WorldWideScience

Sample records for health assessment predha

  1. Health needs assessment

    Directory of Open Access Journals (Sweden)

    Ibrahim A Bani

    2008-01-01

    The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools.

  2. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

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

    2007-01-01

    health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...

  3. Health effects assessment summary tables

    International Nuclear Information System (INIS)

    1999-01-01

    The document is an excellent pointer system to identify current literature or changes in assessment criteria for many chemicals of interest to Superfund. It was prepared for Superfund use by the Environmental Criteria and Assessment Office (ECAO-Cin) in EPA's Office of Health and Environmental Assessment. Chemicals considered are those for which Health Effects Assessment Documents, Health and Environmental Effects Profiles, Health Assessment Documents or Air Quality Criteria Documents have been prepared by ECAO. Radionuclides considered are those believed to be most common at Superfund sites. Tables summarize reference doses (RfDs) for toxicity from subchronic and chronic inhalation, oral exposure, slope factors and unit risk values for carcinogenicity based on lifetime inhalation and oral exposure, and radionuclide carcinogenicity

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

    Science.gov (United States)

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

  5. Health impact assessment in Korea

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  6. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...

  7. Assessing Your Weight and Health Risk

    Science.gov (United States)

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

  8. Physiotherapy students’ mental health assessment

    OpenAIRE

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

    2012-01-01

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

  9. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...... to generate knowledge and evidence about the patient aspects of a given technology. This raises questions about how knowledge is produced in HTA reports and what kind of knowledge is considered relevant. This article uses a Danish HTA on patient education from 2009 as empirical material for a critical...

  10. Agroecosystem health assessment in Mashhad

    Directory of Open Access Journals (Sweden)

    kazem vafabakhsh

    2009-06-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed...

  12. Assessing elders using the functional health pattern assessment model.

    Science.gov (United States)

    Beyea, S; Matzo, M

    1989-01-01

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

  13. What is Health Impact Assessment?

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2010-12-01

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

  14. Health technology assessment in Mexico.

    Science.gov (United States)

    Gómez-Dantés, Octavio; Frenk, Julio

    2009-07-01

    The history of health technology assessment (HTA) in Mexico is examined, starting with the efforts to incorporate this topic into the policy agenda and culminating with the recent creation of a specialized public agency. Information was gathered through a bibliographic search and interviews with actors involved in HTA in Mexico. HTA efforts were developed in Mexico since the mid-1980s with the participation both of academics and of policy makers, a relationship that eventually led to the creation of the Center for Technological Excellence within the Ministry of Health. Institutionalization of HTA in resource-constrained settings requires the development of a critical mass of researchers involved in this field, the implementation of information efforts, and the establishment of strong relationships between HTA experts and policy makers.

  15. Approaches to health assessment related to housing

    NARCIS (Netherlands)

    Guerra Santin, O.

    2006-01-01

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

  16. Assessing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Cuff, Patricia A.

    2014-01-01

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

  17. Promoting Health Literacy through the Health Education Assessment Project

    Science.gov (United States)

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

    2007-01-01

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

  18. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    than assessing a present situation. As part of this process, however, methods applied in risk assessment are used. Risk assessment typically characterises relation of a well-defined risk factor to a well-defined health outcome. Within HIA usually several individual risk assessments are needed...... of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...

  19. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

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

  20. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

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

    1983-10-01

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

  1. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-10-01

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

  2. Establishment of Health Technology Assessment in Iran

    Directory of Open Access Journals (Sweden)

    Shila Doaee

    2012-06-01

    Full Text Available Objective: Health Technology Assessment (HTA aims at informing healthcare policymakers, managers and practitioners of the "clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice". So considering the policy-oriented nature of HTA that calls for a close integration into the functioning and governance of health systems the present study focuses on executive processes and function of the HTA office of Iran.Materials and methods: Data of this review study were collected through documented sources and observations from 2007 to 2010.Results: Health Technology Assessment began its activities as a secretariat in the Deputy of Health in 2007 and it continues as a Health Technology Assessment Office at the Management of Health Technology Assessment, Standardization, and Tariff at the Deputy of curative affairs of MOHME in the beginning of 2010.14 Technology of modern medical equipment and 8 pharmaceutical medicine are assessed, Now many of measures for HTA establishment  such as cooperation National Institute of Health Research (NIHR, Holding scientific committee meetings, Establishing  the  Master's degree of  health technology assessment ,Building capacities for health technology assessment through education in major universities of the country.Conclusion: pay attention to health technology assessment, selection and application of proper technologies in the frameworks of policy-making and managerial strategies and make efforts to develop it with the support of the governmental in Iran is necessary.

  3. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

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

  4. Health economic assessment: a methodological primer.

    Science.gov (United States)

    Simoens, Steven

    2009-12-01

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

  5. Health Economic Assessment: A Methodological Primer

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2009-11-01

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

  6. Task force report on health effects assessment

    International Nuclear Information System (INIS)

    Anderson, C.; Hushon, J.

    1978-08-01

    From April to August, 1978 MITRE supported the Health Effects Assessment Task Force sponsored by the Office of the Assistant Secretary for the Environment at DOE. The findings of that Task Force are incorporated in this report and include a detailed definition of health effects assessment, a survey of the mandates for health effects assessments within DOE/EV, a review of current DOE-EV health effects assessment activities, an analysis of the constraints affecting the health effects assessment process and a discussion of the Task Force recommendations. Included as appendices are summaries of two workshops conducted by the Task Force to determine the state-of-the-art of health effects assessment and modeling and a review of risk assessment activities in other federal agencies. The primary recommendation of the panel was that an office be designated or created under the Office of the Assistant Secretary for the Environment to coordinate the Health Effects Risk Assessment effort covering up to 40 program and policy areas; a similar need was expressed for the environmental effects assessment area. 1 tab

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  8. Assessment factors for human health risk assessment: a discussion paper

    NARCIS (Netherlands)

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

    1998-01-01

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

  9. The contribution of health technology assessment, health needs assessment, and health impact assessment to the assessment and translation of technologies in the field of public health genomics.

    Science.gov (United States)

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

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

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

    Science.gov (United States)

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

  11. Assessment of health risks of policies

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  12. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

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

    National Research Council Canada - National Science Library

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

    2004-01-01

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

  14. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

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

    2001-01-01

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

  15. Reliability assessments in qualitative health promotion research.

    Science.gov (United States)

    Cook, Kay E

    2012-03-01

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

  16. Low-frequency fields - health risk assessment

    International Nuclear Information System (INIS)

    Bernhardt, J.

    1993-01-01

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

  17. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    1992-12-01

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

  18. Bearing Health Assessment Based on Chaotic Characteristics

    Directory of Open Access Journals (Sweden)

    Chen Lu

    2013-01-01

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

  19. Risk assessment in support of plant health

    DEFF Research Database (Denmark)

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

    2012-01-01

    environmental risk assessment and the evaluation of risk reducing options. Quantitative approaches have become increasingly important during this time. The Panel has developed such methods in climatic mapping (in association with the Joint Research Councils), application of spatial spread models, re......With the establishment of the Plant Health Panel in 2006, EFSA became the body responsible for risk assessment in the plant health area for the European Union (EU). Since then more than 70 outputs have been produced dealing with the full range of organisms harmful to plant health across all crop...... types and plants in the environment. There has been an increasing trend towards producing scientific opinions which are full pest risk assessments for the whole EU territory. In its work, and as a contribution to the wider development of risk assessment methodology, the Panel has developed a series...

  20. Environment, safety and health progress assessment manual

    International Nuclear Information System (INIS)

    1992-12-01

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

  1. Environmental health risk assessment: Energy systems

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  2. [Health research and health technology assessment in Chile].

    Science.gov (United States)

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

    2014-01-01

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

  3. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

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

    2015-04-01

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

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

    Science.gov (United States)

    Appleton, Jane V; Cowley, Sarah

    2008-02-01

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

  5. New approaches in human health risk assessment.

    Science.gov (United States)

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

  6. New approaches in human health risk assessment

    Directory of Open Access Journals (Sweden)

    Khaled Abass

    2016-12-01

    Full Text Available Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu.

  7. Assessment of primary health care: health professionals’ perspective

    Directory of Open Access Journals (Sweden)

    Simone Albino da Silva

    2014-08-01

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

  8. Assessment of Postgraduate Health Professions Students ...

    African Journals Online (AJOL)

    Background: Ebola virus disease is a serious acute illness that is often fatal if untreated. Multiple outbreaks have occurred in Africa from 1976 to 2014. The recent outbreak of Ebola in West Africa was declared by the WHO as a public health emergency of international concern. Objective: The aim of this study was to assess ...

  9. History of health technology assessment in Belgium.

    Science.gov (United States)

    Cleemput, Irina; Van Wilder, Philippe

    2009-07-01

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

  10. Risk assessment of integrated electronic health records.

    Science.gov (United States)

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

    2010-01-01

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

  11. Risk assessment and toxicology databases for health effects assessment

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

  12. Exploration Health Risks: Probabilistic Risk Assessment

    Science.gov (United States)

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

    2006-01-01

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

  13. Assessment and development of implementation models of health ...

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

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

  14. Teaching health assessment in the virtual classroom.

    Science.gov (United States)

    Lashley, Mary

    2005-08-01

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

  15. Assessment on health and energy sources

    International Nuclear Information System (INIS)

    Acket, C.; Yvon, M.

    2013-01-01

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

  16. Microbiological risk assessment and public health

    International Nuclear Information System (INIS)

    Roger Skinner

    1992-01-01

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

  17. Microbiological risk assessment and public health

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Roger

    1992-07-01

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

  18. Miniature Biosensor with Health Risk Assessment Feedback

    Science.gov (United States)

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

    2016-01-01

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

  19. Primary data collection in health technology assessment.

    Science.gov (United States)

    McIsaac, Michelle L; Goeree, Ron; Brophy, James M

    2007-01-01

    This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

  20. Health technology assessment: the process in Brazil.

    Science.gov (United States)

    Lessa, Fernanda; Ferraz, Marcos Bosi

    2017-06-08

    To describe, analyze, and compare the opinions of decisionmakers involved in the health technology assessment (HTA) process in Brazil in 2011. A cross-sectional study was conducted using a structured questionnaire to evaluate the opinions of a convenience sample of health care professionals from both the public and private health care systems (HCS). The survey collected demographic data for each respondent along with their input on national regulations. Data analysis included descriptive statistics, including chi-square tests to compare groups. Of the 200 completed questionnaires, 65% of the respondents were 31-50 years of age; 36% were HCS managers, 49.3% from the public and 50.7% from the private system. The majority of respondents (85%) considered the time permitted for submission of new technology to be inadequate; 88% also stated that the composition of the evaluation committee needed improvement. Respondents from the private health system more frequently stated that submission times were inappropriate (P = 0.019) and that the deadline for a decision by the committee should be defined (P = 0.021), with a maximum of no more than 180 days / 6 months (P < 0.001). Respondents indicated that the HTA process should be improved to meet their expectations. Given that new legislation has been enacted to continuously accept submissions, to make decisions within 180 days, and to expand the committee to represent more stakeholders, most of the respondents concerns have been addressed. This study is valuable as an historical analysis of HTA process improvement. Further surveys are needed to track the new HTA process, its application, and its contribution to health care needs in Brazil.

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

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

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

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

    Science.gov (United States)

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

  3. History of health technology assessment: Spain.

    Science.gov (United States)

    Sampietro-Colom, Laura; Asua, Jose; Briones, Eduardo; Gol, Jordi

    2009-07-01

    The aim of this study was to describe the characteristics of the introduction and diffusion of health technology assessment (HTA) in Spain. A survey to summarize the evolution of HTA was sent to representatives of different HTA initiatives in Spain. HTA was introduced in the late 1980s. The main factors were the trend to an increase in healthcare expenditure, concerns regarding efficiency in providing health care, as well as in the level of rationality introducing high technology. Spain has direct (i.e., regulation) and indirect (i.e., payment systems, evidence-based programs, HTA) mechanisms to control health technologies. A recent high priority regulation has established the need of HTA to decide the introduction of a new health technology in the lists of public healthcare coverage, although similar regulations existed in the past and were scarcely implemented. HTA initiatives started at the regional government level. Its introduction followed a progressive pattern among regions. In the beginning, resources were scarce and expertise limited, with work done at intramural level. With time, expertise increase, and promotion of commissioned work was implemented. HTA knowledge transfer in the healthcare system has been carried out through courses, publications, and commissioned research. Currently, there are seven HTA units/agencies, which coordinate their work. HTA in Spain is in its maturity. Facing the unavoidable change of health care environment over time, HTA is also evolving and, currently, there is a trend to broaden the areas of influence of HTA by devolving capacity to hospitals and applying principles to very early phases of health technology development, under the umbrella of regional HTA units/agencies. However, there are two main challenges ahead. One is to have a real impact at the highest level of healthcare policy coordination among Spanish regions, which is done at the Central Ministry of Health. The other is to avoid the influence of political waves

  4. Health technology assessment in Saudi Arabia.

    Science.gov (United States)

    Al-Aqeel, Sinaa

    2018-05-16

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

  5. Comparative Assessment of Health Workers Performance and The ...

    African Journals Online (AJOL)

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

  6. Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

    Science.gov (United States)

    Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

    The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

  7. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

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

  8. Assessing Psychological Health: The Contribution of Psychological Strengths

    Science.gov (United States)

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

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

  9. Assessment of radiological technologist health condition by Todai health index

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan College, Ansan (Korea, Republic of); Kim, Wha Sun [College of Medicine, Hanyang Univ., Seoul (Korea, Republic of)

    2001-04-01

    The purpose of this study was to examine the general health status of radiological technologists by using Todai Health Index(THI) that has been employed as a standard health assessment tool for a specific group. The subjects in this study were 800 radiological technologists who were working in clinics, hospitals and university hospitals in and around Seoul and in some provincial cities. A survey was conducted directly or by mail in June and July, 2001. And the response rate was 68%. Using THI, the following findings were acquired: 1. By gender, both male and female radiological technologists complained about multiple subjective symptom(I) the most, And the women made more significant complaint of eight items including irregular life. 2. By age group, the radiological technologists whose age ranged from 20 to 24 got higher marks in most of the items, including multiple subjective symptom(I) and symptoms related to eyes and skin. 3. For career, those who had worked for a year or less or for one to five years got higher marks in most of the items. 4. Concerning marital status, the unmarried people complained about many items more, and the married people's symptom was more associated with live scale(L). 5. By the type of medical institution, the radiological technologists in the university hospitals got higher marks in two items including aggressiveness(F), but those in the clinics complained about the others more. 6. Regarding a place of service, there were little differences between the radiological technologists in basement and on the ground.

  10. Assessment of radiological technologist health condition by Todai health index

    International Nuclear Information System (INIS)

    Kim, Ham Gyum; Kim, Wha Sun

    2001-01-01

    The purpose of this study was to examine the general health status of radiological technologists by using Todai Health Index(THI) that has been employed as a standard health assessment tool for a specific group. The subjects in this study were 800 radiological technologists who were working in clinics, hospitals and university hospitals in and around Seoul and in some provincial cities. A survey was conducted directly or by mail in June and July, 2001. And the response rate was 68%. Using THI, the following findings were acquired: 1. By gender, both male and female radiological technologists complained about multiple subjective symptom(I) the most, And the women made more significant complaint of eight items including irregular life. 2. By age group, the radiological technologists whose age ranged from 20 to 24 got higher marks in most of the items, including multiple subjective symptom(I) and symptoms related to eyes and skin. 3. For career, those who had worked for a year or less or for one to five years got higher marks in most of the items. 4. Concerning marital status, the unmarried people complained about many items more, and the married people's symptom was more associated with live scale(L). 5. By the type of medical institution, the radiological technologists in the university hospitals got higher marks in two items including aggressiveness(F), but those in the clinics complained about the others more. 6. Regarding a place of service, there were little differences between the radiological technologists in basement and on the ground

  11. Health risk assessment for program managers

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  12. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

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

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

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

  13. Environmental assessment in health care organizations.

    Science.gov (United States)

    Romero, Isabel; Carnero, María Carmen

    2017-12-22

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

  14. Assessing river health in Europe and Switzerland

    Science.gov (United States)

    Milano, Marianne; Chèvre, Nathalie; Reynard, Emmanuel

    2017-04-01

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

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

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  17. Structure health assessment and warning system (SHAWS)

    Science.gov (United States)

    Bock, Daniel M.; Kim, Keehoon; Mapar, Jalal

    2008-03-01

    We are developing a Structure Health Assessment and Warning System (SHAWS) based on building displacement measurements and wireless communication. SHAWS will measure and predict the stability/instability of a building, determine whether it is safe for emergency responders to enter during an emergency, and provide individual warnings on the condition of the structure. SHAWS incorporates remote sensing nodes (RSNs) installed on the exterior frame of a building. Each RSN includes a temperature sensor, a three-axis accelerometer making static-acceleration measurements, and a ZigBee wireless system (IEEE 802.15.4). The RSNs will be deployed remotely using an air cannon delivery system, with each RSN having an innovative adhesive structure for fast (<10 min) and strong installation under emergency conditions. Once the building has moved past a threshold (~0.25 in./building story), a warning will be issued to emergency responders. In addition to the RSNs, SHAWS will include a base station located on an emergency responder's primary vehicle, a PDA for mobile data display to guide responders, and individual warning modules that can be worn by each responder. The individual warning modules will include visual and audio indicators with a ZigBee receiver to provide the proper degree of warning to each responder.

