong, Zhang; Xiaodong, Yang; Shengtian, Yang

    2018-01-08

    This study sought to analyze heavy metal (Pb, Zn, Cu, Ni, Mn, and Fe) pollution status in the waters of Aibi Lake in northwest China through the use of an applied comprehensive pollution index, health risk model, and multivariate statistical analyses in combination with the lake's land use types. Results showed that (1) the maximum (average) values of the heavy metals Pb, Zn, Cu, Ni, Mn, and Fe were 0.0644 (0.0123), 0.0006 (0.0002), 0.0009 (0.0032), 0.1235 (0.0242), 0.0061 (0.0025), and 0.0222 (0.0080) μg/L, respectively. Among these, in all the samples, Pb and Ni exceeded the standard and acceptable values put forth by the World Health Organization by 21.13 and 25.67%, respectively. Ni also exceeded (30.16%) the third grade of the Environmental Quality Standards for Surface Water of China. The levels of the six heavy metals were all within the fishery and irrigation water quality standard ranges in China. (2) The average values for single pollution index of heavy metals Pb, Zn, Cu, Ni, Mn, and Fe were 1.000, 0.0006, 0.0009, 3.000, 0.060, and 0.070, respectively, among which Ni levels indicated moderate to significant pollution, while others indicated healthy levels. (3) Health risk evaluation showed that the R n values for Pb, Zn, Cu, Mn, and Fe were 1.8 × 10 -4 , 5.33 × 10 -9 , 4.80 × 10 -7 , 1.08 × 10 -6 , and 2.51 × 10 -7  a -1 , respectively, of which, in all samples, Pb and Ni contents all exceeded the maximum acceptable risk levels according to the International Commission on Radiological Protection (ICRP) as well as the U.S. Environment Protection Agency. (4) Combining with multivariate statistical analyses along with the land use distribution within the lake basin, Pb, Zn, Cu, Ni, and Mn were mainly influenced by the agriculture production and emission from urban lives and traffics, and Fe mainly originated from the natural environment. The results of this research can provide reference values for heavy metal pollution

  11. Human Health Risk from Metals in Fish from Saudi Arabia: Consumption Patterns for Some Species Exceed Allowable Limits

    KAUST Repository

    Burger, Joanna; Gochfeld, Michael; Mannalamkunnath Alikunhi, Nabeel; Al-Jahdali, Haitham; Al-Jebreen, Dalal Hamad; Al-Suwailem, Abdulaziz M.; Aziz, Mohammed A M; Batang, Zenon B.

    2014-01-01

    ABSTRACT: Fish are a healthful source of protein, but contaminants in some fish pose a risk. While there are multiple risk assessments from Europe and North America, there are far fewer for other parts of the world. We examined the risks from

  12. State-level income inequality and family burden of U.S. families raising children with special health care needs.

    Science.gov (United States)

    Parish, Susan L; Rose, Roderick A; Dababnah, Sarah; Yoo, Joan; Cassiman, Shawn A

    2012-02-01

    Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household's absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005-06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child's care and whether the parent stopped working due to the child's health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child's health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child's impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Health risk assessment from contaminated foodstuffs: a field study in chromite mining-affected areas northern Pakistan.

    Science.gov (United States)

    Nawab, Javed; Li, Gang; Khan, Sardar; Sher, Hassan; Aamir, Muhammad; Shamshad, Isha; Khan, Anwarzeb; Khan, Muhammad Amjad

    2016-06-01

    This study aimed to investigate the potential health risk associated with toxic metals in contaminated foodstuffs (fruits, vegetables, and cereals) collected from various agriculture fields present in chromite mining-affected areas of mafic and ultramafic terrains (northern Pakistan). The concentrations of Cr, Ni, Zn, Cd, and Pb were quantified in both soil and food samples. The soil samples were highly contaminated with Cr (320 mg/kg), Ni (108 mg/kg), and Cd (2.55 mg/kg), which exceeded their respective safe limits set by FAO/WHO. Heavy metal concentrations in soil were found in the order of Cr>Ni>Pb>Zn>Cd and showed significantly (p pollution load index (PLI) value was observed greater than three indicating high level of contamination in the study area. The concentrations of Cr (1.80-6.99 mg/kg) and Cd (0.21-0.90 mg/kg) in foodstuffs exceeded their safe limits, while Zn, Pb, and Ni concentrations were observed within their safe limits. In all foodstuffs, the selected heavy metal concentrations were accumulated significantly (p 1 for children and can pose potential health threats for local inhabitants. Graphical Abstract Heavy metals released from chromite mining lead to soil and foodstuff contamination and human health risk.

  14. Human health tradeoffs in wellhead drinking water treatment: Comparing exposure reduction to embedded life cycle risks.

    Science.gov (United States)

    Gifford, Mac; Chester, Mikhail; Hristovski, Kiril; Westerhoff, Paul

    2018-01-01

    Treatment of drinking water decreases human health risks by reducing pollutants, but the required materials, chemicals, and energy emit pollutants and increase health risks. We explored human carcinogenic and non-carcinogenic disease tradeoffs of water treatment by comparing pollutant dose-response curves against life cycle burden using USEtox methodology. An illustrative wellhead sorbent groundwater treatment system removing hexavalent chromium or pentavalent arsenic serving 3200 people was studied. Reducing pollutant concentrations in drinking water from 20 μg L -1 to 10 μg L -1 avoided 37 potential cancer cases and 64 potential non-cancer disease cases. Human carcinogenicity embedded in treatment was 0.2-5.3 cases, and non-carcinogenic toxicity was 0.2-14.3 cases, depending on technology and degree of treatment. Embedded toxicity impacts from treating Cr(VI) using strong-base anion exchange were 90% of the toxicity impacts for treatment options requiring pH control. In scenarios where benefits exceeded burdens, tradeoffs still existed. Benefits are experienced by a local population but burdens are born externally where the materials and energy are produced, thus exporting the health risks. Even when burdens clearly exceeded benefits, cost considerations may still drive selecting a detrimental treatment level or technology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The health effects of depleted uranium munitions. Summary

    International Nuclear Information System (INIS)

    2002-01-01

    The three main routes of human exposure to DU on the battlefield are inhalation, ingestion and wounding. On impact with an armoured vehicle substantial amounts of DU may be dispersed as particles that can be inhaled and DU fragments may cause shrapnel wounds. Due to the lack of measurements of actual levels, our approach has been to estimate the typical levels of exposure on the battlefield over a wide range of scenarios, and the worst- case exposures that are unlikely to be exceeded. From these we calculated the potential health risks from radiation and toxic effects. We have also considered relevant animal studies and epidemiological studies of occupational exposures to uranium in other situations as an independent source of information on the risks of inhaling DU particles, although we recognise that the parallels may not be precise

  16. The Need to Increase Regulatory Controls on Imports and Exports came from the Detection of an Argentine Import Containing Exceeding Pellets of Ir-192

    International Nuclear Information System (INIS)

    Samsolo, N.A.; Vidal, D.N.

    2011-01-01

    In Argentina, radioactive sources for application in Industrial Gamma radiography are manufactured using small metallic discs called pellets of radioactive isotope Ir-192, that are imported. They have to be shipped in specially sealed recipients according to their high radioactive levels. These recipients are large enough to contain activities as high as 296 TBq and are therefore approved as Type B(U) packages. This paper thoroughly describes a particular import of this material in which an exceeding 220 ± 2 Pellets (75,62 TBq) was found. The total amount of activity had not been declared adequately by the consignor. The corresponding notification to the Argentine Nuclear Regulatory Authority (NRA) was made by the importer and national manufacturer at the moment these particular Pellets were to be used for source production. The exceeding material doubled that which had been authorized to be imported. After the notification and since the material had entered to the country illicitly, customs legislations were applied in a legal process in which the Nuclear Regulatory Authority participated as well. The decision of the judge was to ship the exceeding cargo again to its proceeding country. However, a significant time had passed since the cargo arrived and the pellets had stuck to each other due to high temperature. This made them impossible to handle in order to encapsulate them as special form radioactive material again for their shipment in the available Type B(U) package. In the outcome, the material was retained at the manufacturer facilities, in its original packaging, with suitable radiological and physical conditions to guarantee safety and security, waiting until its activity had decayed to acceptable levels for its shipment as Type A package. As a result, a need to require further technical specifications from the vendor was detected. These specifications should warn about the period in which these Pellets may be utilized for source production before