  18. Speaking of Health: Assessing Health Communication Strategies for Diverse Populations

    National Research Council Canada - National Science Library

    2002-01-01

    .... Lifestyle choices have enormous impact on our health and well being. But, how do we communicate the language of good health so that it is uniformly received-and accepted-by people from different cultures and backgrounds...

  19. Assessment of job satisfaction among health workers in a tertiary ...

    African Journals Online (AJOL)

    Assessment of job satisfaction among health workers in a tertiary hospital in Zaria ... factors affecting job satisfaction and retention of health professionals working in ... help the hospital management to increase their employee's job satisfaction.

  20. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

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

  1. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  2. Methods to Quantify Uncertainty in Human Health Risk Assessment

    National Research Council Canada - National Science Library

    Aurelius, Lea

    1998-01-01

    ...) and other health professionals, such as the Bioenviroumental Engineer, to identify the appropriate use of probabilistic techniques for a site, and the methods by which probabilistic risk assessment...

  3. An integrated framework for health and ecological risk assessment

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  4. Human Health Toxicity Values in Superfund Risk Assessments

    Science.gov (United States)

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

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

    Science.gov (United States)

    Hazarika, Indrajit

    2013-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  7. Assessment of acculturation in minority health research.

    Science.gov (United States)

    Fox, Molly; Thayer, Zaneta; Wadhwa, Pathik D

    2017-03-01

    Acculturation represents an important construct in the context of health disparities. Although several studies have reported relationships between various aspects of acculturation and health in minority populations, crucial inconsistencies remain. One likely reason for these inconsistencies may relate to limitations in the conceptualization and operationalization of acculturation, particularly in the context of health research. The acculturation construct underwent major conceptual and operational change when it was adapted from anthropology to psychology, and we argue another major shift is now required for use of this construct in health research. Issues include determining whether acculturation measures should focus on an individual's internal attitudes or overt behaviors; whether they should characterize cultural orientation status at a given point in time or change over time; whether measures should be culture-specific or more global in nature; how the issue of multiculturalism should be addressed; how measures can optimally incorporate multiple dimensions of acculturation; and whether proxy measures should be used. These issues are important in the context of health research because of their implications for determining the direct and indirect effects of cultural change on health-related biological and behavioral processes. We elaborate on and address each of these issues from a perspective that spans multiple disciplines across the biological and social sciences, and offer concrete recommendations with the ultimate goal of achieving a better understanding of the role of acculturation in minority health and health disparities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Assessment of acculturation in minority health research

    Science.gov (United States)

    Fox, Molly; Thayer, Zaneta; Wadhwa, Pathik D.

    2017-01-01

    Acculturation represents an important construct in the context of health disparities. Although several studies have reported relationships between various aspects of acculturation and health in minority populations, crucial inconsistencies remain. One likely reason for these inconsistencies may relate to limitations in the conceptualization and operationalization of acculturation, particularly in the context of health research. The acculturation construct underwent major conceptual and operational change when it was adapted from anthropology to psychology, and we argue another major shift is now required for use of this construct in health research. Issues include determining whether acculturation measures should focus on an individual’s internal attitudes or overt behaviors; whether they should characterize cultural orientation status at a given point in time or change over time; whether measures should be culture-specific or more global in nature; how the issue of multiculturalism should be addressed; how measures can optimally incorporate multiple dimensions of acculturation; and whether proxy measures should be used. These issues are important in the context of health research because of their implications for determining the direct and indirect effects of cultural change on health-related biological and behavioral processes. We elaborate on and address each of these issues from a perspective that spans multiple disciplines across the biological and social sciences, and offer concrete recommendations with the ultimate goal of achieving a better understanding of the role of acculturation in minority health and health disparities. PMID:28135691

  9. Revisiting Health System Performance Assessment in Africa

    NARCIS (Netherlands)

    Achoki, Tom

    2016-01-01

    Health systems in Africa have long faced a huge burden of disease, amidst pressing resource constraints. However, despite the constraints, the last three decades have seen the region make progress in tackling some of the most critical health challenges. Notably, many countries have registered

  10. HEALTH RISK ASSESSMENT OF HEAVY METALS VIA ...

    African Journals Online (AJOL)

    runoff to the rivers is a major threat for human health that consumes ... spinach were analyzed for Fe, Zn, Cu, Pb, Cr and Cd using FAAS. Based on ... health due to their toxicity, accumulative tendencies and persistence in the environment with.

  11. Assessment of Health Informatics Competencies in Undergraduate ...

    African Journals Online (AJOL)

    Rwanda Journal Series F: Medicine and Health Sciences Vol. ... establishment of continuous on-the-job training in health informatics for those ... deals with the resources, devices and formalized methods .... informatics competencies in undergraduate level, the tool ... Descriptive statistics were used to describe numerical.

  12. Application of epigenetic data in human health risk assessment.

    Science.gov (United States)

    Cote, Ila L; McCullough, Shaun D; Hines, Ronald N; Vandenberg, John J

    2017-11-06

    Despite the many recent advances in the field of epigenetics, application of this knowledge in environmental health risk assessment has been limited. In this paper, we identify opportunities for application of epigenetic data to support health risk assessment. We consider current applications and present a vision for the future.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

    General health assessment of refugees claiming to have been previously exposed to torture takes place in a psychological atmosphere affected by the difficult situation of the refugee. Thirty-one refugees, mainly from the Middle East and Africa, were assessed as regards their physical and mental...... (P general) health. Reliability was moderate with respect to clinical observation during interview....

  15. The Development of a Secondary School Health Assessment Model

    Science.gov (United States)

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

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

  16. Lifestyle Assessment: Helping Patients Change Health Behaviors

    OpenAIRE

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

    This article is the second in a series of six on lifestyle assessment and behavior change. The first article presented an assessment tool called FANTASTIC, which has been tested for reliability and is currently in wide use. After assessment, family physicians must help patients decide to change—and give them guidance on how to change—unhealthy behaviors. This article explains how the family physician can use educational, behavioral and relaxation strategies to increase patients' motivation, m...

  17. Assessing STD Partner Services in State and Local Health Departments.

    Science.gov (United States)

    Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

    2018-02-07

    State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

  18. Development of bilingual tools to assess functional health patterns.

    Science.gov (United States)

    Krozy, R E; McCarthy, N C

    1999-01-01

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

  19. Soil microbiology and soil health assessment

    Science.gov (United States)

    Soil scientists have long recognized the importance of soil biology in ecological health. In particular, soil microbes are crucial for many soil functions including decomposition, nutrient cycling, synthesis of plant growth regulators, and degradation of synthetic chemicals. Currently, soil biologis...

  20. Assessment of Student Outcomes in Undergraduate Health Information Administration Programs

    OpenAIRE

    Smith, Jody

    2006-01-01

    The purpose of this research was to a) determine what assessment methods are being used in undergraduate health information administration programs to assess student learning and the usefulness of those methods, b) determine to what extent programs have incorporated good student learning assessment practices. Programs use a variety of assessment tools to measure student learning; the most useful include assessments by the professional practice supervisor, course tests, assignments, presentati...

  1. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

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

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  3. 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.

  4. HEALTH - module for assessment of stochastic health effects after nuclear accidents

    International Nuclear Information System (INIS)

    Raicevic, J.J.; Gajic, M.; Popovic, Z.

    2003-01-01

    In this paper the program module HEALTH for assessment of stochastic health effects in the case of nuclear accidents is presented. Program module HEALTH is a part of the new European real-time computer system RODOS for nuclear emergency and preparedness. Some of the key features of module HEALTH are presented, and some possible further improvements are discussed (author)

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

    National Research Council Canada - National Science Library

    Institute Of Medicine Staff; Board on Children, Youth, and Families; Division of Behavioral and Social Sciences and Education; National Research Council; Institute of Medicine; National Academy of Sciences

    2004-01-01

    ... competences and with regard for appropriate balance. This study was supported by contract number 282-99-0045, task order number 6 between the National Academy of Sciences and the Department of Health and Human Services. Supplementary funding for a report synthesis and dissemination of the report and report synthesis was supported by contrac...

  6. Speaking of Health: Assessing Health Communication Strategies for Diverse Populations

    National Research Council Canada - National Science Library

    2002-01-01

    ... for their special competences and with regard for appropriate balance. Support for this project was provided by the Institute of Medicine. The views presented in this report are those of the Institute of Medicine Committee on Communication for Behavior Change in the 21st Century: Improving the Health of Diverse Populations and are not necessarily those of ...

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  8. Molecular assessment of muscle health and function

    NARCIS (Netherlands)

    Hangelbroek, Roland W.J.

    2017-01-01

    Prolonged lifespan and decreased fertility will lead to an increased proportion of older adults in the world population (population aging). An important strategy to deal with population aging has been to promote healthy aging; not only to prevent mounting health care costs, but also to maintain

  9. Assessment of Health Knowledge in College Women.

    Science.gov (United States)

    Richmond, Gail; And Others

    1991-01-01

    The level of accurate health knowledge that young adult women possess regarding selected information dealing with nutrition; disease; and over-the-counter, prescription, and social drugs is discussed. Sections include the introduction, methods, results, discussion, and implications for biology teachers. (KR)

  10. Assessing mobile health applications with twitter analytics.

    Science.gov (United States)

    Pai, Rajesh R; Alathur, Sreejith

    2018-05-01

    Advancement in the field of information technology and rise in the use of Internet has changed the lives of people by enabling various services online. In recent times, healthcare sector which faces its service delivery challenges started promoting and using mobile health applications with the intention of cutting down the cost making it accessible and affordable to the people. The objective of the study is to perform sentiment analysis using the Twitter data which measures the perception and use of various mobile health applications among the citizens. The methodology followed in this research is qualitative with the data extracted from a social networking site "Twitter" through a tool RStudio. This tool with the help of Twitter Application Programming Interface requested one thousand tweets each for four different phrases of mobile health applications (apps) such as "fitness app", "diabetes app", "meditation app", and "cancer app". Depending on the tweets, sentiment analysis was carried out, and its polarity and emotions were measured. Except for cancer app there exists a positive polarity towards the fitness, diabetes, and meditation apps among the users. Following a system thinking approach for our results, this paper also explains the causal relationships between the accessibility and acceptability of mobile health applications which helps the healthcare facility and the application developers in understanding and analyzing the dynamics involved the adopting a new system or modifying an existing one. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    DEFF Research Database (Denmark)

    Borup, Ina K.

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2012-10-16

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

  14. Gross national happiness as a framework for health impact assessment

    International Nuclear Information System (INIS)

    Pennock, Michael; Ura, Karma

    2011-01-01

    The incorporation of population health concepts and health determinants into Health Impact Assessments has created a number of challenges. The need for intersectoral collaboration has increased; the meaning of 'health' has become less clear; and the distinctions between health impacts, environmental impacts, social impacts and economic impacts have become increasingly blurred. The Bhutanese concept of Gross National Happiness may address these issues by providing an over-arching evidence-based framework which incorporates health, social, environmental and economic contributors as well as a number of other key contributors to wellbeing such as culture and governance. It has the potential to foster intersectoral collaboration by incorporating a more limited definition of health which places the health sector as one of a number of contributors to wellbeing. It also allows for the examination of the opportunity costs of health investments on wellbeing, is consistent with whole-of-government approaches to public policy and emerging models of social progress.

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

    International Nuclear Information System (INIS)

    Ginevan, M.E.; Grahn, D.; Lundy, R.T.; Brown, C.D.; Curtiss, J.B.

    1979-01-01

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

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

    Science.gov (United States)

    Banta, David; Jonsson, Egon; Childs, Paul

    2009-07-01

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

  17. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

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

  18. Assessment of health physics manpower needs

    International Nuclear Information System (INIS)

    Moeller, D.W.; Eliassen, R.

    1976-01-01

    A detailed analysis of data on current employment and projected need indicates that there is a serious impending shortage of qualified professional health physicists within the U.S. Because of the withdrawal and curtailment of Federal financial support, health physics programs at the Master of Science degree levels at many of the nation's colleges and universities are on the decline. Estimates are that during the next 5 to 10 yr, the number of graduates from these programs will be sufficient to meet only about half the projected requirements. Through the Energy Reorganization Act of 1974, a major responsibility for addressing this problem at the Federal level has been assigned to the U.S. Energy Research and Development Administration. (author)

  19. Assessing Community Quality of Health Care.

    Science.gov (United States)

    Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J

    2016-02-01

    To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.

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

    Science.gov (United States)

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

    2003-08-01

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

  1. Watershed health assessment to monitor land degradation

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

    Ikeda, Chiseko; Saeki, Kazuko; Hirano, Michiyo

    2016-06-21

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

  3. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

    Structural Health Monitoring (SHM) systems are designed for assisting owners and operators with information and forecasts concerning the fitness for purpose of structures and building systems. The benefit associated with the implementation of SHM may in some cases be intuitively anticipated...... as their responses and performances over their life-cycle. In addition, the quality of monitoring and the performance of possible remedial actions triggered by monitoring results are modeled probabilistically.The consequences accounted for, in principle include all consequences associated with the performance...

  4. The consideration of health in strategic environmental assessment (SEA)

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  5. Framework for Human Health Risk Assessment to Inform Decision Making

    Science.gov (United States)

    The purpose of this document is to describe a Framework for conducting human health risk assessments that are responsive to the needs of decision‐making processes in the U.S. Environmental Protection Agency (EPA).

  6. Assessment of job satisfaction, job stress and psychological health ...

    African Journals Online (AJOL)

    McRoy

    2014-12-31

    Dec 31, 2014 ... Aim: The study assessed the job satisfaction, perception of job stress and psychological ... on the work-health balance of journalists in. Nigeria. ..... Life. New York: Basic Books,1990. 15. Lu L. Work Motivation, Job Stress and.

  7. assessment of clients' satisfaction with health service deliveries at ...

    African Journals Online (AJOL)

    Abrham

    Hence, the objective of this study was to assess the perceived levels of clients' ... doctor. Furthermore, satisfaction with the health care was found to have a significant association with the age ... those client values and expectations, which are.

  8. How health risk from radiation is assessed

    International Nuclear Information System (INIS)

    Rahm-Crites, L.

    1994-07-01

    The likelihood that a dose of radiation will result in death from cancer at some future time can be estimated by multiplying the dose equivalent by a risk factor, or dose-to-risk conversion factor. Conversion factors, which are based on studies of atomic bomb survivors and others, provide approximate predictions of the health effects to be expected from a given radiological exposure. Following recommendations of the Nuclear Regulatory Commission, the Department of Energy currently uses risk conversion factors of 4 x 10 -4 (0.0004 LCFs) per person-rem for workers and 5 x 10 -4 (0.0005 LCFs) per person-rem for the general public (NRC 1991; DOE 1993). The conversion factor for general public is slightly higher than that for workers because the general public includes infants and children, who are more susceptible to cancer. The current overall death rate from cancer in the United States is between 20 and 25 percent, in other words, cancer accounts for one out of nearly every four deaths. An action affecting a population of 20,000 people, with the estimated potential to induce one latent cancer fatality, should therefore be understood as adding one death from cancer to a normally expected total of 4500. Studies dedicated to improving their ability to predict radiation health effects are constantly in progress, nationally and internationally, and risk conversion factors are periodically revised to incorporate new experimental and epidemiological information

  9. Health Libraries and Information Services in Tanzania: A Strategic Assessment.

    Science.gov (United States)

    Haruna, Hussein; Mtoroki, Majaliwa; Gerendasy, Dan D; Detlefsen, Ellen G

    The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence. To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania. A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents. Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field. The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania. Copyright © 2016 Icahn School of

  10. Mental Health Professionals' Suicide Risk Assessment and Management Practices.

    Science.gov (United States)

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

    2018-01-01

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

  11. ASSESSMENT OF LOGISTICS MANAGEMENT IN GHANA HEALTH SERVICE

    Directory of Open Access Journals (Sweden)

    john frimpong manso

    2013-08-01

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

  12. Health impact assessment – A survey on quantifying tools

    Energy Technology Data Exchange (ETDEWEB)

    Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [Fakultaet fuer Gesundheitswissenschaften, Universitaet Bielefeld, Universitaetsstr. 25, 33615 Bielefeld (Germany); Mekel, Odile C.L., E-mail: odile.mekel@lzg.nrw.de [Gesundheitsdaten und analysen, Versorgungsstrukturen, Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Fintan Hurley, J., E-mail: fintan.hurley@iom-world.org [Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, Scotland (United Kingdom); Mackenbach, Johan P., E-mail: j.mackenbach@erasmusmc.nl [Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)

    2016-02-15

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

  13. Assessment of utilization of maternal health care provisions in ...

    African Journals Online (AJOL)

    Assessment of utilization of maternal health care provisions in Orumba North Local Government Area of Anambra State, Nigeria. ... care facilities (52%). This study therefore, recommends equipping modern health care facilities with both human and material resources to enhance their performance. Also, periodic training of ...

  14. Health impact assessment – A survey on quantifying tools

    International Nuclear Information System (INIS)

    Fehr, Rainer; Mekel, Odile C.L.; Fintan Hurley, J.; Mackenbach, Johan P.

    2016-01-01

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

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

    African Journals Online (AJOL)

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

  16. Potential human health risk assessment of heavy metals intake via ...

    African Journals Online (AJOL)

    Potential human health risk assessment of heavy metals intake via consumption of some leafy vegetables obtained from four market in Lagos Metropolis, Nigeria. ... This result reflected the risk associated with exposure for the period of life expectancy considered, and the inhabitants are highly exposed to health risks ...

  17. Methodology for the assessment of human health risks associated ...

    African Journals Online (AJOL)

    Studies have shown that the aquatic environment can be polluted by contaminates that are accumulated by freshwater fish and this may pose a health risk to the ... bioaccumulation potential and health risks of analytes, sound sampling design, risk assessment procedures and performing monitoring at different scales and ...

  18. Methodology of constructive technology assessment in health care

    NARCIS (Netherlands)

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

    2007-01-01

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

  19. Methodology of constructive technology assessment in health care

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

    Borup, Ina K.

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

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

    OpenAIRE

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

    2016-01-01

    Objectives: The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). Material and Methods: This paper attempts to address some of the gaps within the HIA practice b...

  2. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

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

    2016-03-10

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

  3. Editorial: Lead Risk Assessment and Health Effects

    Directory of Open Access Journals (Sweden)

    Howard W. Mielke

    2016-06-01

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

  4. mHealth Assessment: Conceptualization of a Global Framework.

    Science.gov (United States)

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

    2017-05-02

    The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the

  5. Short Assessment of Health Literacy for Portuguese-speaking Adults

    Directory of Open Access Journals (Sweden)

    Daniel Apolinario

    2012-08-01

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

  6. The family receiving home care: functional health pattern assessment.

    Science.gov (United States)

    Hooper, J I

    1996-01-01

    The winds of change in health care make assessment of the family more important than ever as a tool for health care providers seeking to assist the family move themselves toward high-level wellness. Limited medical care and imposed self-responsibility for health promotion and illness prevention, which are natural consequences of these changes, move the locus of control for health management back to the family. The family's teachings, modeling, and interactions are greater influences than ever on the health of the patient. Gordon's functional health patterns provide a holistic model for assessment of the family because assessment data are classified under 11 headings: health perception and health management, nutritional-metabolic, elimination, activity and exercise, sleep and rest, cognition and perception, self-perception and self-concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, and values and beliefs. Questions posed under each of the health patterns can be varied to reflect the uniqueness of the individual family as well as to inquire about family strengths and weaknesses in all patterns. Data using this model provide a comprehensive base for including the family in designing a plan of care.

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Online reporting and assessing new occupational health risks in SIGNAAL.

    Science.gov (United States)

    Lenderink, A F; Keirsbilck, S; van der Molen, H F; Godderis, L

    2015-11-01

    Changes in work and working conditions continuously give rise to new work-related health risks. Without sufficient knowledge of these, opportunities for prevention and intervention may be missed. To develop, implement and evaluate an online tool called SIGNAAL for reporting and assessment of new work-related health risks by occupational health physicians and experts in the Netherlands and Belgium. Development and implementation of SIGNAAL to allow both easy and sufficient detailed reporting by occupational health physicians and structured and transparent assessment by occupational health experts. A new work-related health risk is defined as a work-related disease due to specific exposure in a specific work setting not described in the literature before. The online reporting and assessment tool proved to be a feasible means of reporting possible new combinations of health problems and exposures in the work situation. Eleven of the 15 cases reported until October 2014 were fully assessed: one was an entirely new work-related disease, four were known but uncommon work-related diseases, five were known but new in the reported work situation and one was a well-known work-related disease. An online reporting system used in an occupational health setting can provide insight into new work-related health risks by creating a structured way to gather, report and assess new combinations of health problems and exposure in the workplace. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  11. Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

    Directory of Open Access Journals (Sweden)

    Minjin Lee

    2018-04-01

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

  12. Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

    Science.gov (United States)

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

    2018-01-01

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

  13. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  15. Mind the Gap: Assessing the Disconnect Between Postpartum Health Information Desired and Health Information Received.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Siek, Katie A

    Seeking and receiving health information are critical aspects of prenatal and postpartum care; however, many informational sources lack postpartum content. This study explores the gaps between information desired and information received postpartum and identifies the sources women use for health information seeking, with an emphasis on emergent online and mobile phone-based resources. Participants were recruited from our community partners' client base for a cross-sectional study. Mothers (n = 77) of a child 48 months or younger completed a survey on health information seeking, health information needs, and technology use. Postpartum health information gaps were defined as topics about which a participant indicated that she wanted information, but did not receive information. Bivariate analyses assessed the association between demographic characteristics, sources of health information used during pregnancy, and postpartum information gaps. Health care providers, Internet-based resources, and mobile applications were common sources of health information during pregnancy. Mental and sexual health were the most common types of postpartum health information gaps. In bivariate analyses, higher income and education were associated with postpartum information gaps in mental health and sexual health, respectively (p higher levels of education and income and postpartum health information gaps were observed in bivariate analyses. Health educators have the opportunity to capitalize on high rates of Internet information seeking by providing health information online. Health care providers must incorporate mental and sexual health into routine postpartum care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Currie Leanne M

    2011-08-01

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

  17. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

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

    Science.gov (United States)

    Henshall, Chris; Schuller, Tara

    2013-10-01

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

  19. Health Promoting Hospitals – Assessing developments in the network

    Directory of Open Access Journals (Sweden)

    Jürgen M. Pelikan

    2007-12-01

    Full Text Available Hospitals are specific organizational settings for health promotion efforts. As health care institutions they are already oriented at health, or better at ill health, but with a rather limited focus on health outcomes for patients. Therefore, the Ottawa Charter explicitly asks for the reorientation of health services. And, hospitals also have considerable health effects for other stakeholder populations. This specific potential and challenge has been taken up by the WHO network of Health Promoting Hospitals (HPH, in the last two decades. Based on available literature the article relates the HPH concept to a more general paradigm of health promoting organizational settings; reconstructs the developmental phases of the international WHO HPH Network; elaborates on its concept development and implementation experiences, and discusses its rather limited investments in evaluation studies and the few assessments from outside. HPH has developed a convincing comprehensive concept by demonstration projects, using systematically action and evaluation research. To a lesser degree, the same holds true for its developments of health promotion policies for selected vulnerable groups and linking HPH to quality methodology. But there is no systematic evaluation of health promotion in and by hospitals, especially for the networks and member hospitals of HPH. Even if much of the relevant evidence for HPH comes and will have to come from more general clinical epidemiological, health promotion, quality, organizational and management research, there is need for specific HPH evaluation research, to better utilize, what can be learned from the social experiment of HPH.

  20. ENVIRONMENTAL IMPACT ASSESSMENT OF A HEALTH TECHNOLOGY: A SCOPING REVIEW.

    Science.gov (United States)

    Polisena, Julie; De Angelis, Gino; Kaunelis, David; Gutierrez-Ibarluzea, Iñaki

    2018-06-13

    The Health Technology Expert Review Panel is an advisory body to Canadian Agency for Drugs and Technologies in Health (CADTH) that develops recommendations on health technology assessments (HTAs) for nondrug health technologies using a deliberative framework. The framework spans several domains, including the environmental impact of the health technology(ies). Our research objective was to identify articles on frameworks, methods or case studies on the environmental impact assessment of health technologies. A literature search in major databases and a focused gray literature search were conducted. The main search concepts were HTA and environmental impact/sustainability. Eligible articles were those that described a conceptual framework or methods used to conduct an environmental assessment of health technologies, and case studies on the application of an environmental assessment. From the 1,710 citations identified, thirteen publications were included. Two articles presented a framework to incorporate environmental assessment in HTAs. Other approaches described weight of evidence practices and comprehensive and integrated environmental impact assessments. Central themes derived include transparency and repeatability, integration of components in a framework or of evidence into a single outcome, data availability to ensure the accuracy of findings, and familiarity with the approach used. Each framework and methods presented have different foci related to the ecosystem, health economics, or engineering practices. Their descriptions suggested transparency, repeatability, and the integration of components or of evidence into a single outcome as their main strengths. Our review is an initial step of a larger initiative by CADTH to develop the methods and processes to address the environmental impact question in an HTA.

  1. WHO's health risk assessment of extremely low frequency electric fields

    International Nuclear Information System (INIS)

    Repacholi, M.H.

    2003-01-01

    The World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), WHOs scientific collaborating centres (including the UKs National Radiological Protection Board (NRPB) and over 50 participating Member States are participants of WHOs International EMF Project. As part of WHOs health risk assessment process for extremely low frequency fields (ELFs), this workshop was convened by NRPB to assist WHO in evaluating potential health impacts of electrical currents and fields induced by ELF in molecules, cells, tissues and organs of the body. This paper describes the process by which WHO will conduct its health risk assessment. WHO is also trying to provide information on why exposure to ELF magnetic fields seems to be associated with an increased incidence of childhood leukaemia. Are there mechanisms that could lead to this health outcome or does the epidemiological evidence incorporate biases or other factors that need to be further explored? (author)

  2. NASA Occupational Health Program FY98 Self-Assessment

    Science.gov (United States)

    Brisbin, Steven G.

    1999-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Joana Christina Carvalho

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Shilu Tong

    2013-03-01

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

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

    Science.gov (United States)

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

    2013-03-22

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

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

    Science.gov (United States)

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

    2012-09-01

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

  7. Health risk assessment of exposure to ionizing radiation

    International Nuclear Information System (INIS)

    Ogata, Hiromitsu

    2011-01-01

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

  8. Practical consequences of the assessment of different energy health risks

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dandan Xu

    2015-01-01

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

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

    Science.gov (United States)

    Xu, Dandan; Guo, Xulin

    2015-01-29

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

  11. Health assessment of the Arab American community in southwest Brooklyn.

    Science.gov (United States)

    Sarsour, Linda; Tong, Virginia S; Jaber, Omar; Talbi, Mohammed; Julliard, Kell

    2010-12-01

    Data on Arab American health is lacking nationwide. This survey of the Arab American community in southwest Brooklyn assessed perceptions of health status, needs, behaviors, and access to services. Bilingual interviewers administered a structured survey to community members in public gathering places. Of 353 surveyed, 43% were men and 57% women, most spoke Arabic and were Muslim, and most had moved to the U.S. after 1990. One quarter were unemployed. Over 50% reported household incomes below federal poverty level. Nearly 30% had no health insurance. 58% reported choosing their health care venue based on language considerations. 43% reported problems in getting health care, including ability to pay, language barriers, and immigration. 42% of men, and 8% of women reported current smoking. Almost half of respondents never exercised. Rates of poverty, lack of health insurance, and smoking in men are cause for concern and were high even for immigrant groups.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  13. Occupational health policies on risk assessment in Japan.

    Science.gov (United States)

    Horie, Seichi

    2010-09-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

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

    Directory of Open Access Journals (Sweden)

    Yzermans CJ

    2010-06-01

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

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

    OpenAIRE

    Wright, John; Parry, Jayne; Scully, Edward

    2005-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  18. Assessing trauma and mental health in refugee children and youth

    DEFF Research Database (Denmark)

    Gadeberg, A. K.; Montgomery, Edith; Frederiksen, H. W.

    2017-01-01

    Background: It is estimated that children below 18 years constitute 50% of the refugee population worldwide, which is the highest figure in a decade. Due to conflicts like the Syrian crises, children are continuously exposed to traumatic events. Trauma exposure can cause mental health problems...... of the validated screening and measurement tools available for assessment of trauma and mental health among refugee children and youth. Methods: We systematically searched the databases PubMed, PsycINFO and PILOTS. The search yielded 913 articles and 97 were retained for further investigation. In accordance...... with the PRISMA guidelines two authors performed the eligibility assessment. The full text of 23 articles was assessed and 9 met the eligibility criteria. Results: Only nine studies had validated trauma and mental health tools in refugee children and youth populations. A serious lack of validated tools...

  19. Place shaping to create health and wellbeing using health impact assessment: health geography applied to develop evidence-based practice.

    Science.gov (United States)

    Learmonth, Alyson; Curtis, Sarah

    2013-11-01

    In a political milieu where there is pressure towards localised and participative decisionmaking, and an environment of global recession and environmental degradation, it is crucial that population health considerations inform strategic decisions. The paper puts forward 'place shaping to create health and wellbeing' as a strategic tool, drawing on ideas that are fundamental in health geography, and argues that this is an important emerging application of Health Impact Assessment (HIA), as part of evidence-based practice. These views developed primarily from case study work in the North East of England aiming to enhance health and wellbeing in a population with significant health disadvantages. © 2013 Elsevier Ltd. All rights reserved.

  20. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  1. Health technology assessment in Iran: challenges and views

    Science.gov (United States)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    1992-05-01

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

  3. General health literacy assessment of Iranian women in Mashhad.

    Science.gov (United States)

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

    2017-11-01

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

  4. Reduction of inequalities in health: assessing evidence-based tools

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

    Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

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

    Science.gov (United States)

    Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

    2018-01-05

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

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

    Science.gov (United States)

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

    2010-01-01

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

  7. Assessing systemwide occupational health and safety risks of energy technologies

    International Nuclear Information System (INIS)

    Rowe, M.D.

    1982-01-01

    Input-output modelling is now being used to assess systemwide occupational and public health and safety risks of energy technologies. Some of the advantages and disadvantages of this method are presented and some of its important limitations are discussed. Its primary advantage is that it provides a standard method with which to compare technologies on a consistent basis without extensive economic analysis. Among the disadvantages are limited range of applicability, limited spectrum of health impacts, and inability to identify unusual health impacts unique to a new technology. (author)

  8. Assessment of health risks caused by air pollutants

    International Nuclear Information System (INIS)

    Nilsson, Robert.

    1991-02-01

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

  9. Use of quantitative uncertainty analysis for human health risk assessment

    International Nuclear Information System (INIS)

    Duncan, F.L.W.; Gordon, J.W.; Kelly, M.

    1994-01-01

    Current human health risk assessment method for environmental risks typically use point estimates of risk accompanied by qualitative discussions of uncertainty. Alternatively, Monte Carlo simulations may be used with distributions for input parameters to estimate the resulting risk distribution and descriptive risk percentiles. These two techniques are applied for the ingestion of 1,1=dichloroethene in ground water. The results indicate that Monte Carlo simulations provide significantly more information for risk assessment and risk management than do point estimates

  10. Implementation of health impact assessment in Danish municipal context

    DEFF Research Database (Denmark)

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

    2014-01-01

    . Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.......Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health...... policy. Methods: Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used...

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

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

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

  12. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    Science.gov (United States)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  13. Differing forms, differing purposes: A typology of health impact assessment

    International Nuclear Information System (INIS)

    Harris-Roxas, Ben; Harris, Elizabeth

    2011-01-01

    There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between different forms of HIAs. This paper describes the three historical and disciplinary fields from which HIA has emerged - environmental health, a social view of health, and health equity. It also puts forward a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-led HIAs. This paper argues that these different forms of HIA serve different purposes and are not necessarily in competition; rather they allow HIA to be responsive to a range of population health concerns and purposes.

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

    Science.gov (United States)

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

    2015-09-16

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

  15. [Teaching performance assessment in Public Health employing three different strategies].

    Science.gov (United States)

    Martínez-González, Adrián; Moreno-Altamirano, Laura; Ponce-Rosas, Efrén Raúl; Martínez-Franco, Adrián Israel; Urrutia-Aguilar, María Esther

    2011-01-01

    The educational system depends upon the quality and performance of their faculty and should therefore be process of continuous improvement. To assess the teaching performance of the Public Health professors, at the Faculty of Medicine, UNAM through three strategies. Justification study. The evaluation was conducted under a mediational model through three strategies: students' opinion assessment, self-assessment and students' academic achievement. We applied descriptive statistics, Student t test, ANOVA and Pearson correlation. Twenty professors were evaluated from the Public Health department, representing 57% of all them who teach the subject. The professor's performance was highly valued self-assessment compared with assessment of student opinion, was confirmed by statistical analysis the difference was significant. The difference amongst the three evaluation strategies became more evident between self-assessment and the scores obtained by students in their academic achievement. The integration of these three strategies offers a more complete view of the teacher's performance quality. Academic achievement appears to be a more objective strategy for teaching performance assessment than students' opinion and self-assessment.

  16. Hardware and software for physical assessment work and health students

    Directory of Open Access Journals (Sweden)

    Олександр Юрійович Азархов

    2016-11-01

    Full Text Available The hardware and software used to assess the state of the students’ health by means of information technology were described in the article and displayed in the form of PEAC – (physical efficiency assessment channel. The list of the diseases that students often suffer from has been prepared for which minimum number of informative primary biosignals have been selected. The structural scheme PEAC has been made up, the ways to form and calculate the secondary parameters for evaluating the health of students have been shown. The resulting criteria, indices, indicators and parameters grouped in a separate table for ease of use, are also presented in the article. The given list necessitates the choice of vital activities parameters, which are further to be used as the criteria for primary express-diagnostics of the health state according to such indicators as electrocardiogram, photoplethysmogram, spirogram, blood pressure, body mass length, dynamometry. But these indicators (qualitative should be supplemented with measurement methods which provide quantitative component of an indicator. This method makes it possible to obtain assessments of students’ health with desired properties. Channel of the student physical disability assessment, along with the channel of activity comprehensive evaluation and decision support subsystem ensure assessment of the student's health with all aspects of his activity and professional training, thereby creating adequate algorithm of his behavior that provides maximum health, longevity and professional activities. The basic requirements for hardware have been formed, and they are, minimum number of information-measuring channels; high noise stability of information-measuring channels; comfort, providing normal activity of a student; small dimensions, weight and power consumption; simplicity, and in some cases service authorization

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Statistical assessment of the learning curves of health technologies.