  17. The need to increase regulatory controls on imports and exports came from the detection of an Argentine import containing exceeding pellets of Ir-192

    International Nuclear Information System (INIS)

    Samsolo, Nicolas; Vidal, Dora

    2008-01-01

    In Argentina, radioactive sources for application in industrial gamma radiography are manufactured using small metallic discs called pellets of radioactive isotope Ir-192, that are imported. They are to be shipped in specially sealed recipients according to their high radioactive levels. These recipients are large enough to contain activities as high as 296 TBq and are therefore approved as type B (U) packages. This paper thoroughly describes a particular import of this material in which an exceeding 220±2 pellets (75,62 TBq) was found. The total amount of activity had not been declared adequately by the consignor. The corresponding notification to the Argentine Nuclear Regulatory Authority (NRA) was made by the importer and national manufacturer at the moment these particular pellets were to be used for source production. The exceeding material doubled that which had been authorized to be imported. After the notification and since the material had entered to the country Illicitly, customs legislation were applied in a legal process in which the Nuclear regulatory Authority participated as well. The decision of the judge was to ship the exceeding cargo again to its proceeding country. However, a significant time had passed since the cargo arrived and the pellets has struck to each other due to high temperature. This made them impossible to handle in order to encapsulate them as special form radioactive material again for their shipment in the available Type B (U) package. In the outcome, the material was retained at the manufacturer facilities, in its original packaging, with suitable radiological and physical conditions to guarantee safety and security, waiting until its activity had decayed to acceptable levels for its shipments as type A package. As a result, a need to require further technical specifications from the vendor was detected. These specifications should warn about the period in which these pellets may be utilized for source production before

  18. Technical specifications: Health Physics Research Reactor

    International Nuclear Information System (INIS)

    1986-03-01

    These technical specifications define the key limitations that must be observed for safe operation of the Health Physics Research Reactor (HPRR) and an envelope of operation within which there is assurance that these limits will not be exceeded

  19. Mental health and school dropout across educational levels and genders: a 4.8-year follow-up study

    Directory of Open Access Journals (Sweden)

    Cathrine F. Hjorth

    2016-09-01

    Full Text Available Abstract Background Education is a key determinant of future employment and income prospects of young people. Poor mental health is common among young people and is related to risk of dropping out of school (dropout. Educational level and gender might play a role in the association, which remains to be studied. Methods Mental health was measured in 3146 Danish inhabitants aged 16–29 years using the 12-Item Short-Form Health Survey and examined across genders and educational levels. For students, educational level at baseline was used; for young people who were not enrolled in school at baseline (non-students, the highest achieved educational level was used. The risk of dropout in students was investigated in administrative registers over a 4.8–year period (1st March 2010–31th December 2014. Odds ratios (OR and 95 % confidence intervals (CI were calculated for mental health and in relation to dropout in logistic regression models, adjusting for age, gender, educational level, parental education, parental income and ethnicity. Results Poor mental health was present in 24 % (n = 753 of the participants, 29 % (n = 468 in females and 19 % (n = 285 in males (p < 0.0001. The prevalence differed from 19 to 39 % across educational levels (p < 0.0001. Females had a statistically significantly higher adjusted risk of poor mental health than males (OR = 1.8, CI = 1.5–2.2. Among the students the lowest risk was found at the elementary level (OR = 1.3, CI = 0.8–2.3, while students in higher education had a statistically significantly higher risk (OR = 1.9, CI = 1.2–2.9. The lowest-educated non-students had the highest OR of poor mental health (OR = 3.3, CI = 2.1–5.4. Dropout occurred in 8 % (n = 124 of the students. Poor mental health was associated to dropout in vocational (OR = 1.8, CI = 1.0–3.2 and higher education (OR = 2.0, CI = 1.0–4.2. For males in higher

  20. Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

    Science.gov (United States)

    Agyepong, I A

    1999-03-01

    Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.

  1. Essential levels of health information in Europe: an action plan for a coherent and sustainable infrastructure.

    Science.gov (United States)

    Carinci, Fabrizio

    2015-04-01

    The European Union needs a common health information infrastructure to support policy and governance on a routine basis. A stream of initiatives conducted in Europe during the last decade resulted into several success stories, but did not specify a unified framework that could be broadly implemented on a continental level. The recent debate raised a potential controversy on the different roles and responsibilities of policy makers vs the public health community in the construction of such a pan-European health information system. While institutional bodies shall clarify the statutory conditions under which such an endeavour is to be carried out, researchers should define a common framework for optimal cross-border information exchange. This paper conceptualizes a general solution emerging from past experiences, introducing a governance structure and overarching framework that can be realized through four main action lines, underpinned by the key principle of "Essential Levels of Health Information" for Europe. The proposed information model is amenable to be applied in a consistent manner at both national and EU level. If realized, the four action lines outlined here will allow developing a EU health information infrastructure that would effectively integrate best practices emerging from EU public health initiatives, including projects and joint actions carried out during the last ten years. The proposed approach adds new content to the ongoing debate on the future activity of the European Commission in the area of health information. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Health-hazard-evaluation report HETA 83-144-2001, Feed Materials Production Center (Westinghouse Materials Company of Ohio), Fernald, Ohio

    International Nuclear Information System (INIS)

    Boiano, J.M.; Moss, C.E.; Burr, G.A.

    1989-12-01

    In response to a request from District 34, International Association of Machinists, an evaluation was made of possible health problems arising among employees at the Feed Materials Production Center, Fernald, Ohio. The company was a large scale integrated uranium metals production facility which converted a variety of chemical forms of depleted or slightly enriched uranium into uranium metal. Approximately 850 workers were employed at the time of this study. A cross sectional study was made of the workers which included evaluations for evidence of lung and kidney disease attributable to uranium exposure. The ratio of the 1 second forced expiratory volume to the forced vital capacity was associated with a job history derived uranium exposure index. Shortness of breath was associated with a self reported history of uranium exposure incidents. Measurements were taken of surface alpha particle radiation contamination at approximately 50 worksites in the facility. In all but one case the levels of contamination exceeded the recommended allowable limits. Air samples indicated nitrogen-dioxide was the only chemical air contaminant which exceeded current criteria. The authors conclude that a potential health hazard existed due to high levels of surface alpha particle contamination. The authors recommend specific measures to lower worker exposures

  3. Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015-2016.

    Science.gov (United States)

    Nguyen, Quynh C; McCullough, Matt; Meng, Hsien-Wen; Paul, Debjyoti; Li, Dapeng; Kath, Suraj; Loomis, Geoffrey; Nsoesie, Elaine O; Wen, Ming; Smith, Ken R; Li, Feifei

    2017-11-01

    To leverage geotagged Twitter data to create national indicators of the social environment, with small-area indicators of prevalent sentiment and social modeling of health behaviors, and to test associations with county-level health outcomes, while controlling for demographic characteristics. We used Twitter's streaming application programming interface to continuously collect a random 1% subset of publicly available geo-located tweets in the contiguous United States. We collected approximately 80 million geotagged tweets from 603 363 unique Twitter users in a 12-month period (April 2015-March 2016). Across 3135 US counties, Twitter indicators of happiness, food, and physical activity were associated with lower premature mortality, obesity, and physical inactivity. Alcohol-use tweets predicted higher alcohol-use-related mortality. Social media represents a new type of real-time data that may enable public health officials to examine movement of norms, sentiment, and behaviors that may portend emerging issues or outbreaks-thus providing a way to intervene to prevent adverse health events and measure the impact of health interventions.

  4. A meta-level analysis of major trends in environmental health risk governance

    NARCIS (Netherlands)

    Runhaar, H.A.C.; Driessen, P.P.J.; Bree, L. van; Sluijs, J.P. van der

    2010-01-01

    Internationally but also within countries, large differences exist regarding how environmental health risks (EHRs) are governed. Despite these differences, at a meta-level some general trends can be discerned that may point to a convergence of EHR governance regimes. One, EHR governance regimes are

  5. Effects of Minority Stress, Group-Level Coping, and Social Support on Mental Health of German Gay Men.

    Science.gov (United States)

    Sattler, Frank A; Wagner, Ulrich; Christiansen, Hanna

    2016-01-01

    According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1) it was hypothesized that minority stressors would positively predict mental health problems and that 2) group-level coping and social support variables would moderate these predictions negatively. Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity), group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism), and social support (gay social support and non-gay social support). A moderated multiple regression was conducted. Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems. The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.

  6. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  7. Social capital and health: measuring and understanding social capital at a local level could help to tackle health inequalities more effectively.

    Science.gov (United States)

    Pilkington, Paul

    2002-09-01

    This paper examines whether an understanding of the concept of social capital and its local measurement can help to tackle inequalities in health within and across communities. The paper concludes that the concept of social capital offers a valuable opportunity to help public health professionals understand how to approach inequalities in health with a greater awareness of the social processes affecting the health of communities. The measurement of social capital has been problematic. However, new guidance from the Health Development Agency (HDA) provides a useful tool for developing social capital research. A greater understanding of whether, and how social capital relates to health will help to improve strategies to reduce health inequalities at the community level. Public health professionals contributing to community development strategies such as Neighbourhood Renewal Projects, Community Safety Partnerships, Health Action Zones and Health Improvement Programmes (HImPs) should encourage thought to be given about the role that an understanding of social capital could play in making these strategies more effective. Using the HDA measurement tool locally could be one way of doing this.

  8. Estimating the prevalence of 26 health-related indicators at neighbourhood level in the Netherlands using structured additive regression.

    Science.gov (United States)

    van de Kassteele, Jan; Zwakhals, Laurens; Breugelmans, Oscar; Ameling, Caroline; van den Brink, Carolien

    2017-07-01

    Local policy makers increasingly need information on health-related indicators at smaller geographic levels like districts or neighbourhoods. Although more large data sources have become available, direct estimates of the prevalence of a health-related indicator cannot be produced for neighbourhoods for which only small samples or no samples are available. Small area estimation provides a solution, but unit-level models for binary-valued outcomes that can handle both non-linear effects of the predictors and spatially correlated random effects in a unified framework are rarely encountered. We used data on 26 binary-valued health-related indicators collected on 387,195 persons in the Netherlands. We associated the health-related indicators at the individual level with a set of 12 predictors obtained from national registry data. We formulated a structured additive regression model for small area estimation. The model captured potential non-linear relations between the predictors and the outcome through additive terms in a functional form using penalized splines and included a term that accounted for spatially correlated heterogeneity between neighbourhoods. The registry data were used to predict individual outcomes which in turn are aggregated into higher geographical levels, i.e. neighbourhoods. We validated our method by comparing the estimated prevalences with observed prevalences at the individual level and by comparing the estimated prevalences with direct estimates obtained by weighting methods at municipality level. We estimated the prevalence of the 26 health-related indicators for 415 municipalities, 2599 districts and 11,432 neighbourhoods in the Netherlands. We illustrate our method on overweight data and show that there are distinct geographic patterns in the overweight prevalence. Calibration plots show that the estimated prevalences agree very well with observed prevalences at the individual level. The estimated prevalences agree reasonably well with the

  9. Low level ionizing radiation and human mortality: multi-regional epidemiological studies

    International Nuclear Information System (INIS)

    Hickey, R.J.; Bowers, E.J.; Spence, D.E.; Zemel, B.S.; Clelland, A.B.; Clelland, R.C.

    1981-01-01

    Analyses of relationships involving environmental chemicals, background radiation, and mortality rates for diseases of the heart and several cancer categories are presented. Bivariate correlation coefficients between radiation and mortality rate were significantly negative for cancer of the lung and respiratory organs, cancer of the buccal cavity and pharynx, cancer of the digestive organs and peritoneum, total cancer and diseases of the heart. Only the correlation coefficient between background radiation and leukemia-aleukemia was positive, and that not significantly positive. Initial multivariate statistical studies support the bivariate results in that all significant regression terms that represent background radiation have been negative. Background radiation level was not a significant predictor for leukemia-aleukemia mortality rate when examined without regard to age. This preliminary work suggests that any health effects of background radiation on the diseases studied do not exceed in magnitude those of environmental chemicals. It also suggests that models implying important long-term deleterious effects of low levels of ionizing radiation on humans may be invalid. (author)

  10. Assessment of Work Zone Noise Levels at a Cement Factory in ...

    African Journals Online (AJOL)

    Assessment of Work Zone Noise Levels at a Cement Factory in Tanga, Tanzania. ... measured in most production sections exceeded the allowed limit value of 85 ... Keywords: Noise levels, Noise exposure, Cement factory, Survey, Tanzania ...

  11. Risk estimation and decision making: the health effects on populations of exposure to low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1982-01-01

    Presented is a background for an understanding of the potential health effects in populations exposed to low-level radiation. Discussed is the knowledge about the health effects of low-level radiation. Comments on how the risks of radiation-induced cancer and genetically-related ill-health in man may be estimated, the sources of the scientific and epidemiological data, the dose-response models used, and the uncertainties which limit precise estimates of excess risks from radiation. Also discussed are the implications of numerical risk estimation for radiation protection and decision-making for public health policy

  12. Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: a representative statewide survey.

    Science.gov (United States)

    Kaphingst, Kimberly A; Weaver, Nancy L; Wray, Ricardo J; Brown, Melissa L R; Buskirk, Trent; Kreuter, Matthew W

    2014-10-07

    The effects of health literacy are thought to be based on interactions between patients' skill levels and health care system demands. Little health literacy research has focused on attributes of health care organizations. We examined whether the attribute of individuals' experiences with front desk staff, patient engagement through bringing questions to a doctor visit, and health literacy skills were related to two patient-reported outcomes. We administered a telephone survey with two sampling frames (i.e., household landline, cell phone numbers) to a randomly selected statewide sample of 3358 English-speaking adult residents of Missouri. We examined two patient-reported outcomes - whether or not respondents reported knowing more about their health and made better choices about their health following their last doctor visit. Multivariable logistic regression models were used to examine the independent contributions of predictor variables (i.e., front desk staff, bringing questions to a doctor visit, health literacy skills). Controlling for self-reported health, having a personal doctor, time since last visit, number of chronic conditions, health insurance, and sociodemographic characteristics, respondents who had a good front desk experience were 2.65 times as likely (95% confidence interval [CI]: 2.13, 3.30) and those who brought questions were 1.73 times as likely (95% CI: 1.32, 2.27) to report knowing more about their health after seeing a doctor. In a second model, respondents who had a good front desk experience were 1.57 times as likely (95% CI: 1.26, 1.95) and those who brought questions were 1.66 times as likely (95% CI: 1.29, 2.14) to report making better choices about their health after seeing a doctor. Patients' health literacy skills were not associated with either outcome. Results from this representative statewide survey may indicate that one attribute of a health care organization (i.e., having a respectful workforce) and patient engagement through

  13. Developing population segments with different levels of complexity and primary health care needs: An analysis using health administrative data in British Columbia, Canada

    Directory of Open Access Journals (Sweden)

    Julia Langton

    2017-04-01

    We developed population segments designed to account for patient complexity and primary health care needs; as such, segments provide more information than traditional indices of morbidity burden based on counts of chronic conditions. These segments will be used to report information on the quality of primary care. We plan to include conduct validation studies using additional variables (e.g, socio-economic factors, level of vulnerability from patient surveys so that segments more accurately represent the level of complexity and patients’ primary health care needs.

  14. Toxic element contamination of natural health products and pharmaceutical preparations.

    Directory of Open Access Journals (Sweden)

    Stephen J Genuis

    Full Text Available BACKGROUND: Concern has recently emerged regarding the safety of natural health products (NHPs-therapies that are increasingly recommended by various health providers, including conventional physicians. Recognizing that most individuals in the Western world now consume vitamins and many take herbal agents, this study endeavored to determine levels of toxic element contamination within a range of NHPs. METHODS: Toxic element testing was performed on 121 NHPs (including Ayurvedic, traditional Chinese, and various marine-source products as well as 49 routinely prescribed pharmaceutical preparations. Testing was also performed on several batches of one prenatal supplement, with multiple samples tested within each batch. Results were compared to existing toxicant regulatory limits. RESULTS: Toxic element contamination was found in many supplements and pharmaceuticals; levels exceeding established limits were only found in a small percentage of the NHPs tested and none of the drugs tested. Some NHPs demonstrated contamination levels above preferred daily endpoints for mercury, cadmium, lead, arsenic or aluminum. NHPs manufactured in China generally had higher levels of mercury and aluminum. CONCLUSIONS: Exposure to toxic elements is occurring regularly as a result of some contaminated NHPs. Best practices for quality control-developed and implemented by the NHP industry with government oversight-is recommended to guard the safety of unsuspecting consumers.