    Science.gov (United States)

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

    2001-01-01

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

  20. Hawai'i Island Health Workforce Assessment 2008.

    Science.gov (United States)

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

    2009-12-01

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

  1. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  2. Assessment of time management attitudes among health managers.

    Science.gov (United States)

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

    2005-01-01

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

  3. Multiple criteria decision analysis for health technology assessment.

    Science.gov (United States)

    Thokala, Praveen; Duenas, Alejandra

    2012-12-01

    Multicriteria decision analysis (MCDA) has been suggested by some researchers as a method to capture the benefits beyond quality adjusted life-years in a transparent and consistent manner. The objectives of this article were to analyze the possible application of MCDA approaches in health technology assessment and to describe their relative advantages and disadvantages. This article begins with an introduction to the most common types of MCDA models and a critical review of state-of-the-art methods for incorporating multiple criteria in health technology assessment. An overview of MCDA is provided and is compared against the current UK National Institute for Health and Clinical Excellence health technology appraisal process. A generic MCDA modeling approach is described, and the different MCDA modeling approaches are applied to a hypothetical case study. A comparison of the different MCDA approaches is provided, and the generic issues that need consideration before the application of MCDA in health technology assessment are examined. There are general practical issues that might arise from using an MCDA approach, and it is suggested that appropriate care be taken to ensure the success of MCDA techniques in the appraisal process. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Reproductive Health Needs Assessment of Girl and Boy Teenagers

    Directory of Open Access Journals (Sweden)

    M Shakour

    2016-11-01

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

  5. Incorporating Human Interindividual Biotransformation Variance in Health Risk Assessment

    Science.gov (United States)

    The protection of sensitive individuals within a population dictates that measures other than central tendencies be employed to estimate risk. The refinement of human health risk assessments for chemicals metabolized by the liver to reflect data on human variability can be accom...

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  7. Mapping of health technology assessment in selected countries

    NARCIS (Netherlands)

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

    2013-01-01

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

  8. Validity of various epidemiological approaches to assessing radon health risk

    International Nuclear Information System (INIS)

    Conrath, S.M.

    1990-01-01

    In this paper various epidemiologic study designs are defined and evaluated for their utility in assessing radon health risk. The strengths and limitations of these approaches are addressed. Common pitfalls and errors of epidemiologic method are delineated with examples of causes and remedies

  9. Games for the assessment and treatment of mental health

    NARCIS (Netherlands)

    Mandryk, R.L.; Birk, M.V.; Lobel, A.M.; Rooij, M.M.J.W. van; Granic, I.; Abeele, V. vanden

    2017-01-01

    The community for research on video games for assessment and intervention for mental health spans multiple disciplines, from cognitive sciences, computer science, and interaction design, to psychology, neurobiology, and medicine. The goal of this workshop is to bring together an international group

  10. A DECADE OF HEALTH TECHNOLOGY ASSESSMENT IN POLAND

    NARCIS (Netherlands)

    Lipska, Iga; McAuslane, James Neil; Leufkens, Bert; Hövels, Anke

    OBJECTIVES: The objective of this study is to illustrate and provide a better understanding of the role of health technology assessment (HTA) processes in decision making for drug reimbursement in Poland and how this approach could be considered by other countries of limited resources. METHODS: We

  11. Health impact assessment of the Atlanta BeltLine.

    Science.gov (United States)

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

    2012-03-01

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

  12. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    van Es, Harold

    2016-04-01

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

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

    Science.gov (United States)

    Castillo-Riquelme, Marianela; Santelices C, Emilio

    2014-01-01

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

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

    Science.gov (United States)

    Ali, Dena A

    2016-01-01

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

  15. Assessing income redistributive effect of health financing in Zambia.

    Science.gov (United States)

    Mulenga, Arnold; Ataguba, John Ele-Ojo

    2017-09-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  17. Assessing organizational change in multisector community health alliances.

    Science.gov (United States)

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

    2015-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Wu Liming, E-mail: lmwu@scdc.sh.c [Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336 (China); Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia); Rutherford, Shannon; Chu, Cordia [Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia)

    2011-07-15

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

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

    International Nuclear Information System (INIS)

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  1. The Assessment of Mental Health within Health Personnel and Paramedical in "Tabriz Social Insurance Hospitals", Iran

    Directory of Open Access Journals (Sweden)

    Firouzan Vahideh

    2015-01-01

    Full Text Available Objective: Mental health is an important part of individual, social and occupational life. World Health Organization defines mental health as absolute ability of performing social, physical and mental roles. Inattention to mental health is one of the important factors that lowers efficacy, uses up human powers, causes physical and mental complications and job exhaustion, especially in professional services. As health personnel is major part of health services and their high job incentive is a necessity for their health insurance, this research was implemented to assess their mental health quality. Materials and Methods: This is a descriptive cross-sectional, correlative study which is conducted on 190 health personnel. The questionnaire consisted of two parts: Demographic characteristics and Goldenberg general health questionnaire-28 data analysis was performed by using SPSS and statistical methods were independent samples t-test, chi-square, one-way ANOVA and Pearson correlative index. Results: Two-third of cases were female, mean age was 32.22. 76.3% were married, 49.5% had no child, and most of the others had one child. 32.2% of cases had mental disorders (score > 23. Conclusion: Mean score of cases was 21, this score comparing with the general population of Iran is high. Mental health of health personnel for many reasons is at risk. According to these findings, great stressors of such jobs are: Facing with unexpected situations, work turns, especially night turns, organizational and individual factors.

  2. Occupational Health Policies on Risk Assessment in Japan

    Directory of Open Access Journals (Sweden)

    Seichi Horie

    2010-09-01

    Full Text Available Industrial Safety and Health Law (ISH Law of Japan requires abnormalities identifi ed in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording “employers shall endeavor.” Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifi es criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer signifi cant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, fi nancial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. 42 CFR 90.4 - Contents of requests for health assessments.

    Science.gov (United States)

    2010-10-01

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

  5. Ecosystem Health Assessment of Mining Cities Based on Landscape Pattern

    Science.gov (United States)

    Yu, W.; Liu, Y.; Lin, M.; Fang, F.; Xiao, R.

    2017-09-01

    Ecosystem health assessment (EHA) is one of the most important aspects in ecosystem management. Nowadays, ecological environment of mining cities is facing various problems. In this study, through ecosystem health theory and remote sensing images in 2005, 2009 and 2013, landscape pattern analysis and Vigor-Organization-Resilience (VOR) model were applied to set up an evaluation index system of ecosystem health of mining city to assess the healthy level of ecosystem in Panji District Huainan city. Results showed a temporal stable but high spatial heterogeneity landscape pattern during 2005-2013. According to the regional ecosystem health index, it experienced a rapid decline after a slight increase, and finally it maintained at an ordinary level. Among these areas, a significant distinction was presented in different towns. It indicates that the ecosystem health of Tianjijiedao town, the regional administrative centre, descended rapidly during the study period, and turned into the worst level in the study area. While the Hetuan Town, located in the northwestern suburb area of Panji District, stayed on a relatively better level than other towns. The impacts of coal mining collapse area, land reclamation on the landscape pattern and ecosystem health status of mining cities were also discussed. As a result of underground coal mining, land subsidence has become an inevitable problem in the study area. In addition, the coal mining subsidence area has brought about the destruction of the farmland, construction land and water bodies, which causing the change of the regional landscape pattern and making the evaluation of ecosystem health in mining area more difficult. Therefore, this study provided an ecosystem health approach for relevant departments to make scientific decisions.

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

    Directory of Open Access Journals (Sweden)

    Lindsay C. McCallum

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

    The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral). There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space), and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values). Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics) without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  8. Who comes to a workplace health risk assessment?

    Science.gov (United States)

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

    1998-01-01

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

  9. Assessing Health Literacy in Deaf American Sign Language Users

    Science.gov (United States)

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

    2015-01-01

    Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, healthcare messages, and health care communication, which when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version of the NVS (ASL-NVS). Forty-eight percent of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research. PMID:26513036

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

    Science.gov (United States)

    Bhatia, Rajiv; Wernham, Aaron

    2008-08-01

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

  11. Health risk assessment of groundwater arsenic pollution in southern Taiwan.

    Science.gov (United States)

    Liang, Ching-Ping; Wang, Sheng-Wei; Kao, Yu-Hsuan; Chen, Jui-Sheng

    2016-12-01

    Residents of the Pingtung Plain, Taiwan, use groundwater for drinking. However, monitoring results showed that a considerable portion of groundwater has an As concentration higher than the safe drinking water regulation of 10 μg/L. Considering residents of the Pingtung Plain continue to use groundwater for drinking, this study attempted to evaluate the exposure and health risk from drinking groundwater. The health risk from drinking groundwater was evaluated based on the hazard quotient (HQ) and target risk (TR) established by the US Environmental Protection Agency. The results showed that the 95th percentile of HQ exceeded 1 and TR was above the safe value of threshold value of 10 -6 . To illustrate significant variability of the drinking water consumption rate and body weight of each individual, health risk assessments were also performed using a spectrum of daily water intake rate and body weight to reasonably and conservatively assess the exposure and health risk for the specific subgroups of population of the Pingtung Plain. The assessment results showed that 0.01-7.50 % of the population's HQ levels are higher than 1 and as much as 77.7-93.3 % of the population being in high cancer risk category and having a TR value >10 -6 . The TR estimation results implied that groundwater use for drinking purpose places people at risk of As exposure. The government must make great efforts to provide safe drinking water for residents of the Pingtung Plain.

  12. Assessing Performance and Learning in Interprofessional Health Care Teams.

    Science.gov (United States)

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

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

  14. Risk assessment for improved treatment of health considerations in EIA

    International Nuclear Information System (INIS)

    Demidova, Olga; Cherp, Aleg

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

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

    Science.gov (United States)

    Wood, Annette

    2016-06-01

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

  17. 76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

    Science.gov (United States)

    2011-06-24

    ... Best Practices for Community Health Needs Assessment and Implementation Strategy; Public Forum AGENCY... processes relating to community health needs assessment (CHNA) and implementation strategy/plan development... practices in CHNA and implementation strategy development and execution for improved community health...

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

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2007-08-01

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

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

    Science.gov (United States)

    Fujino, Yoshihisa; Matsuda, Shinya

    2007-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Fries James F

    2003-06-01

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

  1. STAKEHOLDERS' PERCEPTIONS OF HEALTH TECHNOLOGY ASSESSMENT IN TURKEY.

    Science.gov (United States)

    Ozturk, Kirstin; Karadayı, Bilgehan; Şener, Olgun

    2018-01-01

    In April of 2014, the Turkish Ministry of Health held the First Annual Health Technology Assessment (HTA) Meeting in Antalya. The objectives were to understand the perceptions of stakeholders regarding the current status of HTA and document their recommendations and strategies for promoting systematic use of HTA in Turkey. The study was conducted using a qualitative written survey assessing current compliance with the fifteen HTA principles suggested by Drummond et al. (Key principles for the improved conduct of health technology assessments for resource allocation decision. Int J Technol Assess Health Care. 2008;24:244-258) and a qualitative method referred to as the Collective Intelligence Platform®. A total of 216 stakeholders representing academic, public, and the private health sector attended the annual meeting; 178 completed the survey and 183 participated in the Platform. Quantitative Results: Survey participants reported that, although Turkey does not currently fully comply with any of the fifteen HTA principles, there is some compliance with all of them. The overall average score for all fifteen principles was 3.04. Quantitivate Results: Participants recommended a more transparent, independent, and evidence-based policy decision-making system through better coordination of HTA activities, data aggregation, capacity development, and a national HTA core model and framework. Platform participants described the current HTA environment as disjointed and lacking in resources and support from policy-making leaders. Despite the persisting challenges, awareness of the strengths and weaknesses of the current system combined with increasing interaction among Turkish stakeholders and the international HTA community can meaningfully contribute to the continued development and promotion of HTA in Turkey.

  2. Participation in health impact assessment: objectives, methods and core values.

    Science.gov (United States)

    Wright, John; Parry, Jayne; Mathers, Jonathan

    2005-01-01

    Health impact assessment (HIA) is a multidisciplinary aid to decision-making that assesses the impact of policy on public health and on health inequalities. Its purpose is to assist decision-makers to maximize health gains and to reduce inequalities. The 1999 Gothenburg Consensus Paper (GCP) provides researchers with a rationale for establishing community participation as a core value of HIA. According to the GCP, participation in HIA empowers people within the decision-making process and redresses the democratic deficit between government and society. Participation in HIA generates a sense that health and decision-making is community-owned, and the personal experiences of citizens become integral to the formulation of policy. However, the participatory and empowering dimensions of HIA may prove difficult to operationalize. In this review of the participation strategies adopted in key applications of HIA in the United Kingdom, we found that HIA's aim of influencing decision-making creates tension between its participatory and knowledge-gathering dimensions. Accordingly, researchers have decreased the participatory dimension of HIA by reducing the importance attached to the community's experience of empowerment, ownership and democracy, while enlarging its knowledge-gathering dimension by giving pre-eminence to "expert" and "research-generated" evidence. Recent applications of HIA offer a serviceable rationale for participation as a means of information gathering and it is no longer tenable to uphold HIA as a means of empowering communities and advancing the aims of participatory democracy. PMID:15682250

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

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

    Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives' and immigrants' individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

    2013-01-01

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

  5. E-health readiness assessment framework in iran.

    Science.gov (United States)

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

    2012-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-15

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

  7. E-Health Readiness Assessment Framework in Iran

    Science.gov (United States)

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

    2012-01-01

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

  8. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    International Nuclear Information System (INIS)

    Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-01-01

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA

  9. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    Niessen, Maurice A. J.; Laan, Eva L.; Robroek, Suzan J. W.; Essink-Bot, Marie-Louise; Peek, Niels; Kraaijenhagen, Roderik A.; van Kalken, Coen K.; Burdorf, Alex

    2013-01-01

    The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. To analyze whether individual characteristics including demographics, health

  10. Risk assessment and management approaches on mental health units.

    Science.gov (United States)

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Fantke, Peter; Friedrich, Rainer; Jolliet, Olivier

    2012-11-15

    Health impacts from pesticide use are of continuous concern in the European population, requiring a constant evaluation of European pesticide policy. However, health impacts have never been quantified accounting for specific crops contributing differently to overall human exposure as well as accounting for individual substances showing distinct environmental behavior and toxicity. We quantify health impacts and related damage costs from exposure to 133 pesticides applied in 24 European countries in 2003 adding up to almost 50% of the total pesticide mass applied in that year. Only 13 substances applied to 3 crop classes (grapes/vines, fruit trees, vegetables) contribute to 90% of the overall health impacts of about 2000 disability-adjusted life years in Europe per year corresponding to annual damage costs of 78 million Euro. Considering uncertainties along the full impact pathway mainly attributable to non-cancer dose-response relationships and residues in treated crops, we obtain an average burden of lifetime lost per person of 2.6 hours (95% confidence interval between 22 seconds and 45.3 days) or costs per person over lifetime of 12 Euro (95% confidence interval between 0.03 Euro and 5142 Euro), respectively. 33 of the 133 assessed substances accounting for 20% of health impacts in 2003 are now banned from the European market according to current legislation. The main limitation in assessing human health impacts from pesticides is related to the lack of systematic application data for all used substances. Since health impacts can be substantially influenced by the choice of pesticides, the need for more information about substance application becomes evident. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-07-01

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

  13. The NICE ADHD health technology assessment: A review and critique

    Directory of Open Access Journals (Sweden)

    Schlander Michael

    2008-01-01

    Full Text Available Abstract Background Health technology assessments (HTAs by the National Institute for Health and Clinical Excellence (NICE enjoy high levels of international attention. The present analysis addresses NICE's appraisal of methylphenidate, atomoxetine and dexamphetamine for attention-deficit/hyperactivity disorder (ADHD in children and adolescents, published in March 2006. Methods A qualitative study of NICE Technology Appraisal No. 98 was done focusing on the >600-page technology assessment report, which aimed at evaluating ADHD treatment strategies by a clinical effectiveness review and an economic analysis using meta-analytical techniques and a cost-effectiveness model. Results The technology assessment was unable to differentiate between the various drugs in terms of efficacy, and its economic model was ultimately driven by cost differences. While the assessment concluded that the economic model "clearly identified an optimal treatment strategy" with first-line dexamphetamine, the NICE appraisal committee subsequently found it impossible to distinguish between the different strategies on grounds of cost-effectiveness. Analyzing the assessment reveals gaps and inconsistencies concerning data selection (ultimately relying on a small number of short-term studies only, data synthesis (pooling of heterogeneous study designs and clinical endpoints, and economic model structure (identifying double-counting of nonresponders as a likely source of bias, alongside further methodological anomalies. Conclusion Many conclusions of the NICE technology assessment rest on shaky grounds. There remains a need for a new, state-of-the-art systematic review of ADHD treatment strategies including economic evaluation, which ideally should address outcomes beyond children's health-related quality of life, such as long-term sequelae of the disorder and caregiver burden.