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

    International Nuclear Information System (INIS)

    Bender, M.A.

    1976-01-01

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

  16. Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants

    Science.gov (United States)

    Burton, Scot; Creyer, Elizabeth H.; Kees, Jeremy; Huggins, Kyle

    2006-01-01

    Objectives. Requiring restaurants to present nutrition information on menus is under consideration as a potential way to slow the increasing prevalence of obesity. Using a survey methodology, we examined how accurately consumers estimate the nutrient content of typical restaurant meals. Based on these results, we then conducted an experiment to address how the provision of nutrition information on menus influences purchase intentions and reported preferences. Methods. For both the survey and experiment, data were analyzed using analysis of variance techniques. Results. Survey results showed that levels of calories, fat, and saturated fat in less-healthful restaurant items were significantly underestimated by consumers. Actual fat and saturated fat levels were twice consumers’ estimates and calories approached 2 times more than what consumers expected. In the subsequent experiment, for items for which levels of calories, fat, and saturated fat substantially exceeded consumers’ expectations, the provision of nutrition information had a significant influence on product attitude, purchase intention, and choice. Conclusions. Most consumers are unaware of the high levels of calories, fat, saturated fat, and sodium found in many menu items. Provision of nutrition information on restaurant menus could potentially have a positive impact on public health by reducing the consumption of less-healthful foods. PMID:16873758

  17. Building a competent health manager at district level: a grounded theory study from Eastern Uganda.

    Science.gov (United States)

    Tetui, Moses; Hurtig, Anna-Karin; Ekirpa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

    2016-11-21

    Health systems in low-income countries are often characterized by poor health outcomes. While many reasons have been advanced to explain the persistently poor outcomes, management of the system has been found to play a key role. According to a WHO framework, the management of health systems is central to its ability to deliver needed health services. In this study, we examined how district managers in a rural setting in Uganda perceived existing approaches to strengthening management so as to provide a pragmatic and synergistic model for improving management capacity building. Twenty-two interviews were conducted with district level administrative and political managers, district level health managers and health facility managers to understand their perceptions and definitions of management and capacity building. Kathy Charmaz's constructive approach to grounded theory informed the data analysis process. An interative, dynamic and complex model with three sub-process of building a competent health manager was developed. A competent manager was understood as one who knew his/her roles, was well informed and was empowered to execute management functions. Professionalizing health managers which was viewed as the foundation, the use of engaging learning approaches as the inside contents and having a supportive work environment the frame of the model were the sub-processes involved in the model. The sub-processes were interconnected although the respondents agreed that having a supportive work environment was more time and effort intensive relative to the other two sub-processes. The model developed in our study makes four central contributions to enhance the WHO framework and the existing literature. First, it emphasizes management capacity building as an iterative, dynamic and complex process rather than a set of characteristics of competent managers. Second, our model suggests the need for professionalization of health managers at different levels of the health

  18. Comparison of Health Behaviors Among Women Brothel Workers to Those of the General Population of Women in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Pia Vivian; Arnfred, Anders; Algren, Maria Holst

    2016-01-01

    of wanting to quit smoking was lower. The prevalence rates of exceeding the Danish high-risk level of alcohol consumption, binge drinking, and illicit drug use were higher among women brothel workers compared to Danish women. The prevalence of underweight was higher and overweight and obesity lower among...... brothel workers compared to Danish women. These differences were significant when adjusted for age and educational level. We noted few differences regarding dietary habits and no differences regarding physical activity. Our findings suggest the need for health promotion initiatives, particularly...... for smoking, alcohol consumption and drug use, targeted at women brothel workers....

  19. Cost of delivering secondary-level health care services through public sector district hospitals in India

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2017-01-01

    Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

  20. Preparing master-level mental health nurses to work within a wellness paradigm: Findings from the eMenthe project.

    Science.gov (United States)

    Doyle, Louise; Ellilä, Heikki; Jormfeldt, Henrika; Lahti, Mari; Higgins, Agnes; Keogh, Brian; Meade, Oonagh; Sitvast, Jan; Skärsäter, Ingela; Stickley, Theo; Kilkku, Nina

    2018-04-01

    Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship. © 2017 Australian College of Mental Health Nurses Inc.

  1. Estimating oxygen needs for childhood pneumonia in developing country health systems: a new model for expecting the unexpected.

    Directory of Open Access Journals (Sweden)

    Beverly D Bradley

    Full Text Available Planning for the reliable and cost-effective supply of a health service commodity such as medical oxygen requires an understanding of the dynamic need or 'demand' for the commodity over time. In developing country health systems, however, collecting longitudinal clinical data for forecasting purposes is very difficult. Furthermore, approaches to estimating demand for supplies based on annual averages can underestimate demand some of the time by missing temporal variability.A discrete event simulation model was developed to estimate variable demand for a health service commodity using the important example of medical oxygen for childhood pneumonia. The model is based on five key factors affecting oxygen demand: annual pneumonia admission rate, hypoxaemia prevalence, degree of seasonality, treatment duration, and oxygen flow rate. These parameters were varied over a wide range of values to generate simulation results for different settings. Total oxygen volume, peak patient load, and hours spent above average-based demand estimates were computed for both low and high seasons.Oxygen demand estimates based on annual average values of demand factors can often severely underestimate actual demand. For scenarios with high hypoxaemia prevalence and degree of seasonality, demand can exceed average levels up to 68% of the time. Even for typical scenarios, demand may exceed three times the average level for several hours per day. Peak patient load is sensitive to hypoxaemia prevalence, whereas time spent at such peak loads is strongly influenced by degree of seasonality.A theoretical study is presented whereby a simulation approach to estimating oxygen demand is used to better capture temporal variability compared to standard average-based approaches. This approach provides better grounds for health service planning, including decision-making around technologies for oxygen delivery. Beyond oxygen, this approach is widely applicable to other areas of

  2. Cognitive level and health decision-making in children: A preliminary study.

    Science.gov (United States)

    Okwumabua, J O; Okwumabua, T M; Hayes, A; Stovall, K

    1994-06-01

    The study examines children's stage of cognitive development in relation to their patterns of health decision-making, including their cognitive capabilities in integrating the sequential stages of the decision-making process. A sample of 81 male (N=33) and female (N=48) students were drawn from two urban public schools in West Tennessee. All participants in the study were of African-American descent. The Centers for Disease Control Decision-Making Instrument was used to assess students' decision-making as well as their understanding of the decision-making process. The children's cognitive level was determined by their performance on three Piagetian conservation tasks. Findings revealed that both the preoperational and concrete operational children performed significantly below the formal operational children in terms of total correct responses to the decision-making scenarios. Error type analyses indicated that the preoperational children made more errors involving "skipped step" than did either the concrete or formal operational children. There were no significant differences between children's level of cognitive development and any other error type. Implications for health promotion and disease prevention programs among prevention practitioners who work regularly with children are discussed.

  3. A Population-Level Data Analytics Portal for Self-Administered Lifestyle and Mental Health Screening.

    Science.gov (United States)

    Zhang, Xindi; Warren, Jim; Corter, Arden; Goodyear-Smith, Felicity

    2016-01-01

    This paper describes development of a prototype data analytics portal for analysis of accumulated screening results from eCHAT (electronic Case-finding and Help Assessment Tool). eCHAT allows individuals to conduct a self-administered lifestyle and mental health screening assessment, with usage to date chiefly in the context of primary care waiting rooms. The intention is for wide roll-out to primary care clinics, including secondary school based clinics, resulting in the accumulation of population-level data. Data from a field trial of eCHAT with sexual health questions tailored to youth were used to support design of a data analytics portal for population-level data. The design process included user personas and scenarios, screen prototyping and a simulator for generating large-scale data sets. The prototype demonstrates the promise of wide-scale self-administered screening data to support a range of users including practice managers, clinical directors and health policy analysts.

  4. Methods for estimating annual exceedance-probability discharges and largest recorded floods for unregulated streams in rural Missouri.

    Science.gov (United States)

    2014-01-01

    Regression analysis techniques were used to develop a : set of equations for rural ungaged stream sites for estimating : discharges with 50-, 20-, 10-, 4-, 2-, 1-, 0.5-, and 0.2-percent : annual exceedance probabilities, which are equivalent to : ann...