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

    Science.gov (United States)

    Soares Teles, Ariel; Rocha, Artur; José da Silva E Silva, Francisco; Correia Lopes, João; O'Sullivan, Donal; Van de Ven, Pepijn; Endler, Markus

    2017-01-10

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

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

    Directory of Open Access Journals (Sweden)

    Ariel Soares Teles

    2017-01-01

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

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

    Science.gov (United States)

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

    2007-11-01

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

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

    Science.gov (United States)

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

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

  18. Health numeracy: the importance of domain in assessing numeracy.

    Science.gov (United States)

    Levy, Helen; Ubel, Peter A; Dillard, Amanda J; Weir, David R; Fagerlin, Angela

    2014-01-01

    Existing research concludes that measures of general numeracy can be used to predict individuals' ability to assess health risks. We posit that the domain in which questions are posed affects the ability to perform mathematical tasks, raising the possibility of a separate construct of "health numeracy" that is distinct from general numeracy. The objective was to determine whether older adults' ability to perform simple math depends on domain. Community-based participants completed 4 math questions posed in 3 different domains: a health domain, a financial domain, and a pure math domain. Participants were 962 individuals aged 55 and older, representative of the community-dwelling US population over age 54. We found that respondents performed significantly worse when questions were posed in the health domain (54% correct) than in either the pure math domain (66% correct) or the financial domain (63% correct). Our experimental measure of numeracy consisted of only 4 questions, and it is possible that the apparent effect of domain is specific to the mathematical tasks that these questions require. These results suggest that health numeracy is strongly related to general numeracy but that the 2 constructs may not be the same. Further research is needed into how different aspects of general numeracy and health numeracy translate into actual medical decisions.

  19. Implementation of health impact assessment in Danish municipal context.

    Science.gov (United States)

    Kraemer, Stella Rebecca Johnsdatter; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-12-01

    Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

  20. Assessing alternative measures of wealth in health research.

    Science.gov (United States)

    Cubbin, Catherine; Pollack, Craig; Flaherty, Brian; Hayward, Mark; Sania, Ayesha; Vallone, Donna; Braveman, Paula

    2011-05-01

    We assessed whether it would be feasible to replace the standard measure of net worth with simpler measures of wealth in population-based studies examining associations between wealth and health. We used data from the 2004 Survey of Consumer Finances (respondents aged 25-64 years) and the 2004 Health and Retirement Survey (respondents aged 50 years or older) to construct logistic regression models relating wealth to health status and smoking. For our wealth measure, we used the standard measure of net worth as well as 9 simpler measures of wealth, and we compared results among the 10 models. In both data sets and for both health indicators, models using simpler wealth measures generated conclusions about the association between wealth and health that were similar to the conclusions generated by models using net worth. The magnitude and significance of the odds ratios were similar for the covariates in multivariate models, and the model-fit statistics for models using these simpler measures were similar to those for models using net worth. Our findings suggest that simpler measures of wealth may be acceptable in population-based studies of health.

  1. [Review of the health technology assessment on surgeries in Japan].

    Science.gov (United States)

    Nishigori, Tatsuto; Kawakami, Koji; Goto, Rei; Hida, Koya; Sakai, Yoshiharu

    2015-01-01

    Health Technology Assessment (HTA) is the systematic evaluation to measure the value of new health technologies. It improves the quality of choices on hand for cost-effective health technologies that are considered valuable. Japan has built a society of longevity consisted of the institution of the universal health care system, which is financially unsustainable. In Japan, no independent HTA organization has been publicly established but the government is contemplating implementation of such system. To advance the usage of HTA into surgery, we need to establish methods for evaluating new surgical technologies with steep learning curves. The promotion of clinical researches is also essential, especially by taking advantage of observational studies from medical big data such as the Japanese nationwide database which has more than four million surgical cases registered. In addition, we need more clinical information regarding each surgical patient's quality of life and socioeconomic status. The countries already introduced HTA into their health care system have measures to solve the problems that arose and have developed necessary evaluating methods. To introduce and promote HTA in Japan without taking away the benefit of our current healthcare, it is required that surgeons collaborate with other specialists such as methodologists and health economists.

  2. Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

    Science.gov (United States)

    Bramesfeld, A; Stegbauer, C

    2016-10-01

    The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

  3. The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend.

    Science.gov (United States)

    Fabius, Raymond; Frazee, Sharon Glave; Thayer, Dixon; Kirshenbaum, David; Reynolds, Jim

    2018-02-19

    Employers that strive to create a corporate environment that fosters a culture of health often face challenges when trying to determine the impact of improvements on health care cost trends. This study aims to test the stability of the correlation between health care cost trend and corporate health assessment scores (CHAS) using a culture of health measurement tool. Correlation analysis of annual health care cost trend and CHAS on a small group of employers using a proprietary CHAS tool. Higher CHAS scores are generally correlated with lower health care cost trend. For employers with several years of CHAS measurements, this correlation remains, although imperfectly. As culture of health scores improve, health care costs trends moderate. These findings provide further evidence of the inverse relationship between organizational CHAS performance and health care cost trend.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0.

  4. Assessing and Planning Health Actions During a Crisis

    Directory of Open Access Journals (Sweden)

    Selim SUNER

    2015-10-01

    Full Text Available SUMMARY: Initial stage of a disaster is managed with existing resources. The following stages of disaster response often involve assistance from outside of the disaster zone. This may consist of mutual aid from neighboring communities for small-scale incidents but in major disasters, the response is from federal or international agencies or often both. Rapid needs assessment after an incident is a collaborative effort between responding agencies and local emergency preparedness and health authorities. Ideally, a team from responding agencies with intimate knowledge and experience regarding the capabilities and assets of the responding entity along with local authorities, with decision making capacity, who have knowledge of the community, the limitations of the responding agencies and can obtain near real-time information about the incident and subject matter experts (engineering, medical, law enforcement, etc. comprise the needs assessment team. Keywords: Crisis, health action, disaster planning

  5. Health technology assessment in Australia: The role of AHTAC

    International Nuclear Information System (INIS)

    Kearney, B.; Willis, E.

    1997-01-01

    This paper outlines and discusses the field of medical technology assessment and the role of the Australian Health Technology Advisory Committee (AHTAC) in that process. Developments in medical technologies have altered the way in which health care is practised and delivered. As part of its work program, AHTAC has re-evaluating some existing medical technologies to assess how and under what circumstances new developments can contribute to the alleviation of the illness and suffering of the patients. Three case studies are described. These are: magnetic resonance imaging, diagnostic ultrasound and beam and isotope radiotherapy. It is stressed that the policy task is a complex one attempting to balance the need for cost containment whilst at the same time ensuring that the processes of innovation into Australia and diffusion occur in a manner which maximizes the benefit and minimizes any harm to the Australian community

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

    Science.gov (United States)

    Eichbaum, Quentin

    2017-04-01

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

  7. Automated assessment of cognitive health using smart home technologies.

    Science.gov (United States)

    Dawadi, Prafulla N; Cook, Diane J; Schmitter-Edgecombe, Maureen; Parsey, Carolyn

    2013-01-01

    The goal of this work is to develop intelligent systems to monitor the wellbeing of individuals in their home environments. This paper introduces a machine learning-based method to automatically predict activity quality in smart homes and automatically assess cognitive health based on activity quality. This paper describes an automated framework to extract set of features from smart home sensors data that reflects the activity performance or ability of an individual to complete an activity which can be input to machine learning algorithms. Output from learning algorithms including principal component analysis, support vector machine, and logistic regression algorithms are used to quantify activity quality for a complex set of smart home activities and predict cognitive health of participants. Smart home activity data was gathered from volunteer participants (n=263) who performed a complex set of activities in our smart home testbed. We compare our automated activity quality prediction and cognitive health prediction with direct observation scores and health assessment obtained from neuropsychologists. With all samples included, we obtained statistically significant correlation (r=0.54) between direct observation scores and predicted activity quality. Similarly, using a support vector machine classifier, we obtained reasonable classification accuracy (area under the ROC curve=0.80, g-mean=0.73) in classifying participants into two different cognitive classes, dementia and cognitive healthy. The results suggest that it is possible to automatically quantify the task quality of smart home activities and perform limited assessment of the cognitive health of individual if smart home activities are properly chosen and learning algorithms are appropriately trained.

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

    Directory of Open Access Journals (Sweden)

    Patrick Harris

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Hosseinpoor

    2016-10-01

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

  11. Assessing the public health impact of using poison center data for public health surveillance.

    Science.gov (United States)

    Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

    2017-12-13

    The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

  12. Health impact assessment of climate change in Bangladesh

    International Nuclear Information System (INIS)

    Nelson, Deborah Imel

    2003-01-01

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

  13. Clean Slate transportation and human health risk assessment

    International Nuclear Information System (INIS)

    1997-02-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing......There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case...... and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some...

  15. Integrated approach to assess ecosystem health in harbor areas.

    Science.gov (United States)

    Bebianno, M J; Pereira, C G; Rey, F; Cravo, A; Duarte, D; D'Errico, G; Regoli, F

    2015-05-01

    Harbors are critical environments with strategic economic importance but with potential environmental impact: health assessment criteria are a key issue. An ecosystem health status approach was carried out in Portimão harbor as a case-study. Priority and specific chemical levels in sediments along with their bioavailability in mussels, bioassays and a wide array of biomarkers were integrated in a biomarker index (IBR index) and the overall data in a weight of evidence (WOE) model. Metals, PAHs, PCBs and HCB were not particularly high compared with sediment guidelines and standards for dredging. Bioavailability was evident for Cd, Cu and Zn. Biomarkers proved more sensitive namely changes of antioxidant responses, metallothioneins and vittellogenin-like proteins. IBR index indicated that site 4 was the most impacted area. Assessment of the health status by WOE approach highlighted the importance of integrating sediment chemistry, bioaccumulation, biomarkers and bioassays and revealed that despite some disturbance in the harbor area, there was also an impact of urban effluents from upstream. Environmental quality assessment in harbors. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. How do we make health impact assessment fit for purpose?

    Science.gov (United States)

    Joffe, M

    2003-09-01

    Progress has been made in recent years in the process of health impact assessment (HIA), including community involvement. The technical side is less well developed. A minimum requirement is that there should be some consistency or robustness, so that the outcome of an HIA does not depend just on who happens to carry it out, that it is not easily swayed by the vested interests that typically surround any project, and that it can withstand legal challenge. Validity is an important criterion, as well as repeatability, as the latter can be achieved merely by propagating errors. All types of evidence should be considered legitimate, including qualitative and quantitative methods. The quality of evidence, and its generalisability, need to be carefully assessed; we should leave behind the divisive discourse around "positivism". Typically there is less information on the links from interventions (policies or projects) to changes in determinants of health than there is on the immediate precursors of health and ill-health. A practical question is, how the best existing knowledge can be made available to HIA practitioners. Other issues are more tractable than is often thought, e.g. that an HIA has to be able to trade off positive and negative impacts to different groups of people, and that the complexity of social causation prevents clear analysis of cause and effect.

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

    Science.gov (United States)

    Aydın, Özlem Müge; Chouseinoglou, Oumout

    2013-12-01

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

  18. A short history of health technology assessment in Germany.

    Science.gov (United States)

    Perleth, Matthias; Gibis, Bernhard; Göhlen, Britta

    2009-07-01

    To provide an overview of the development of health technology assessment (HTA) in Germany since the 1990s. Analysis of key documents (e.g. literature, laws, and other official documentation) and personal experiences. Health technology assessment (HTA) entered the political agenda in Germany only in the mid-1990s, basically as the result of a top-down approach toward more efficiency in health care, but with a strong impetus of an evidence-based medicine movement. Accordingly, HTA became part of several healthcare reform laws since 1997, which led to the establishment of the Federal Joint Committee (G-BA) and the Institute for Quality and Efficiency in Health Care (IQWiG) in 2004. This tandem construction aims at using evidence in decision-making processes for coverage and other decisions. These developments have led to a considerable impact of HTA in Germany. In addition, a broad spectrum of activities at universities and in other organizations, such as the German Institute for Medical Documentation and Information (DIMDI), can be observed that contribute to both teaching and research in HTA. German researchers in the field of HTA are actively involved in international projects, such as EUNetHTA, and contribute to scientific conferences and journals.

  19. 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

  20. Assessment of health surveys: fitting a multidimensional graded response model.

    Science.gov (United States)

    Depaoli, Sarah; Tiemensma, Jitske; Felt, John M

    The multidimensional graded response model, an item response theory (IRT) model, can be used to improve the assessment of surveys, even when sample sizes are restricted. Typically, health-based survey development utilizes classical statistical techniques (e.g. reliability and factor analysis). In a review of four prominent journals within the field of Health Psychology, we found that IRT-based models were used in less than 10% of the studies examining scale development or assessment. However, implementing IRT-based methods can provide more details about individual survey items, which is useful when determining the final item content of surveys. An example using a quality of life survey for Cushing's syndrome (CushingQoL) highlights the main components for implementing the multidimensional graded response model. Patients with Cushing's syndrome (n = 397) completed the CushingQoL. Results from the multidimensional graded response model supported a 2-subscale scoring process for the survey. All items were deemed as worthy contributors to the survey. The graded response model can accommodate unidimensional or multidimensional scales, be used with relatively lower sample sizes, and is implemented in free software (example code provided in online Appendix). Use of this model can help to improve the quality of health-based scales being developed within the Health Sciences.

  1. Social and ethical analysis in health technology assessment.

    Science.gov (United States)

    Tantivess, Sripen

    2014-05-01

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

  2. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    Science.gov (United States)

    2016-01-01

    Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

  3. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

    Science.gov (United States)

    Hallo De Wolf, Antenor; Toebes, Brigit

    2016-12-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

  4. Assessment of the Knowledge of Primary Health Care Staff about Primary Health Care

    OpenAIRE

    Elzubier, Ahmed G.; Bella, Hassan; Sebai, Zohair A.

    1995-01-01

    The orientation about Primary Health Care among staff working in the PHC centers was assessed. Staff members numbering 909 were studied. The main criteria for judging orientation were a working knowledge of the definition and elements of PHC in addition to knowledge of the meaning of the word Alma Ata. Differences of this knowledge depending on sex, age, spoken language, type of job, postgraduate experience, previous experience in PHC and previous training in PHC were assessed. The main findi...

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

    Science.gov (United States)

    Becchetti, Leonardo; Bachelet, Maria; Riccardini, Fabiola

    2018-02-01

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

  6. Health assessment of environmental pollutants: proliferative and degenerative diseases

    International Nuclear Information System (INIS)

    Stuart, B.O.

    1988-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Loeste de Arruda-Barbosa

    2011-12-01

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

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

    Science.gov (United States)

    Kneale, Laura; Choi, Yong; Demiris, George

    2016-01-01

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

  9. Innovative human health and ecological risk assessment techniques at Hanford

    International Nuclear Information System (INIS)

    Clarke, S.; Jones, K.; Goller, E.

    1993-01-01

    The open-quotes Hanford Site Baseline Risk Assessment Methodologyclose quotes (HSBRAM) was developed to enhance the preparation of risk assessments supporting the Hanford site cleanup mission. This methodology satisfies a Hanford federal facility agreement and consent order (tri-party agreement) milestone and is used to evaluate the risk to human health and the environment under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and the Resource Conservation and Recovery Act (RCRA). The methodology was prepared by the Hanford Risk Assessment Committee (RAC) consisting of tri-party representatives: the U.S. Department of Energy, the State of Washington Department of Ecology, and the U.S. Environmental Protection Agency (EPA), with associated contractors. The risk assessment guidance provided by EPA is sufficiently general to permit tailoring of specific parameters to meet the risk assessment needs of individual sites. The RAC utilized EPA's Risk Assessment Guidance for Superfund, (RAGS) as the cornerstone of the HSBRAM. The RAC added necessary Hanford-specific elements to construct a complete risk assessment guidance for utilization as an independent document. The HSBRAM is a living document because the RAC charter emphasizes the importance of continued methodology reevaluation. The HSBRAM also provides guidelines for the application of EPA's open-quotes Framework for Ecological Risk Assessmentclose quotes to Hanford-specific environmental baseline risk assessments by including endangered and threatened species in addition to sensitive habitats potentially associated with the Hanford site and guidance for selection of ecotoxicological data. Separate negotiations for the selection of risk parameters for each operable unit were avoided by defining parameters in the HSBRAM. There are 78 past-practice operable units at Hanford requiring risk assessments

  10. An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS

    Directory of Open Access Journals (Sweden)

    Cooper Sara

    2010-01-01

    Full Text Available Abstract Background The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. Methods A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS Version 2.2. Results Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC. The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health, and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population. Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Conclusion Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.

  11. Oral-to-inhalation route extrapolation in occupational health risk assessment: A critical assessment

    NARCIS (Netherlands)

    Rennen, M.A.J.; Bouwman, T.; Wilschut, A.; Bessems, J.G.M.; Heer, C.de

    2004-01-01

    Due to a lack of route-specific toxicity data, the health risks resulting from occupational exposure are frequently assessed by route-to-route (RtR) extrapolation based on oral toxicity data. Insight into the conditions for and the uncertainties connected with the application of RtR extrapolation

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1992-07-01

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

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  15. Transportation Matters: A Health Impact Assessment in Rural New Mexico.