  5. Effects of Minority Stress, Group-Level Coping, and Social Support on Mental Health of German Gay Men.

    Directory of Open Access Journals (Sweden)

    Frank A Sattler

    Full Text Available According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1 it was hypothesized that minority stressors would positively predict mental health problems and that 2 group-level coping and social support variables would moderate these predictions negatively.Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity, group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism, and social support (gay social support and non-gay social support. A moderated multiple regression was conducted.Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems.The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.

  6. Using key performance indicators as knowledge-management tools at a regional health-care authority level.

    Science.gov (United States)

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

    The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  8. Australian health professionals' health website recommendation trends.

    Science.gov (United States)

    Usher, Wayne T

    2011-08-01

    This study was concerned with indentifying motivations and trends associated with a health website recommendation from eight of Australia's major health professions to the health consumer. Health professions included in this study are: psychiatrists, general practitioners, social workers, dietitians, chiropractors, physiotherapists, optometrists and pharmacists. An online survey (www.limesurvey.org) was developed from a common set of questions negotiated between all eight health professions. Survey questions were constructed in an attempt to identify participants' reasons for or against recommending a health website to a patient. A 5-point scale (not, slightly, neutral, moderately, strongly) to measure influence was used throughout the question set. This study indicates that Australian general practitioners (GPs) were the highest Australian health professionals to undertake a health website recommendation (86%), followed by psychiatrists (80%), with the lowest being physiotherapists (42%) and optometrists (33%). A profile of the Australian health professional who recommends a health website is identified as male, aged above 50 years, has had more than 10 years experience, works in a major city, is in private practice and has patient numbers exceeding 500 in a 12-month period (2009). Recommendations from this study include the need to develop mechanisms that identify high-quality online medical information and the development and implementation of Continuing Professional Development (CPD) courses which up-skill health professionals concerning the recommendation of health websites for health care delivery.

  9. Potentially toxic contamination of sediments, water and two animal species in Lake Kalimanci, FYR Macedonia: Relevance to human health

    International Nuclear Information System (INIS)

    Vrhovnik, Petra; Arrebola, Juan P.; Serafimovski, Todor; Dolenec, Tadej; Šmuc, Nastja Rogan; Dolenec, Matej; Mutch, Elaine

    2013-01-01

    The objectives of the research were: (1) to examine the concentrations of metals in Vimba melanops and Rana temporaria and (2) to evaluate the potential risks of the contaminated organisms to human health in Makedonska Kamenica region. Analyses identified high levels of Cr, Hg, Ni and Pb in studied animals, which also exceeded their permissible levels in food. In sediment and soil samples, levels of Cd, Cu, Cr, Pb, Zn and As were perceived, while Cd, Cu, Ni, Pb, Se and As were increased in water samples. Results of transfer factor revealed that the examined animals had higher bioaccumulation rate from surrounding waters than from sediments or soils. The accomplished Health Risk Index disclosed that studied animals can have considerably high health risks for inhabitants. Conclusively, they could be considered as highly contaminated with metals and can consequently harm human health, especially children in their early development stages. -- Highlights: •The study merges the accumulation of PTE in animal species, sediments, soils and water. •Correlation between different media and their impact to living organisms'. •Considerably high health risks for inhabitants. -- In the Makedonska Kamenica region had been described several potential sources of exposure therefore exists the potential threat to human health

  10. [The physical activity level of people working at a regional health office in Lima, Peru].

    Science.gov (United States)

    Sanabria-Rojas, Hernán; Tarqui-Mamani, Carolina; Portugal-Benavides, Walter; Pereyra-Zaldívar, Héctor; Mamani-Castillo, Lorenzo

    2014-01-01

    Determining the prevalence of physical activity for health workers from a regional health office in Lima; their nutritional status and history of non-communicable diseases is also described. The study was cross-sectional and observations were made between August and November 2012. The study population involved 172 health workers working at a regional health office in Lima (DIRESA) according to the inclusion criteria and their acceptance of the offer to participate. Workers were excluded who had some kind of physical limitation regarding physical exercise. Their physical activity level was determined by using the International Physical Activity Questionnaire (IPAQ) which measures physical activity domains: work, home, transport and leisure. SPSS-19 was used for processed the data and nutritional status was evaluated using the body mass index (BMI), according to WHO classification. 88.0 % of DIRESA workers had a low level of physical activity and 64.0 % were overweight. Among the most common non-communicable diseases, it was found that 4.7 % had diabetes, 15.6 % hypertension, 32.6 % dyslipidaemia and 15.0 % smoked. DIRESA workers had a high prevalence of physical inactivity and excess weight, so it is advisable to implement healthy policies helping to improve their health.

  11. High levels of DDT in breast milk: Intake, risk, lactation duration, and involvement of gender

    International Nuclear Information System (INIS)

    Bouwman, Hindrik; Kylin, Henrik; Sereda, Barbara; Bornman, Riana

    2012-01-01

    We investigated presence and levels of DDT in 163 breast milk samples from four South African villages where, in three of them, malaria is controlled with DDT-sprayed indoors. Mean ΣDDT levels in breast milk were 18, 11, and 9.5 mg/kg mf (milk fat) from the three DDT-sprayed villages, respectively, including the highest ΣDDT level ever reported for breast milk from South Africa (140 mg/kg mf). Understanding the causes for these differences would be informative for exposure reduction intervention. The Provisional Tolerable Daily Intake (PTDI) for DDT by infants, and the Maximum Residue Limit (MRL) were significantly exceeded. DDT had no effect on duration of lactation. There were indications (not significant) from DDT-sprayed villages that first-born female infants drink milk with more ΣDDT than first-born male infants, and vice versa for multipara male and female infants, suggesting gender involvement on levels of DDT in breast milk – requiring further investigation. - Highlights: ► The highest ΣDDT in breast milk ever found in South Africa is reported. ► Maximum Residue Limit is exceeded, up to 99 times. ► Provisional Tolerable Daily Intake is exceeded, up to 310 times. ► High ΣDDT did not affect duration of lactation. ► Infant gender may affect levels of ΣDDT in breast milk. - High levels of DDT in breast milk from a DDT-spayed area exceeded known limits in milk, but did not affect duration lactation. Infant gender may affect levels of ΣDDT in breast milk.

  12. Ground-level Ozone (Smog) Information | New England | US ...

    Science.gov (United States)

    2017-09-05

    Ground-level ozone presents a serious air quality problem in New England. In 2008, EPA revised the ozone standard to a level of 0.075 parts per million, 8-hour average. Over the last 5 years (2006 through 2010), there have been an average of 31 days per summer when New England's air exceeded this standard.

  13. Job satisfaction in nurses working in tertiary level health care settings of Islamabad, Pakistan.

    Science.gov (United States)

    Bahalkani, Habib Akhtar; Kumar, Ramesh; Lakho, Abdul Rehman; Mahar, Benazir; Mazhar, Syeda Batool; Majeed, Abdul

    2011-01-01

    Job satisfaction greatly determines the productivity and efficiency of human resource for health. It literally means: 'the extent to which Health Professionals like or dislike their jobs'. Job satisfaction is said to be linked with employee's work environment, job responsibilities, and powers; and time pressure among various health professionals. As such it affects employee's organizational commitment and consequently the quality of health services. Objective of this study was to determine the level of job satisfaction and factors influencing it among nurses in a public sector hospital of Islamabad. A cross sectional study with self-administered structured questionnaire was conducted in the federal capital of Pakistan, Islamabad. Sample included 56 qualified nurses working in a tertiary care hospital. Overall 86% respondents were dissatisfied with about 26% highly dissatisfied with their job. The work environments, poor fringe benefits, dignity, responsibility given at workplace and time pressure were reason for dissatisfaction. Poor work environment, low salaries, lack of training opportunities, proper supervision, time pressure and financial rewards reported by the respondents. Our findings state a low level of overall satisfaction among workers in a public sector tertiary care health organization in Islamabad. Most of this dissatisfaction is caused by poor salaries, not given the due respect, poor work environment, unbalanced responsibilities with little overall control, time pressure, patient care and lack of opportunities for professional development.

  14. Adaptation level as the basic health status characteristics: possibilitics of its assessment and forecasting of desadaptation violations

    Directory of Open Access Journals (Sweden)

    Vysochyna I.L.

    2015-09-01

    Full Text Available On the basis of comprehensive survey with integrative assessment of health state (medical history data, physical examination, anthropometry, battery of psychological tests (Eysenck, Shmishek’s Personality Inventory (teen version, tapping - test by E.P. Ilyin, children's questionnaire of neuroses; test for rapid assessment of health, activity and mood, anxiety diagnosis by Spielberg - Khanin; Luscher test, color relations test level of adaptation was defined in 236 children from orphanages aged from 4 to 18 years. The manifestations of maladjustment were registered both on psychological level (neuroticism, high anxiety, decreased performance, activity and psychological endurance, sleep disturbance, presence of accentuation and neurotic disorders and somatic level (recurrent acute respiratory infections, poor physical development, exacerbation of chronic foci of infection and burdened biological history; this summarizes conclusions on a low level of health status of children in orphanages. The author has developed mathematical models of adaptation assessment and prediction of desadaptation, which allowed to identify children at risk for the development of adaptation disorders and children with maladjustment; according to the level and severity of maladaptive disorders correction programs are designed.

  15. Serum immunoglobulin levels in the ABCC-JNIH adult health study: Hiroshima and Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    King, R A; Milton, R C; Hamilton, H B

    1973-05-31

    Immunoglobulin levels (IgG, IgA, and IgM) were determined on 2043 individuals in the ABCC-JNIH Adult Health Study population, and levels were compared to disease states and the dose of radiation ATB. Mean levels for both cities and sexes combined were IgG = 1577 mg%, IgA = 312 mg%, and IgM = 127 mg%. Differences between these mean levels and those reported in other studies are thought secondary to racial and environmental factors, and technical differences with the methods used for quantitation. Females had higher IgM levels that tended to go down with advancing age. Of the diseases evaluated, rheumatoid arthritis, cirrhosis, and pulmonary tuberculosis affected immunoglobulin levels the greatest. There was no apparent relationship between radiation dose from the atomic bomb and immunoglobulin levels determined more than 25 years after exposure. (6 tables)

  16. [Equivalent continuous noise level in neonatal intensive care unit associated to burnout syndrome].

    Science.gov (United States)

    Garrido Galindo, A P; Camargo Caicedo, Y; Vélez-Pereira, A M

    2015-01-01

    Noise levels in neonatal intensive care units allow the appearance of symptoms associated with burnout such as stress, irritability, fatigue and emotional instability on health care personnel. The aim of this study was to evaluate the equivalent continuous noise levels in the neonatal intensive care unit and compare the results with noise levels associated with the occurrence of burnout syndrome on the care team. Continuous sampling was conducted for 20 days using a type I sound level meter on the unit. The maximum, the ninetieth percentile and the equivalent continuous noise level (Leq) values were recorded. Noise level is reported in the range of 51.4-77.6 decibels A (dBA) with an average of 64 dBA, 100.6 dBA maximum, and average background noise from 57.9 dBA. Noise levels exceed the standards suggested for neonatal intensive care units, are close to maximum values referred for noise exposure in the occupational standards and to noise levels associated with the onset of burnout; thus allowing to infer the probability of occurrence of high levels of noise present in the unit on the development of burnout in caregivers. Copyright © 2013 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  17. Exploring the nature of governance at the level of implementation for health system strengthening: the DIALHS experience.

    Science.gov (United States)

    Scott, Vera; Schaay, Nikki; Olckers, Patti; Nqana, Nomsa; Lehmann, Uta; Gilson, Lucy

    2014-09-01

    Health system governance has been recognized as a critical element of the health system strengthening agenda. To date, health governance research often focuses at national or global levels, adopting a macro-perspective that deals with governance structures, forms and principles. Little attention has been given to a micro-perspective which recognizes the role of health system actors in governance, or to considering the operational level of the health system. This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. In an embedded case study, action learning and reflection theory were used to design and implement the intervention. Data in this article were drawn from minutes, observations and recorded reflections of the meetings and workshops that comprised the intervention. A theoretical governance framework was used both to understand the context of the intervention and to analyse the dimensions of governance relevant in the experience. The study shows how, through action learning and reflection, local managers in two organizations came to understand how the higher level misalignment of organizational structures and processes imposed governance constraints on them, and to see the impact this had on their organizational relationships. By re-framing the conflict as organizational, they were then able to create opportunities for staff to understand their context and participate in negotiating principles for communication and collaborative work. The result reduced conflict between staff in the two organizations, leading to improved implementation of programme support. Strengthening relationships among those working at local level by building collaborative norms and values is an important part of local health system governance for

  18. Reevaluation of 1999 Health-Based Environmental Screening Levels (HBESLs) for Chemical Warfare Agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Annetta Paule [ORNL; Dolislager, Fredrick G [ORNL

    2007-05-01

    This report evaluates whether new information and updated scientific models require that changes be made to previously published health-based environmental soil screening levels (HBESLs) and associated environmental fate/breakdown information for chemical warfare agents (USACHPPM 1999). Specifically, the present evaluation describes and compares changes that have been made since 1999 to U.S. Environmental Protection Agency (EPA) risk assessment models, EPA exposure assumptions, as well as to specific chemical warfare agent parameters (e.g., toxicity values). Comparison was made between screening value estimates recalculated with current assumptions and earlier health-based environmental screening levels presented in 1999. The chemical warfare agents evaluated include the G-series and VX nerve agents and the vesicants sulfur mustard (agent HD) and Lewisite (agent L). In addition, key degradation products of these agents were also evaluated. Study findings indicate that the combined effect of updates and/or changes to EPA risk models, EPA default exposure parameters, and certain chemical warfare agent toxicity criteria does not result in significant alteration to the USACHPPM (1999) health-based environmental screening level estimates for the G-series and VX nerve agents or the vesicant agents HD and L. Given that EPA's final position on separate Tier 1 screening levels for indoor and outdoor worker screening assessments has not yet been released as of May 2007, the study authors find that the 1999 screening level estimates (see Table ES.1) are still appropriate and protective for screening residential as well as nonresidential sites. As such, risk management decisions made on the basis of USACHPPM (1999) recommendations do not require reconsideration. While the 1999 HBESL values are appropriate for continued use as general screening criteria, the updated '2007' estimates (presented below) that follow the new EPA protocols currently under development

  19. Occupational Health and Safety in Ethiopia: A review of Situational ...

    African Journals Online (AJOL)

    The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. ... Commonly observed hazards in the workplace include occupational noise and ... Exposure to dust in textile and cement factories greatly exceeded ...

  20. MANAGEMENT OF INNOVATION IN HEALTH CARE AT THE REGIONAL LEVEL

    Directory of Open Access Journals (Sweden)

    Ye. G. Totskaya

    2014-01-01

    Full Text Available The paper reviews topical issues of organization and management of innovative activity in the regional health care system.Objective. Development and scientific substantiation of a conceptual model of managing innovation in the regional health care system, introduction of institutional mechanisms for its implementation, and evaluation of their efficacy in using diagnosis and treatment technologies. Objectives of the study included reviewing the organization status and problems hampering the development, identification of prospects, and justification for appropriate changes in innovation in healthcare system and medical science at the regional level.Material and methods. To conduct a comprehensive assessment of the status and meet challenges of innovation promotion, a methodology for social-hygienic research was worked out including bibliographic and analytical methods, situational analysis, sociological and economic methods, expert assessment, methods for quality management system audit in accordance with ISO 19011:2002, IDEFO function modeling (RD IDEF0-2000, and organizational modeling. The study was based on the analysis of foreign and domestic literature, statistics, methods for managerial modeling, as well as management experience (including innovative methodological approaches gained by Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan which meets the requirements for a platform for research and innovative product reproduction, including research, clinical, organizational, and managerial aspects. Other facilities were considered in conjunction with the leading innovative platform.Results. The paper presents a scientifically based model of innovative medical environment with its elements as subjects, each with a set of functions. Conceptual model for management includes structuring (resource, processes, and quality management; application of international standards and strategic management mechanisms

  1. Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men.