    Science.gov (United States)

    Del Rio, Michelle; Hargrove, William L; Tomaka, Joe; Korc, Marcelo

    2017-06-13

    This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

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

    Science.gov (United States)

    Quaye, Randolph K

    2016-05-03

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

  17. Transportation Matters: A Health Impact Assessment in Rural New Mexico

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-06-01

    Full Text Available This Health Impact Assessment (HIA informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1 84% for health services; (2 83% for formal and informal education opportunities; and (3 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1 health services, and fresh foods, especially for older adults; (2 education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3 economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1 long distances to travel; (2 difficulties in scheduling to meet all needs; and (3 poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  18. The 6/94 gap in health impact assessment

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  19. Assessment of university student health literacy toward Influenza

    Directory of Open Access Journals (Sweden)

    Marzieh Meraji

    2016-12-01

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

  20. Innovative Training for Occupational Health and Infection Control Workplace Assessment in Health Care

    Science.gov (United States)

    O'Hara, Lyndsay; Bryce, Elizabeth Ann; Scharf, Sydney; Yassi, Annalee

    2012-01-01

    A user-friendly, high quality workplace assessment field guide and an accompanying worksheet are invaluable tools for recognizing hazards in the hospital environment. These tools ensure that both front line workers as well as health and safety and infection control professionals can systematically evaluate hazards and formulate recommendations.…

  1. Messing with Mother Nature Can Be Hazardous to Your Health. Assessment of Environmental Health Impacts.

    Science.gov (United States)

    Americans for Indian Opportunity, Inc., Albuquerque, NM.

    Environmental health impacts of development on Indian communities, and the roles of government agencies responsible for environmental protection and individual safety are being assessed by Americans for Indian Opportunity (AIO) during a two-year project. Although the more than 250 Indian tribes within the U.S. have federal guarantees for…

  2. Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

    Science.gov (United States)

    Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

    2017-01-01

    This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

  3. Tackling ethical issues in health technology assessment: a proposed framework.

    Science.gov (United States)

    Burls, Amanda; Caron, Lorraine; Cleret de Langavant, Ghislaine; Dondorp, Wybo; Harstall, Christa; Pathak-Sen, Ela; Hofmann, Bjørn

    2011-07-01

    Values are intrinsic to the use of health technology assessments (HTAs) in health policy, but neglecting value assumptions in HTA makes their results appear more robust or normatively neutral than may be the case. Results of a 2003 survey by the International Network of Agencies for Health Technology Assessment (INAHTA) revealed the existence of disparate methods for making values and ethical issues explicit when conducting HTA. An Ethics Working Group, with representation from sixteen agencies, was established to develop a framework for addressing ethical issues in HTA. Using an iterative approach, with email exchanges and face-to-face workshops, a report on Handling Ethical Issues was produced. This study describes the development process and the agreed upon framework for reflexive ethical analysis that aims to uncover and explore the ethical implications of technologies through an integrated, context-sensitive approach and situates the proposed framework within previous work in the development of ethics analysis in HTA. It is important that methodological approaches to address ethical reflection in HTA be integrative and context sensitive. The question-based approach described and recommended here is meant to elicit this type of reflection in a way that can be used by HTA agencies. The questions proposed are considered only as a starting point for handling ethics issues, but their use would represent a significant improvement over much of the existing practice.

  4. Health impact assessment: where does the law come in?

    International Nuclear Information System (INIS)

    Hart, David Q.C.

    2004-01-01

    The European Convention on Human Rights has profound implications for HIA. Public authorities have a positive obligation to stop others from infringing citizens' rights to life and to respect for private and family life. These rights are qualified and have now been interpreted in many thousands of cases. Authorities must, as best they reasonably can, secure the safety of citizens and inform the citizens about the safety or otherwise of any development. Authorities have to strike a balance between the individuals rights and the public benefit. Any public authority before approving a scheme or reaching a regulatory decision which may impact on human rights must consider the nature of that impact, its seriousness and whether it can be justified on public interest grounds. A number of court judgements in cases concerning these issues are discussed. This article is not about how certain of the ideas underlying Health Impact Assessment, in certain circumstances, are or can be incorporated in existing legally recognised instruments such as Environmental Impact Assessments. Nor is it about the statutory powers which authorities--local and national--could, if so inclined, exercise, to further the health and well-being of their constituents. It is about something rather more general, important and yet rather formless, namely the duties identified by the European Court of Human Rights as resting upon public authorities to take steps to safeguard the public health rights of their citizens

  5. EMERGENCE OF "DRIVERS" FOR THE IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Castro Jaramillo, Hector Eduardo; Moreno-Mattar, Ornella; Osorio-Cuevas, Diana

    2016-01-01

    Health technology assessment (HTA) examines the consequences of the application of health technologies and is aimed at better informing decision-makers. Over the past 30 years, different countries have implemented HTA organizations. Colombia established by law its own HTA agency (IETS) in 2011 which started operations in November 2012. The aim of this study was to assess the feasibility of conducting and using HTA to inform decision-making in this context. Through a qualitative approach, ten "drivers" emerged with the ability to help or hinder HTA development in this context: availability and quality of data, implementation strategy, cultural aspects, local capacity, financial support, policy/political support, globalization, stakeholder pressure, health system context, and usefulness perception. Semi-structured interviews were conducted with key HTA researchers, after following rigorous transcription, and thematic content analysis, those aspects that may be barriers or facilitator for HTA development and use in Colombia were identified. Although HTA has become a tool to inform decision-making around the world, its use may vary according to setting. Determining those aspects which may enable or interfere with HTA development and use in Colombia may be useful for other countries when considering the establishment of HTA systems. The conceptual transferability of concepts like "drivers" with caveats may be of interest for similar settings trying to incorporate HTA processes and institutions into systematic decision-making.

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

    International Nuclear Information System (INIS)

    Snyder, Jeremy; Wagler, Meghan; Lkhagvasuren, Oyun; Laing, Lory; Davison, Colleen; Janes, Craig

    2012-01-01

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

  7. Hygienic environmental assessment and health of children in Penza

    Directory of Open Access Journals (Sweden)

    Yu.V. Korochkina

    2015-09-01

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

  8. Wearable Vector Electrical Bioimpedance System to Assess Knee Joint Health.

    Science.gov (United States)

    Hersek, Sinan; Toreyin, Hakan; Teague, Caitlin N; Millard-Stafford, Mindy L; Jeong, Hyeon-Ki; Bavare, Miheer M; Wolkoff, Paul; Sawka, Michael N; Inan, Omer T

    2017-10-01

    We designed and validated a portable electrical bioimpedance (EBI) system to quantify knee joint health. Five separate experiments were performed to demonstrate the: 1) ability of the EBI system to assess knee injury and recovery; 2) interday variability of knee EBI measurements; 3) sensitivity of the system to small changes in interstitial fluid volume; 4) reducing the error of EBI measurements using acceleration signals; and 5) use of the system with dry electrodes integrated to a wearable knee wrap. 1) The absolute difference in resistance ( R) and reactance (X) from the left to the right knee was able to distinguish injured and healthy knees (p knee R was 2.5 Ω and for X was 1.2 Ω. 3) Local heating/cooling resulted in a significant decrease/increase in knee R (p knee R and X measured using the wet electrodes and the designed wearable knee wrap were highly correlated ( R 2 = 0.8 and 0.9, respectively). This study demonstrates the use of wearable EBI measurements in monitoring knee joint health. The proposed wearable system has the potential for assessing knee joint health outside the clinic/lab and help guide rehabilitation.

  9. Gender in health technology assessment: pilot study on agency approaches.

    Science.gov (United States)

    Panteli, Dimitra; Zentner, Annette; Storz-Pfennig, Philipp; Busse, Reinhard

    2011-07-01

    Gender as a social construct is a recognized health determinant. Because best practice in reporting health technology assessment (HTA) clearly specifies the need to appraise a technology's social impact within the target population, the extent to which gender issues are taken into account in HTA production is of interest, not only in light of equitable practices but also for reasons of effectiveness. The aim of this study is to provide a first assessment of the degree of gender sensitivity shown by HTA agencies around the world today. The Web sites of sixty HTA agencies were analyzed. The consideration of gender aspects was specifically looked for in each agency's general mission statement, its priority setting process, and its methodological approach. Additionally, specific gender-oriented initiatives not belonging to any of the aforementioned categories were identified. Of the sixty agencies, less than half mention a commitment to addressing the social implication of health technologies. Only fifteen institutions make information on their priority setting principles available on their Web sites and gender was an issue in two of those cases. Data on methodology were obtainable online from 18 agencies, two of which mentioned gender issues explicitly. Finally, gender-oriented initiatives were identified by thirteen agencies. A gender-sensitive approach is apparently rarely adopted in current HTA production. Exceptional practices and relevant tools do exist and could serve as examples to be promoted by international collaborative networks.

  10. Assessing trade in health services in countries of the Eastern Mediterranean from a public health perspective.

    Science.gov (United States)

    Siddiqi, Sameen; Shennawy, Azza; Mirza, Zafer; Drager, Nick; Sabri, Belgacem

    2010-01-01

    Assessing trade in health services (TiHS) in developing countries is challenging since the sources of information are diverse, information is not accessible and professionals lack grasp of issues. A multi-country study was conducted in the Eastern Mediterranean Region (EMR)--Egypt, Jordan, Lebanon, Morocco, Oman, Pakistan, Sudan, Syrian Arab Republic, Tunisia, and Yemen. The objective was to estimate the direction, volume, and value of TiHS; analyze country commitments; and assess the challenges and opportunities for health services.Trade liberalization favored an open trade regime and encouraged foreign direct investment. Consumption abroad and movement of natural persons were the two prevalent modes. Yemen and Sudan are net importers, while Jordan promotes health tourism. In 2002, Yemenis spent US$ 80 million out of pocket for treatment abroad, while Jordan generated US$ 620 million. Egypt, Pakistan, Sudan and Tunisia export health workers, while Oman relies on import and 40% of its workforce is non-Omani. There is a general lack of coherence between Ministries of Trade and Health in formulating policies on TiHS.This is the first organized attempt to look at TiHS in the EMR. The systematic approach has helped create greater awareness, and a move towards better policy coherence in the area of trade in health services. Copyright (c) 2009 John Wiley & Sons, Ltd.

  11. Health effects assessment of chemical exposures: ARIES methodology

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-01

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

  12. Health effects assessment of chemical exposures: ARIES methodology

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  13. A 21st century roadmap for human health risk assessment.

    Science.gov (United States)

    Pastoor, Timothy P; Bachman, Ammie N; Bell, David R; Cohen, Samuel M; Dellarco, Michael; Dewhurst, Ian C; Doe, John E; Doerrer, Nancy G; Embry, Michelle R; Hines, Ronald N; Moretto, Angelo; Phillips, Richard D; Rowlands, J Craig; Tanir, Jennifer Y; Wolf, Douglas C; Boobis, Alan R

    2014-08-01

    The Health and Environmental Sciences Institute (HESI)-coordinated Risk Assessment in the 21st Century (RISK21) project was initiated to develop a scientific, transparent, and efficient approach to the evolving world of human health risk assessment, and involved over 120 participants from 12 countries, 15 government institutions, 20 universities, 2 non-governmental organizations, and 12 corporations. This paper provides a brief overview of the tiered RISK21 framework called the roadmap and risk visualization matrix, and articulates the core principles derived by RISK21 participants that guided its development. Subsequent papers describe the roadmap and matrix in greater detail. RISK21 principles include focusing on problem formulation, utilizing existing information, starting with exposure assessment (rather than toxicity), and using a tiered process for data development. Bringing estimates of exposure and toxicity together on a two-dimensional matrix provides a clear rendition of human safety and risk. The value of the roadmap is its capacity to chronicle the stepwise acquisition of scientific information and display it in a clear and concise fashion. Furthermore, the tiered approach and transparent display of information will contribute to greater efficiencies by calling for data only as needed (enough precision to make a decision), thus conserving animals and other resources.

  14. Can we reliably benchmark health technology assessment organizations?

    Science.gov (United States)

    Drummond, Michael; Neumann, Peter; Jönsson, Bengt; Luce, Bryan; Schwartz, J Sanford; Siebert, Uwe; Sullivan, Sean D

    2012-04-01

    In recent years, there has been growth in the use of health technology assessment (HTA) for making decisions about the reimbursement, coverage, or guidance on the use of health technologies. Given this greater emphasis on the use of HTA, it is important to develop standards of good practice and to benchmark the various HTA organizations against these standards. This study discusses the conceptual and methodological challenges associated with benchmarking HTA organizations and proposes a series of audit questions based on a previously published set of principles of good practice. It is concluded that a benchmarking exercise would be feasible and useful, although the question of who should do the benchmarking requires further discussion. Key issues for further research are the alternative methods for weighting the various principles and for generating an overall score, or summary statement of adherence to the principles. Any weighting system, if developed, would need to be explored in different jurisdictions to assess the extent to which the relative importance of the principles is perceived to vary. Finally, the development and precise wording of the audit questions requires further study, with a view to making the questions as unambiguous as possible, and the reproducibility of the assessments as high as possible.

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

    Science.gov (United States)

    Wright, John; Parry, Jayne; Scully, Edward

    2005-06-01

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

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

    Science.gov (United States)

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

    2013-09-01

    Health impact assessment (HIA) is often used to determine ex ante the health impact of an environmental policy or an environmental intervention. Underpinning any HIA is the framing assumption, which defines the causal pathways mapping environmental exposures to health outcomes. The sensitivity of the HIA to the framing assumptions is often ignored. A novel method based on fuzzy cognitive map (FCM) is developed to quantify the framing assumptions in the assessment stage of a HIA, and is then applied to a housing intervention (tightening insulation) as a case-study. Framing assumptions of the case-study were identified through a literature search of Ovid Medline (1948-2011). The FCM approach was used to identify the key variables that have the most influence in a HIA. Changes in air-tightness, ventilation, indoor air quality and mould/humidity have been identified as having the most influence on health. The FCM approach is widely applicable and can be used to inform the formulation of the framing assumptions in any quantitative HIA of environmental interventions. We argue that it is necessary to explore and quantify framing assumptions prior to conducting a detailed quantitative HIA during the assessment stage. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-08-01

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

  18. Mentoring a health technology assessment initiative in Kazakhstan.

    Science.gov (United States)

    Muratov, Sergei; Hailey, David; Foerster, Vicki; Brady, Bruce; Juzwishin, Don; la Fleur, Philip; McGowan, Jessie

    2014-04-01

    The aim of this study was to assist in the development of a health technology assessment (HTA) program for the Ministry of Health (MOH) of the Republic of Kazakhstan Mentoring of an initial HTA program in Kazakhstan was provided by the Canadian Society for International Health (CSIH) by means of a partnership with the Kazakhstan MOH. HTA materials, courses, and one-on-one support for the preparation of a series of initial HTA reports by MOH HTA staff were provided by a seven-member CSIH team over a 2.5-year project. Guidance documents on HTA and institutional strengthening were prepared in response to an extensive set of deliverables developed by the MOH and the World Bank. Introductory and train-the-trainer workshops in HTA and economic evaluation were provided for MOH staff members, experts from Kazakhstan research institutes and physicians. Five short HTA reports were successfully developed by staff in the Ministry's HTA Unit with assistance from the CSIH team. Challenges that may be relevant to other emerging HTA programs included lack of familiarity with some essential underlying concepts, organization culture, and limited time for MOH staff to do HTA work. The project helped to define the need for HTA and mentored MOH staff in taking the first steps to establish a program to support health policy decision making in Kazakhstan. This experience offers practical lessons for other emerging HTA programs, although these should be tailored to the specific context.

  19. Prisoners' assessments of mental health problems among their children.

    Science.gov (United States)

    Tasca, Melinda; Turanovic, Jillian J; White, Clair; Rodriguez, Nancy

    2014-02-01

    High rates of imprisonment among American men and women have motivated recent research on the well-being of children of incarcerated parents. Despite advances in the literature, little is known regarding the mental health status of children who experience maternal relative to paternal incarceration. Accordingly, we examine whether there are differences in mental health needs among children of incarcerated parents. Specifically, we assess whether incarcerated mothers are more likely than incarcerated fathers to report that their children suffer from mental health problems. Using cross-sectional data on children (N = 1,221) compiled from a sample of parents confined in the Arizona Department of Corrections, we find that children of incarcerated mothers are significantly more likely to be identified as suffering from mental health problems. This effect remained even after controlling for additional parent stressors and child risk factors such as exposure to violence, in utero exposure to drugs/alcohol, and parental mental illness. Policy implications and directions for future research are discussed.

  20. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

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

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. © The Author(s) 2016.

  1. Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

    Science.gov (United States)

    Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

    2003-01-01

    Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.

  2. A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

    Science.gov (United States)

    Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

    2016-02-01

    The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  3. Health impact assessment of cycling network expansions in European cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Salmon, Maëlle; Martinez, David; Ambros, Albert; Brand, Christian; de Nazelle, Audrey; Dons, Evi; Gaupp-Berghausen, Mailin; Gerike, Regine; Götschi, Thomas; Iacorossi, Francesco; Int Panis, Luc; Kahlmeier, Sonja; Raser, Elisabeth; Nieuwenhuijsen, Mark

    2018-04-01

    We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1,210 premature deaths (95% CI: 447-1,972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. A Persian version of Geriatric Oral Health Assessment Index.