    Science.gov (United States)

    Brambilla, Donald J; O'Donnell, Amy B; Matsumoto, Alvin M; McKinlay, John B

    2007-12-01

    Estimates of intraindividual variation in hormone levels provide the basis for interpreting hormone measurements clinically and for developing eligibility criteria for trials of hormone replacement therapy. However, reliable systematic estimates of such variation are lacking. To estimate intraindividual variation of serum total, free and bioavailable testosterone (T), dihydrotestosterone (DHT), SHBG, LH, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), oestrone, oestradiol and cortisol, and the contributions of biological and assay variation to the total. Paired blood samples were obtained 1-3 days apart at entry and again 3 months and 6 months later (maximum six samples per subject). Each sample consisted of a pool of equal aliquots of two blood draws 20 min apart. Men aged 30-79 years were randomly selected from the respondents to the Boston Area Community Health Survey, a study of the health of the general population of Boston, MA, USA. Analysis was based on 132 men, including 121 who completed all six visits, 8 who completed the first two visits and 3 who completed the first four visits. Day-to-day and 3-month (long-term) intraindividual standard deviations, after transforming measurements to logarithms to eliminate the contribution of hormone level to intraindividual variation. Biological variation generally accounted for more of total intraindividual variation than did assay variation. Day-to-day biological variation accounted for more of the total than did long-term biological variation. Short-term variability was greater in hormones with pulsatile secretion (e.g. LH) than those that exhibit less ultradian variation. Depending on the hormone, the intraindividual standard deviations imply that a clinician can expect to see a difference exceeding 18-28% about half the time when two measurements are made on a subject. The difference will exceed 27-54% about a quarter of the time. Given the level of intraindividual variability in hormone

  2. Risk assessment of coccidostatics during feed cross-contamination: Animal and human health aspects

    Energy Technology Data Exchange (ETDEWEB)

    Dorne, J.L.C.M., E-mail: jean-lou.dorne@efsa.europa.eu [European Food Safety Authority, Unit on Contaminants in the Food Chain, Parma (Italy); Fernández-Cruz, M.L. [Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid (Spain); Bertelsen, U. [European Food Safety Authority, Unit on Contaminants in the Food Chain, Parma (Italy); Renshaw, D.W. [Food Standards Agency, London (United Kingdom); Peltonen, K. [Finnish Food Safety Authority, EVIRA, Helsinki (Finland); Anadon, A. [Universidad Complutense de Madrid, Facultad de Veterinaria, Madrid (Spain); Feil, A. [ForschungsinstitutFuttermitteltechnik, Braunschweig (Germany); Sanders, P. [AFSSA, LERMVD, Fougères (France); Wester, P. [RIVM, Food and Consumer Safety, Bilthoven (Netherlands); Fink-Gremmels, J. [Utrecht University, Veterinary Medicine, Utrecht (Netherlands)

    2013-08-01

    Coccidiosis, an intestinal plasmodium infection, is a major infectious disease in poultry and rabbits. Eleven different coccidiostats are licensed in the EU for the prevention of coccidiosis in these animal species. According to their chemical nature and main biological activity, these compounds can be grouped as ionophoric (monensin, lasalocid sodium, salinomycin, narasin, maduramicin and semduramicin) or non-ionophoric (robenidine, decoquinate, nicarbazin, diclazuril, and halofuginone) substances. Coccidiostats are used as feed additives, mixed upon request into the compounded feed. During the technical process of commercial feed production, cross-contamination of feed batches can result in the exposure of non-target animals and induce adverse health effects in these animals due to a specific sensitivity of mammalian species as compared to poultry. Residue formation in edible tissues of non-target species may result in unexpected human exposure through the consumption of animal products. This review presents recent risk assessments performed by the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). The health risk to non-target species that would result from the consumption of cross-contaminated feed with coccidostats at levels of 2, 5 or 10% was found to be negligible for most animal species with the exception of salinomycin and monensin in horses because of the particular sensitivity for which toxicity may occur when cross-contamination exceeds 2% and 5% respectively. Kinetic data and tissue analyses showed that residues of coccidiostats may occur in the liver and eggs in some cases. However, the level of residues of each coccidiostat in edible animal tissues remained sufficiently low that the aggregate exposure of consumers would not exceed the established acceptable daily intake (ADI) of each coccidiostat. It could be concluded that technical cross-contamination of animal feeds would not be expected to

  3. Risk assessment of coccidostatics during feed cross-contamination: Animal and human health aspects

    International Nuclear Information System (INIS)

    Dorne, J.L.C.M.; Fernández-Cruz, M.L.; Bertelsen, U.; Renshaw, D.W.; Peltonen, K.; Anadon, A.; Feil, A.; Sanders, P.; Wester, P.; Fink-Gremmels, J.

    2013-01-01

    Coccidiosis, an intestinal plasmodium infection, is a major infectious disease in poultry and rabbits. Eleven different coccidiostats are licensed in the EU for the prevention of coccidiosis in these animal species. According to their chemical nature and main biological activity, these compounds can be grouped as ionophoric (monensin, lasalocid sodium, salinomycin, narasin, maduramicin and semduramicin) or non-ionophoric (robenidine, decoquinate, nicarbazin, diclazuril, and halofuginone) substances. Coccidiostats are used as feed additives, mixed upon request into the compounded feed. During the technical process of commercial feed production, cross-contamination of feed batches can result in the exposure of non-target animals and induce adverse health effects in these animals due to a specific sensitivity of mammalian species as compared to poultry. Residue formation in edible tissues of non-target species may result in unexpected human exposure through the consumption of animal products. This review presents recent risk assessments performed by the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). The health risk to non-target species that would result from the consumption of cross-contaminated feed with coccidostats at levels of 2, 5 or 10% was found to be negligible for most animal species with the exception of salinomycin and monensin in horses because of the particular sensitivity for which toxicity may occur when cross-contamination exceeds 2% and 5% respectively. Kinetic data and tissue analyses showed that residues of coccidiostats may occur in the liver and eggs in some cases. However, the level of residues of each coccidiostat in edible animal tissues remained sufficiently low that the aggregate exposure of consumers would not exceed the established acceptable daily intake (ADI) of each coccidiostat. It could be concluded that technical cross-contamination of animal feeds would not be expected to

  4. Artificial Heads for High-Level Impulse Sound Measurement

    National Research Council Canada - National Science Library

    Buck, K

    1999-01-01

    If the Insertion Loss (IL) of hearing protectors has to be determined with very high impulse or continuous noise levels, the acoustic insulation of the Artificial Test Fixture has to exceed at least the Insertion Loss (IL...

  5. Planktivory in the changing Lake Huron zooplankton community: Bythotrephes consumption exceeds that of Mysis and fish

    Science.gov (United States)

    Bunnell, D.B.; Hunter, R. Douglas; Warner, D.M.; Chriscinske, M.A.; Roseman, E.F.

    2011-01-01

    Oligotrophic lakes are generally dominated by calanoid copepods because of their competitive advantage over cladocerans at low prey densities. Planktivory also can alter zooplankton community structure. We sought to understand the role of planktivory in driving recent changes to the zooplankton community of Lake Huron, a large oligotrophic lake on the border of Canada and the United States. We tested the hypothesis that excessive predation by fish (rainbow smelt Osmerus mordax, bloater Coregonus hoyi) and invertebrates (Mysis relicta, Bythotrephes longimanus) had driven observed declines in cladoceran and cyclopoid copepod biomass between 2002 and 2007. We used a field sampling and bioenergetics modelling approach to generate estimates of daily consumption by planktivores at two 91-m depth sites in northern Lake Huron, U.S.A., for each month, May-October 2007. Daily consumption was compared to daily zooplankton production. Bythotrephes was the dominant planktivore and estimated to have eaten 78% of all zooplankton consumed. Bythotrephes consumption exceeded total zooplankton production between July and October. Mysis consumed 19% of all the zooplankton consumed and exceeded zooplankton production in October. Consumption by fish was relatively unimportant - eating only 3% of all zooplankton consumed. Because Bythotrephes was so important, we explored other consumption estimation methods that predict lower Bythotrephes consumption. Under this scenario, Mysis was the most important planktivore, and Bythotrephes consumption exceeded zooplankton production only in August. Our results provide no support for the hypothesis that excessive fish consumption directly contributed to the decline of cladocerans and cyclopoid copepods in Lake Huron. Rather, they highlight the importance of invertebrate planktivores in structuring zooplankton communities, especially for those foods webs that have both Bythotrephes and Mysis. Together, these species occupy the epi-, meta- and

  6. Quantitative analysis of the level of readability of online emergency radiology-based patient education resources.

    Science.gov (United States)

    Hansberry, David R; D'Angelo, Michael; White, Michael D; Prabhu, Arpan V; Cox, Mougnyan; Agarwal, Nitin; Deshmukh, Sandeep