    Science.gov (United States)

    Rezaei, Mohammad; Rashedi, Vahid; Khedmati Morasae, Esmaeil

    2016-09-01

    This study aimed to translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into a Persian version and to assess the preliminary psychometric properties of the translated index among a sample of Persian elders. Twelve items included in GOHAI were first translated into Persian using a back-translation technique and then were compared with the original version. Four hundred and seventeen elderly subjects who were admitted to a day care centre answered GOHAI and an attached socio-demographic questionnaire. Internal consistency of the Persian version was measured by Cronbach's alpha. Test-retest reliability was assessed by intraclass correlation coefficient (ICC) and weighted kappa. Factor structure of GOHAI was evaluated by principal component factor analysis. Mean of GOHAI score was 45.71 (SD: 5.14; range: 27-51). The mean of GOHAI score was higher for the elders who rated their oral and general health as 'good'. The Cronbach's alpha for GOHAI score was 0.748, indicating a high degree of internal consistency and homogeneity between the GOHAI items. The test-retest correlation for the total GOHAI score using ICC was 0.763 (95% CI = 0.713-0.809). Factor analysis revealed a three-factor solution that bolstered the theoretical construction of the index. Significant differences in the GOHAI scores were found for income and current number of teeth. The Persian version of the GOHAI can be used reliably to identify oral health-related concerns of older Persian speakers, but further research is needed to confirm its cultural consonance in this population. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  5. Assessment of mercury health risks to adults from coal combustion

    Energy Technology Data Exchange (ETDEWEB)

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  6. A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

    Science.gov (United States)

    Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

    2016-09-01

    The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

  7. Kennedy Axis V: Clinimetric properties assessed by mental health nurses.

    Science.gov (United States)

    Faay, Margo D M; van de Sande, Roland; Gooskens, Floor; Hafsteinsdóttir, Thóra B

    2013-10-01

    The Kennedy Axis V is a routine outcome measurement instrument which can assist the assessment of the short-term risk for violence and other adverse patient outcomes. The purpose of this study was to evaluate the interrater reliability and clinical utility of the instrument when used by mental health nurses in daily care of patients with mental illness. This cross-sectional study was conducted in inpatient and outpatient adult psychiatric care units and in one adolescent inpatient unit at a university hospital in the Netherlands. Interrater reliability was measured based on the independent scores of two different nurses for the same patients. The clinical utility of the instrument was evaluated by means of a clinical utility questionnaire. To gain a deeper understanding of rating difficulties at the adolescent unit, additional data were collected in two focus group interviews. The overall results revealed a substantial level of agreement between nurses (intraclass correlation coefficient and Pearson 0.79). Some rating challenges were identified, including difficulties with scoring the instrument and using tailor-made interventions related to the scores. These challenges can be resolved using refined training and implementation strategies. When the Kennedy Axis V is accompanied by a solid implementation strategy in adult mental health care, the instrument can be used for short-term risk assessment and thereby contribute in efforts to reduce violence, suicide, self-harm, severe self-neglect, and enhanced objectivity in clinical decision-making. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  8. Health Technology Assessment and vaccine: new needs and opportunities?

    Directory of Open Access Journals (Sweden)

    Giuseppe La Torre

    2007-03-01

    Full Text Available Health Technology Assessment (HTA can represent an innovative and effective approach to supply decisionmakers with a valid instrument to improve the allocation of resources in the field of vaccines. We proposed a HTA approach for considering the introduction of a new vaccine that could potentially have a great impact on the population’s health, using as an example the vaccine against Human Papilloma Virus (HPV. This approach could be of great interest when the decision making process involves choices regarding new vaccines. We developed a HTA approach for assessing all of the aspects involved in the introduction of vaccines against HPV in Italy, considering the following issues: - epidemiological evaluation of HPV infection and related pathologies through the consultation of data banks and the scientific literature; - evaluation of health care resources utilisation by people suffering from the infection/ related diseases, through the consultation of hospital archives; - systematic review and meta-analysis of randomised clinical trials on HPV vaccination effectiveness and safety; - mathematical modelling and economic evaluation of the vaccination using a cost-effectiveness analysis; - evaluation of the impact of vaccination on the Health System [organisational aspects, vaccine surveillance, relationship between different decisional levels (national, regional]; - analysis of the ethical, social (acceptability, availability, accessibility, information and legislative aspects of vaccination. A HTA report on the new vaccine could represent an new important tool to support the choice of decision makers in order to better inform the allocation of economic resources and maximize healthcare services, since it takes into account not only the burden and the epidemiology of the disease, and the economic evaluation of different scenarios, but also the social, legal and bioethical aspects. For HTA to support the introduction of new technologies, and new

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

    Science.gov (United States)

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

    2011-07-01

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

  10. What influences the choice of assessment methods in health technology assessments? Statistical analysis of international health technology assessments from 1989 to 2002.

    Science.gov (United States)

    Draborg, Eva; Andersen, Christian Kronborg

    2006-01-01

    Health technology assessment (HTA) has been used as input in decision making worldwide for more than 25 years. However, no uniform definition of HTA or agreement on assessment methods exists, leaving open the question of what influences the choice of assessment methods in HTAs. The objective of this study is to analyze statistically a possible relationship between methods of assessment used in practical HTAs, type of assessed technology, type of assessors, and year of publication. A sample of 433 HTAs published by eleven leading institutions or agencies in nine countries was reviewed and analyzed by multiple logistic regression. The study shows that outsourcing of HTA reports to external partners is associated with a higher likelihood of using assessment methods, such as meta-analysis, surveys, economic evaluations, and randomized controlled trials; and with a lower likelihood of using assessment methods, such as literature reviews and "other methods". The year of publication was statistically related to the inclusion of economic evaluations and shows a decreasing likelihood during the year span. The type of assessed technology was related to economic evaluations with a decreasing likelihood, to surveys, and to "other methods" with a decreasing likelihood when pharmaceuticals were the assessed type of technology. During the period from 1989 to 2002, no major developments in assessment methods used in practical HTAs were shown statistically in a sample of 433 HTAs worldwide. Outsourcing to external assessors has a statistically significant influence on choice of assessment methods.

  11. IMPLEMENTING HEALTH TECHNOLOGY ASSESSMENT-BASED RECOMMENDATIONS IN FINLAND

    DEFF Research Database (Denmark)

    Sihvo, Sinikka; Ikonen, Tuija; Mäkelä, Marjukka

    2017-01-01

    Objectives: The Managed Uptake of Medical Methods Program (MUMM) started 10 years ago as a joint venture of the Finnish Office for Health Technology Assessment (Finohta) and the twenty hospital districts in Finland. The aim is to offer information on the effectiveness, safety, organizational...... in decision making. Conclusions: HTA-based MUMM recommendations were well received by physicians but in practice they are less used than clinical practice guidelines. Short-form electronic surveys were a useful way of gathering information about awareness and implementation. The surveys also functioned...... as another method of informing key physicians about the recommendations....

  12. Impact assessment of the contents of agricultural health discipline

    Directory of Open Access Journals (Sweden)

    Élida Fredesvinda Cordero Peña

    2013-06-01

    Full Text Available This article refers to the theoretical considerations in the process of assessing the impact of a program from the initial training requirements of a teacher's career Agricultural at the present time, so that once graduates are able to project themselves into matching their needs and possibilities. Our research has its practical exponent in the Agricultural Health discipline as science for the develop ment of knowledge, professional skills training and values, consistent with the protection of cultivated plants and domestic animals, in student’s career of Agricultural, at the University of Educational Sciences, in Pinar del Rio, Cuba.

  13. Educational Needs Assessment of Family Health Providers in Tabriz Health Care Centers in 2015

    Directory of Open Access Journals (Sweden)

    Faranak Ghoreyshyzadeh

    2017-06-01

    Full Text Available Background: This study intends to determine the educational needs of family health staff employed in health care centers in Tabriz, the provincial capital of east Azerbaijan, Iran in 2015. Methods: In this cross-sectional study 282 staff were enrolled, together with 22 managers, through census. The data collection tool was a researcher-designed questionnaire whose content validity were confirmed by 5 experts of health care and medical education centers. They self--evaluated their knowledge, skills and attitudes in 6 task processes including "integrated care for pregnant women", "women’s general and reproductive health", "child health care and breastfeeding", "vaccination skills", "teenagers’ and young adults’ health", and "common diseases prevention and control". Cronbach alpha coefficients were over 0.85. Data analysis was done using SPSS version 16 and descriptive statistics (mean and standard deviation and one-sample t tests were calculated to compare the mean of scores with midpoint criteria (=3. Results: Generally family health staff self-evaluated their knowledge, skills and attitudes in all task processes in higher than midpoint criteria level, which was consistent with the opinions of the managers, however, educational needs required by personnel in some processes or sub- process including "common diseases prevention and control" ( knowledge on referring thalassemia couples for genetic testing, mental health counseling, "vaccination skills" ( intradermal vaccination skills, "teenagers’ and young adults’ health" (Self-care training and parents education, "women’s general and reproductive health" (principles of family planning counseling and less needs stated in "integrated care for pregnant mothers" (except for diagnosis and management of ectopic pregnancy, placenta previa and abruption and "child health care" as compared to criteria (All P value <0.05. In contrast to self-assessment results, in interorganization evaluations

  14. Health risk assessment for a MWC ash utilization demonstration project

    International Nuclear Information System (INIS)

    Roffman, H.K.

    1992-01-01

    A Health Risk Assessment (HRA) was conducted for the proposed joint Hennepin County/Municipal Services Corporation (MSC) MSW Ash Utilization Demonstration Project, in which combined HERC ash was shipped to the MSC Pilot Plan near Atlanta, Georgia and used in the production of a synthetic aggregate. The synthetic aggregate, or TAP, will serve as a partial replacement for natural aggregates in a section of bituminous pavement that is proposed to be constructed on Pioneer Trail in the City of Corcoran, Minnesota. In this paper, the assessment compares the following three scenarios: a section of roadway paved using the MSC synthetic aggregate product (TAP) as a replacement for 30 percent of the natural aggregates used in bituminous pavement; a section of regular bituminous (asphalt) pavement; and a section of unpaved road currently in place at the site

  15. E-health readiness assessment for e-health framework for Africa: a case study of hospitals in South Africa

    CSIR Research Space (South Africa)

    Coleman, A

    2011-11-01

    Full Text Available This study assessed e-healthcare readiness of rural and urban hospitals in North West Province of South Africa. Outcome of assessment led to creation of e-health architectural framework for e-health solutions. Assessment was conducted in usage...

  16. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  17. Health risk assessment and the practice of industrial hygiene.

    Science.gov (United States)

    Paustenbach, D J

    1990-07-01

    It has been claimed that there may be as many as 2000 airborne chemicals to which persons could be exposed in the workplace and in the community. Of these, occupational exposure limits have been set for approximately 700 chemicals, and only about 30 chemicals have limits for the ambient air. It is likely that some type of health risk assessment methodology will be used to establish limits for the remainder. Although these methods have been used for over 10 yr to set environmental limits, each step of the process (hazard identification, dose-response assessment, exposure assessment, and risk characterization) contains a number of traps into which scientists and risk managers can fall. For example, regulatory approaches to the hazard identification step have allowed little discrimination between the various animal carcinogens, even though these chemicals can vary greatly in their potency and mechanisms of action. In general, epidemiology data have been given little weight compared to the results of rodent bioassays. The dose-response extrapolation process, as generally practiced, often does not present the range of equally plausible values. Procedures which acknowledge and quantitatively account for some or all of the different classes of chemical carcinogens have not been widely adopted. For example, physiologically based pharmacokinetic (PB-PK) and biologically based models need to become a part of future risk assessments. The exposure evaluation portion of risk assessments can now be significantly more valid because of better dispersion models, validated exposure parameters, and the use of computers to account for complex environmental factors. Using these procedures, industrial hygienists are now able to quantitatively estimate the risks caused not only by the inhalation of chemicals but also those caused by dermal contact and incidental ingestion. The appropriate use of risk assessment methods should allow scientists and risk managers to set scientifically valid

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

    DEFF Research Database (Denmark)

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

    2005-01-01

    cigarette smoking at least once, while 41% reported having tasted alcohol drinks. Multivariate regression analyses showed that perceived dental health status and needs were associated with gender, age, unhealthy lifestyles, poor school performance, and socio-economic status. The establishment of school...

  19. Exploring the role of GIS during community health assessment problem solving: experiences of public health professionals

    Directory of Open Access Journals (Sweden)

    Scotch Matthew

    2006-09-01

    Full Text Available Abstract Background A Community health assessment (CHA involves the use of Geographic Information Systems (GIS in conjunction with other software to analyze health and population data and perform numerical-spatial problem solving. There has been little research on identifying how public health professionals integrate this software during typical problem solving scenarios. A better understanding of this is needed to answer the "What" and the "How". The "What" identifies the specific software being used and the "How" explains the way they are integrated together during problem solving steps. This level of understanding will highlight the role of GIS utilization during problem solving and suggest to developers how GIS can be enhanced to better support data analysis during community health assessment. Results An online survey was developed to identify the information technology used during CHA analysis. The tasks were broken down into steps and for our analysis these steps were categorized by action: Data Management/Access, Data Navigation, Geographic Comparison, Detection of Spatial Boundaries, Spatial Modelling, and Ranking Analysis. 27 CHA professionals completed the survey, with the majority of participants (14 being from health departments. Statistical software (e.g. SPSS was the most popular software for all but one of the types of steps. For this step (detection of spatial boundaries, GIS was identified as the most popular technology. Conclusion Most CHA professionals indicated they use statistical software in conjunction with GIS. The statistical software appears to drive the analysis, while GIS is used primarily for simple spatial display (and not complex spatial analysis. This purpose of this survey was to thoroughly examine into the process of problem solving during community health assessment data analysis and to gauge how GIS is integrated with other software for this purpose. These findings suggest that GIS is used more for spatial

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tiago Ricardo Moreira

    2016-01-01

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

  2. A comparative assessment of the health status of feral populations of ...

    African Journals Online (AJOL)

    A comparative assessment of the health status of feral populations of Clarias gariepinus from three dams in the Limpopo and Olifants river systems, Limpopo province, South Africa, using the fish health assessment index protocol.

  3. Assessment of primary health care in a rural health centre in Enugu South east Nigeria.

    Science.gov (United States)

    M Chinawa, Josephat; T Chinawa, Awoere

    2015-01-01

    Primary health care (PHC) is a vital in any community. Any health centre with a well implemented PHC program can stand the test of time in curbing under five mortality and morbidity. This study was therefore aimed at assessing the activities in a health centre located in a rural area in Enugu state and to determine the pattern and presentation of various diseases in the health centre. This is retrospective study undertaken in a primary health care centre in Abakpa Nike in Enugu east LGA of Enugu State of Nigeria from December 2011 to December 31(st) 2013. Data retrieved were collected with the aid of a structured study proforma and analyzed using SPSS Version 18. Total number of children that attended immunization program in the health centre over 20 months period was 25,438 (12,348 males and 13090 females), however only 17745 children (7998 males and 9747 females) were actually registered in the hospital records. None of the children was immunized for DPT2 and OPV(0) and HBV(1) in the course of this study. The dropout rate using DPT1, 2 and 3 (DPT1-DPT2/DPT3) was very high (494%). The mean immunization coverage rate was 8.3%. Family planning activities, integrated management of childhood illnesses program were also carried out in the health centre but at very low level. The major fulcrum of events in the health centre which include immunization coverage, IMCI, and management of common illnesses were simply non operational. However the health centre had a well knitted referral system.

  4. Assessing the quality of care in a new nation: South Sudan's first national health facility assessment.

    Science.gov (United States)

    Berendes, Sima; Lako, Richard L; Whitson, Donald; Gould, Simon; Valadez, Joseph J

    2014-10-01

    We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments. Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations. Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively. Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Advanced Korean Industrial Safety and Health Policy with Risk Assessment

    Directory of Open Access Journals (Sweden)

    Hyuckmyun Kwon

    2010-09-01

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

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

    Science.gov (United States)

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

    2010-09-01

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

  8. The Value of Mainstreaming Human Rights into Health Impact Assessment

    Science.gov (United States)

    MacNaughton, Gillian; Forman, Lisa

    2014-01-01

    Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well. PMID:25264683

  9. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  10. Das Curriculum Health Technology Assessment (HTA, Version 2.0

    Directory of Open Access Journals (Sweden)

    Perleth, Matthias

    2017-10-01

    Full Text Available Health Technology Assessments (HTAs liefern für zahlreiche Entscheidungen im Gesundheitswesen relevante Informationen. Die Erstellung von HTA-Berichten erfordert gut ausgebildete, interdisziplinär arbeitende Spezialisten, die angemessene Interpretation und Umsetzung in Entscheidungen erfordert Verständnis seitens der Entscheidungsträger.Der Verein zur Förderung der Technologiebewertung im Gesundheitswesen (Health Technology Assessment e.V. und das Deutsche Netzwerk Evidenzbasierte Medizin e.V. haben bereits 2006 ein HTA-Curriculum entwickelt, das als Grundlage für HTA-Fortbildungskurse sowohl für Nutzer von HTA-Informationen wie auch für HTA-Autoren dient. Das Curriculum ist u.a. Grundlage für Fortbildungskurse an mehreren Universitäten. Aufgrund methodischer Weiterentwicklungen wurde nun eine Überarbeitung des Curriculums erforderlich. Das Curriculum greift auf Struktur und Inhalte international etablierter Studiengänge zurück, berücksichtigt aber auch die Besonderheiten der Regulation von Technologien und der Entscheidungsfindung in den Gesundheitssystemen der deutschsprachigen Länder. Es ist in insgesamt 10 Module untergliedert, die neben Grundlagen und Prinzipien von HTA u.a. auf die Statusbestimmung von Technologien, Prioritätensetzung, Wissens- und Informationsmanagement, Methodik der Erstellung von HTA-Berichten und Interessenkonflikte eingehen. Gegenüber der ursprünglichen Version wurden viele Inhalte präzisiert und Erfahrungen aus Lehrveranstaltungen, die das Curriculum umsetzen, wurden berücksichtigt.