    2018-04-01

    The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales. The search terms included the following: abdominal ultrasound, abdominal aortic aneurysm, aortic dissection, appendicitis, cord compression, CT abdomen, cholecystitis, CT chest, diverticulitis, ectopic pregnancy, epidural hematoma, dural venous thrombosis, head CT, MRI brain, MR angiography, MRI spine, ovarian torsion, pancreatitis, pelvic ultrasound, pneumoperitoneum, pulmonary embolism, subarachnoid hemorrhage, and subdural hematoma. Any content that was not written for patients was excluded. The 230 articles that were assessed were written, on average, at a 12.1 grade level. Only 2 of the 230 articles (1%) were written at the third to seventh grade recommended reading level set forth by the National Institutes of Health (NIH) and American Medical Association (AMA). Fifty-two percent of the 230 articles were written so as to require a minimum of a high school education (at least a 12th grade level). Additionally, 17 of the 230 articles (7.3%) were written at a level that exceeded an undergraduate education (at least a 16th grade level). The majority of websites with emergency radiology-related patient education materials are not adhering to the NIH and AMA's recommended reading levels, and it is likely that the average reader is not benefiting fully from these information outlets. With the link between health literacy and poor health outcomes, it is important to address the online content in this area of radiology, allowing for patient to more fully benefit

  7. Palliative care and the growing health needs of older people in Poland

    Directory of Open Access Journals (Sweden)

    Bartłomiej Drop

    2017-07-01

    Full Text Available The development of medicine and new technologies allows for more effective disease diagnosis and early treatment. Life time was significantly extended for both men and women. Society in Poland and other European countries is aging. The number of people in working age is declining, while the proportion of the oldest age groups is increasing. The aging process is accompanied by an increase in the incidence of senile diseases, chronic diseases such as malignant diseases. The purpose of palliative care is to improve the quality of life of a chronically ill person and family. Palliative care is a holistic approach to the patient, focuses on alleviating suffering, pain, and eliminating psychological, social and spiritual problems. Unfortunately, access to palliative and hospice benefits is still insufficient. Waiting time for health services and especially palliative and hospice care exceeded the socially and medically unacceptable level. Health education is needed to target chronically ill persons, their families and the general public to explain the substance of palliative care, opportunities and what it offers. It is essential for the European countries to respond to the growing health needs of seniors. The reorganization of the health sector should be at local, regional and national levels.

  8. A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India

    Directory of Open Access Journals (Sweden)

    Jyoti Dixit

    2017-01-01

    Full Text Available Introduction: Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. Materials and Methods: A cross-sectional quantitative study was conducted from January to June 2015 among health care workers (n = 354 at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Results: Majority of the regular health-care staff was highly satisfied (86.9% as compared to contractual staff (10.5%, which however was moderately satisfied (55.9%. Stepwise regression model showed that work-related matters (β = 1.370, P < 0.01, organizational facilities (β = 1.586, P < 0.01, privileges attached to the job (β = 0.530, P < 0.01, attention to the suggestions (β = 0.515, P < 0.01, chance of promotion (β = 0.703, P < 0.01, and human resource issues (β = 1.0721, P < 0.01 are strong predictors of overall satisfaction level. Conclusion: Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

  9. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  10. A Dyadic Analysis of Relationships and Health: Does Couple-Level Context Condition Partner Effects?

    OpenAIRE

    Barr, Ashley B.; Simons, Ronald L.

    2014-01-01

    Adding to the growing literature explicating the links between romantic relationships and health, this study examined how both couple-level characteristics, particularly union type (e.g. dating, cohabiting, or marriage) and interracial pairing, and interpersonal characteristics (e.g. partner strain and support) predicted young adults’ physical and mental health. Using dyadic data from a sample of 249 young, primarily African American couples, we hypothesized and found support for the importan...

  11. Health hazards of China’s lead-acid battery industry: a review of its market drivers, production processes, and health impacts

    Science.gov (United States)

    2013-01-01

    Despite China’s leaded gasoline phase out in 2000, the continued high rates of lead poisoning found in children’s blood lead levels reflect the need for identifying and controlling other sources of lead pollution. From 2001 to 2007, 24% of children in China studied (N = 94,778) were lead poisoned with levels exceeding 100 μg/L. These levels stand well above the global average of 16%. These trends reveal that China still faces significant public health challenges, with millions of children currently at risk of lead poisoning. The unprecedented growth of China’s lead-acid battery industry from the electric bike, automotive, and photovoltaic industries may explain these persistently high levels, as China remains the world’s leading producer, refiner, and consumer of both lead and lead-acid batteries. This review assesses the role of China’s rising lead-acid battery industry on lead pollution and exposure. It starts with a synthesis of biological mechanisms of lead exposure followed by an analysis of the key technologies driving the rapid growth of this industry. It then details the four main stages of lead battery production, explaining how each stage results in significant lead loss and pollution. A province-level accounting of each of these industrial operations is also included. Next, reviews of the literature describe how this industry may have contributed to mass lead poisonings throughout China. Finally, the paper closes with a discussion of new policies that address the lead-acid battery industry and identifies policy frameworks to mitigate exposure. This paper is the first to integrate the market factors, production processes, and health impacts of China’s growing lead-acid battery industry to illustrate its vast public health consequences. The implications of this review are two-fold: it validates calls for a nationwide assessment of lead exposure pathways and levels in China as well as for a more comprehensive investigation into the health

  12. 48 CFR 736.602-5 - Short selection process for procurements not to exceed the simplified acquisition threshold.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Short selection process for procurements not to exceed the simplified acquisition threshold. 736.602-5 Section 736.602-5... CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Architect-Engineer Services 736.602-5 Short...

  13. 48 CFR 636.602-5 - Short selection processes for contracts not to exceed the simplified acquisition threshold.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Short selection processes... ARCHITECT-ENGINEER CONTRACTS Architect-Engineer Services 636.602-5 Short selection processes for contracts not to exceed the simplified acquisition threshold. The short selection process described in FAR 36...

  14. Process-based modelling to evaluate simulated groundwater levels and frequencies in a Chalk catchment in south-western England

    Science.gov (United States)

    Brenner, Simon; Coxon, Gemma; Howden, Nicholas J. K.; Freer, Jim; Hartmann, Andreas

    2018-02-01

    Chalk aquifers are an important source of drinking water in the UK. Due to their properties, they are particularly vulnerable to groundwater-related hazards like floods and droughts. Understanding and predicting groundwater levels is therefore important for effective and safe water management. Chalk is known for its high porosity and, due to its dissolvability, exposed to karstification and strong subsurface heterogeneity. To cope with the karstic heterogeneity and limited data availability, specialised modelling approaches are required that balance model complexity and data availability. In this study, we present a novel approach to evaluate simulated groundwater level frequencies derived from a semi-distributed karst model that represents subsurface heterogeneity by distribution functions. Simulated groundwater storages are transferred into groundwater levels using evidence from different observations wells. Using a percentile approach we can assess the number of days exceeding or falling below selected groundwater level percentiles. Firstly, we evaluate the performance of the model when simulating groundwater level time series using a spilt sample test and parameter identifiability analysis. Secondly, we apply a split sample test to the simulated groundwater level percentiles to explore the performance in predicting groundwater level exceedances. We show that the model provides robust simulations of discharge and groundwater levels at three observation wells at a test site in a chalk-dominated catchment in south-western England. The second split sample test also indicates that the percentile approach is able to reliably predict groundwater level exceedances across all considered timescales up to their 75th percentile. However, when looking at the 90th percentile, it only provides acceptable predictions for long time periods and it fails when the 95th percentile of groundwater exceedance levels is considered. By modifying the historic forcings of our model

  15. Time to death and the forecasting of macro-level health care expenditures: some further considerations.

    Science.gov (United States)

    van Baal, Pieter H; Wong, Albert

    2012-12-01

    Although the effect of time to death (TTD) on health care expenditures (HCE) has been investigated using individual level data, the most profound implications of TTD have been for the forecasting of macro-level HCE. Here we estimate the TTD model using macro-level data from the Netherlands consisting of mortality rates and age- and gender-specific per capita health expenditures for the years 1981-2007. Forecasts for the years 2008-2020 of this macro-level TTD model were compared to forecasts that excluded TTD. Results revealed that the effect of TTD on HCE in our macro model was similar to those found in micro-econometric studies. As the inclusion of TTD pushed growth rate estimates from unidentified causes upwards, however, the two models' forecasts of HCE for the 2008-2020 were similar. We argue that including TTD, if modeled correctly, does not lower forecasts of HCE. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Cs-137 and Sr-90 level in diary products

    International Nuclear Information Sys