  11. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

    NARCIS (Netherlands)

    M.A.J. Niessen (Maurice); E.L. Laan (Eva); S.J.W. Robroek (Suzan); M.L.E. Essink-Bot (Marie-Louise); N. Peek (Niels); R.A. Kraaijenhagen (Roderik); C.K. van Kalken (Coen); A. Burdorf (Alex)

    2013-01-01

    textabstractBackground: The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. Objective: To analyze whether individual

  12. Assessment of Occupational Hazards, Health Problems and Safety ...

    African Journals Online (AJOL)

    UNIBEN

    Background: Petrol station attendants encounter several hazards and health problems while working. This study was conducted to determine the occupational hazards, health ..... engineering conference on sustainable ... Industrial Health.

  13. Health and exposure assessment of flare gas emissions

    International Nuclear Information System (INIS)

    Kindzierski, W.B.; Byrne-Lewis, C.; Probert, S.

    2000-01-01

    The incomplete combustion of flare gases produces pollutants such as volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) which are cause for concern for public health. Some of the concerns relate to potential long-term cumulative health effects from exposure to hazardous air pollutants including benzene, styrene, naphthalene, and benzopyrene. This study demonstrated that several factors should be taken into account when considering the importance of flaring and human exposure to flare gas emissions. Most flare stacks are located in rural areas, but most time-availability studies have been done on urban populations where the majority of people spend their time indoors. It was recommended that more time-activity studies are needed to emphasize the behaviour of rural populations which are most susceptible to exposure from pollutants from flaring. It was concluded that higher indoor air concentrations exist for many VOCs and PAHs compared to outdoors, but in these instances, indoor sources are the major contributors to indoor air concentrations. It was recommended that health assessments of hazardous air pollutants emitted from gas flaring has to take into account the indoor setting and other background exposures in order to provide useful information for decision makers. 49 refs., 8 tabs., 1 fig

  14. Health Needs Assessment of Plain Populations in Lancaster County, Pennsylvania.

    Science.gov (United States)

    Miller, Kirk; Yost, Berwood; Abbott, Christina; Thompson, Scottie; Dlugi, Emily; Adams, Zachary; Schulman, Meryl; Strauss, Nicole

    2017-02-01

    We performed a health needs assessment for three Plain communities in Lancaster County, Pennsylvania from a random sample of households. Compared with the general population of adults, Plain respondents were more likely to be married, to have children, and they had large families; they were more likely to drink well water, to eat fruit and vegetables, to drink raw milk, and to live on a farm. Plain respondents had better physical and mental health and were less likely to have been diagnosed with various medical conditions compared with the general population of adults in Lancaster County but Old Order Mennonite respondents were more likely to have been diagnosed compared with Old Order Amish respondents. Plain respondents usually have a regular doctor and often receive preventive care but Old Order Mennonite respondents were more likely to have a regular doctor, to receive preventive care, to have had their children vaccinated, and to receive routine dental care compared with Old Order Amish respondents. Despite their relative geographic and genetic isolation, and despite the small, relative differences noted, the health of Plain communities in Lancaster County is similar to that of other adults in the County.

  15. Development of 'health and environmental safety assessment network system (HESANS)'

    International Nuclear Information System (INIS)

    Nakamura, Yuji

    1994-01-01

    With the recent advance of the utilization of nuclear energy in a large scale, social interest is being focussed in the potential risk which the nuclear technology will accompany. Especially after the accidents in Chernobyl and other nuclear facilities, serious anxiety to the utilization of nuclear energy is prevailing among the general public. In order to meet the anxiety and distrust of the population in the use of the nuclear power, the health effect or risk which radioactive materials released into the environment will bring about should be comprehensively and properly evaluated, and then should be widely reported to the population. The development of HESANS code system (Health and Environmental Safety Assessment Network System) was planned to set up such a comprehensive computer code that covers a whole pathway of radioactive material from its release to estimates of derived health effects in the population, including the countermeasures for intervention as well. Though the whole system is not totally completed yet so far, the framework of the system has been concreted together with many sub-systems which compose the main part of the code. This report puts main stress on the objective of the development project and the main frame or the structure of the code system. (author)

  16. Development of health effect assessment software using MACCS2 code

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  17. Vegan lifestyle behaviors: an exploration of congruence with health-related beliefs and assessed health indices.

    Science.gov (United States)

    Dyett, Patricia A; Sabaté, Joan; Haddad, Ella; Rajaram, Sujatha; Shavlik, David

    2013-08-01

    This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in health behaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean=22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Chanchang, Chamchan; Sithisarankul, Pornchai; Supanitayanon, Thanawat

    2016-01-01

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

  19. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    Science.gov (United States)

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  20. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

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

    Directory of Open Access Journals (Sweden)

    Jay Lee

    2011-01-01

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

  2. Barriers and facilitators influencing ethical evaluation in health technology assessment.

    Science.gov (United States)

    Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; O'Reilly, Daria; Goeree, Ron

    2015-01-01

    The objective of this study was to explore barriers and facilitators influencing the integration of ethical considerations in health technology assessment (HTA). The study consisted of two complementary approaches: (a) a systematic review of the literature; and (b) an eighteen-item online survey that was distributed to fifty-six HTA agencies affiliated with the International Network of Agencies for Health Technology Assessment. The review identified twenty-six relevant articles. The most often cited barriers in the literature were: scarcity, heterogeneity and complexity of ethical analysis methods; challenges in translating ethical analysis results into knowledge that is useful for decision makers; and lack of organizational support in terms of required expertise, time and financial resources. The most frequently cited facilitators included: usage of value-based appraisal methods, stakeholder and public engagement, enhancement of practice guidelines, ethical expertise, and educational interventions. Representatives of twenty-six (46.5 percent) agencies from nineteen countries completed the survey. A median of 10 percent (interquartile range, 5 percent to 50 percent) of the HTA products produced by the agencies was reported to include an assessment of ethical aspects. The most commonly perceived barriers were: limited ethical knowledge and expertise, insufficient time and resources, and difficulties in finding ethical evidence or using ethical guidelines. Educational interventions, demand by policy makers, and involvement of ethicists in HTA were the most commonly perceived facilitators. Our results emphasize the importance of simplification of ethics methodology and development of good practice guidelines in HTA, as well as capacity building for engaging HTA practitioners in ethical analyses.

  3. A DECADE OF HEALTH TECHNOLOGY ASSESSMENT IN POLAND.

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    Cavallo, Maria Caterina

    2013-01-01

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

  5. Assessing health literacy in the eastern and middle-eastern cultures

    OpenAIRE

    Nair, Satish Chandrasekhar; Satish, Karthyayani Priya; Sreedharan, Jayadevan; Ibrahim, Halah

    2016-01-01

    Abstract Background Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restr...

  6. Health technology assessment to optimize health technology utilization: using implementation initiatives and monitoring processes.

    Science.gov (United States)

    Frønsdal, Katrine B; Facey, Karen; Klemp, Marianne; Norderhaug, Inger Natvig; Mørland, Berit; Røttingen, John-Arne

    2010-07-01

    The way in which a health technology is used in any particular health system depends on the decisions and actions of a variety of stakeholders, the local culture, and context. In 2009, the HTAi Policy Forum considered how health technology assessment (HTA) could be improved to optimize the use of technologies (in terms of uptake, change in use, or disinvestment) in such complex systems. In scoping, it was agreed to focus on initiatives to implement evidence-based guidance and monitoring activities. A review identified systematic reviews of implementation initiatives and monitoring activities. A two-day deliberative workshop was held to discuss key papers, members' experiences, and collectively address key questions. This consensus paper was developed by email and finalized at a postworkshop meeting. Evidence suggests that the impact and use of HTA could be increased by ensuring timely delivery of relevant reports to clearly determined policy receptor (decision-making) points. To achieve this, the breadth of assessment, implementation initiatives such as incentives and targeted, intelligent dissemination of HTA result, needs to be considered. HTA stakeholders undertake a variety of monitoring activities, which could inform optimal use of a technology. However, the quality of these data varies and is often not submitted to an HTA. Monitoring data should be sufficiently robust so that they can be used in HTA to inform optimal use of technology. Evidence-based implementation initiatives should be developed for HTA, to better inform decision makers at all levels in a health system about the optimal use of technology.

  7. Describing the continuum of collaboration among local health departments with hospitals around the community health assessments.

    Science.gov (United States)

    Wilson, Kristin D; Mohr, Lisa Buettner; Beatty, Kate E; Ciecior, Amanda

    2014-01-01

    Hospitals and local health departments (LHDs) are under policy requirements from the Affordable Care Act and accreditation standards through the Public Health Accreditation Board. Tax exempt hospitals must perform a community health needs assessment (CHNA), similar to the community health assessment (CHA) required for LHDs. These efforts have led to a renewed interest in hospitals and LHDs working together to achieve common goals. The purpose of this study is to gain a better understanding of levels of joint action leading toward collaboration between LHDs and hospitals and describe collaboration around CHAs. Local health departments were selected on the basis of reporting collaboration (n = 26) or unsure about collaboration (n = 29) with local hospitals. Local health departments were surveyed regarding their relationship with local hospitals. For LHDs currently collaborating with a hospital, a collaboration continuum scale was calculated. Appropriate nonparametric tests, chi-squares, and Spearman's rank correlations were conducted to determine differences between groups. A total of 44 LHDs responded to the survey (80.0%). Currently collaborating LHDs were more likely to be interested in accreditation and to refer to their CHA 5 or more times a year compared to the unsure LHDs. In the analysis, a collaboration continuum was created and is positively correlated with aspects of the CHA and CHA process. This study is the first attempt to quantify the level of collaboration between LHDs and hospitals around CHAs. Better understanding of the levels of joint action required may assist LHDs in making informed decisions regarding deployment of resources on the path to accreditation.

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

    Science.gov (United States)

    Carter, P.

    2014-12-01

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

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

    Science.gov (United States)

    Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

    2015-05-01

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

  10. Using evaluability assessment to assess local community development health programmes: a Scottish case-study

    Directory of Open Access Journals (Sweden)

    Melissa Belford

    2017-04-01

    Full Text Available Abstract Background Evaluation of the potential effectiveness of a programme’s objectives (health or otherwise is important in demonstrating how programmes work. However, evaluations are expensive and can focus on unrealistic outcomes not grounded in strong theory, especially where there is pressure to show effectiveness. The aim of this research was to demonstrate that the evaluability assessment (a cost-effective pre-evaluation tool that primarily gives quick, constructive feedback can be used to help develop programme and outcome objectives to improve programmes while they run and to assist in producing more effective evaluations. This was done using the example of a community development programme aiming to improve health and reduce health inequalities in its target population. Methods The setting was Glasgow, Scotland, UK and focused on the Health Issues in the Community programme. Data were collected from documents and nine individual stakeholder interviews. Thematic analysis and a realist approach were used to analyse both datasets and, in conjunction with a workshop with stakeholders, produce a logic model of the programme theory and related evaluation options to explore further. Results Five main themes emerged from the analysis: History; Framework; Structure and Delivery of the Course; Theory of Action; and Barriers to Delivery and Successful Outcomes. These themes aided in drafting the logic model which revealed they key programme activities (e.g. facilitating group learning and 23 potential outcomes. The majority of these outcomes (16 were deemed to be short-term outcomes (more easily measured within the timeframe of an individual being involved in the programme e.g. increased self-esteem or awareness of individual/community health. The remaining 6 outcomes were deemed longer-term and included outcomes such as increased social capital and individual mental health and wellbeing. Conclusions We have shown that the evaluability

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

    Science.gov (United States)

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

    2011-05-01

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

  12. Quality assessment of published health economic analyses from South America.

    Science.gov (United States)

    Machado, Márcio; Iskedjian, Michael; Einarson, Thomas R

    2006-05-01

    Health economic analyses have become important to healthcare systems worldwide. No studies have previously examined South America's contribution in this area. To survey the literature with the purpose of reviewing, quantifying, and assessing the quality of published South American health economic analyses. A search of MEDLINE (1990-December 2004), EMBASE (1990-December 2004), International Pharmaceutical Abstracts (1990-December 2004), Literatura Latino-Americana e do Caribe em Ciências da Saúde (1982-December 2004), and Sistema de Informacion Esencial en Terapéutica y Salud (1980-December 2004) was completed using the key words cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-minimization analysis (CMA), and cost-benefit analysis (CBA); abbreviations CEA, CUA, CMA, and CBA; and all South American country names. Papers were categorized by type and country by 2 independent reviewers. Quality was assessed using a 12 item checklist, characterizing scores as 4 (good), 3 (acceptable), 2 (poor), 1 (unable to judge), and 0 (unacceptable). To be included in our investigation, studies needed to have simultaneously examined costs and outcomes. We retrieved 25 articles; one duplicate article was rejected, leaving 24 (CEA = 15, CBA = 6, CMA = 3; Brazil = 9, Argentina = 5, Colombia = 3, Chile = 2, Ecuador = 2, 1 each from Peru, Uruguay, Venezuela). Variability between raters was less than 0.5 point on overall scores (OS) and less than 1 point on all individual items. Mean OS was 2.6 (SD 1.0, range 1.4-3.8). CBAs scored highest (OS 2.8, SD 0.8), CEAs next (OS 2.7, SD 0.7), and CMAs lowest (OS 2.0, SD 0.5). When scored by type of question, definition of study aim scored highest (OS 3.0, SD 0.8), while ethical issues scored lowest (OS 1.5, SD 0.9). By country, Peru scored highest (mean OS 3.8) and Uruguay had the lowest scores (mean OS 2.2). A nonsignificant time trend was noted for OS (R2 = 0.12; p = 0.104). Quality scores of health economic analyses

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  14. Practitioner survey of the state of health integration in environmental assessment: The case of northern Canada

    International Nuclear Information System (INIS)

    Noble, Bram; Bronson, Jackie

    2006-01-01

    Based on a case study of health integration in Canadian northern EA, this paper further demonstrates the lack of consistent integration of health in EA practice. A survey was administered to northern EA and health practitioners, administrators and special interest groups to assess current northern health assessment practices, the scope of health in EA, EA performance with regard to health assessment and the perceived barriers to health integration. Results suggest that health is currently recognized as an important component of northern EA and is addressed in the majority of cases; however, health is addressed primarily during the pre-decision stages of EA and less often during post-decision follow-up and monitoring. Moreover, when health is addressed, attention is limited to the physical components of health and health impacts due to physical environmental change, with considerably less attention given to the social aspects of health. Results also suggest dissent between EA practitioners, health practitioners and other interests concerning the overall state of health in EA; however, there is consensus on the key challenges to improved integration, namely differences in understanding of the scope of health and expectations of EA to assess health impacts; limited coordination between EA and health practitioners; limited scope and requirements of current EA legislation for health assessment; and the lack of supporting EA methods and frameworks

  15. Frequency and prioritization of patient health risks from a structured health risk assessment.

    Science.gov (United States)

    Phillips, Siobhan M; Glasgow, Russell E; Bello, Ghalib; Ory, Marcia G; Glenn, Beth A; Sheinfeld-Gorin, Sherri N; Sabo, Roy T; Heurtin-Roberts, Suzanne; Johnson, Sallie Beth; Krist, Alex H

    2014-01-01

    To describe the frequency and patient-reported readiness to change, desire to discuss, and perceived importance of 13 health risk factors in a diverse range of primary care practices. Patients (n = 1,707) in 9 primary care practices in the My Own Health Report (MOHR) trial reported general, behavioral, and psychosocial risk factors (body mass index [BMI], health status, diet, physical activity, sleep, drug use, stress, anxiety or worry, and depression). We classified responses as "at risk" or "healthy" for each factor, and patients indicated their readiness to change and/or desire to discuss identified risk factors with providers. Patients also selected 1 of the factors they were ready to change as most important. We then calculated frequencies within and across these factors and examined variation by patient characteristics and across practices. On average, patients had 5.8 (SD = 2.12; range, 0-13) unhealthy behaviors and mental health risk factors. About 55% of patients had more than 6 risk factors. On average, patients wanted to change 1.2 and discuss 0.7 risks. The most common risks were inadequate fruit/vegetable consumption (84.5%) and overweight/obesity (79.6%). Patients were most ready to change BMI (33.3%) and depression (30.7%), and most wanted to discuss depression (41.9%) and anxiety or worry (35.2%). Overall, patients rated health status as most important. Implementing routine comprehensive health risk assessments in primary care will likely identify a high number of behavioral and psychosocial health risks. By soliciting patient priorities, providers and patients can better manage counseling and behavior change. © 2014 Annals of Family Medicine, Inc.

  16. Generic Assessment Criteria for human health risk assessment of potentially contaminated land in China.

    Science.gov (United States)

    Cheng, Yuanyuan; Nathanail, Paul C

    2009-12-20

    Generic Assessment Criteria (GAC) are derived using widely applicable assumptions about the characteristics and behaviour of contaminant sources, pathways and receptors. GAC provide nationally consistent guidance, thereby saving money and time. Currently, there are no human health based Generic Assessment Criteria (GAC) for contaminated sites in China. Protection of human health is therefore difficult to ensure and demonstrate; and the lack of GAC makes it difficult to tell if there is potential significant risk to human health unless site-specific criteria are derived. This paper derived Chinese GAC (GAC) for five inorganic and eight organic substances for three regions in China for three land uses: urban residential without plant uptake, Chinese cultivated land, and commercial/industrial using the SNIFFER model. The SNIFFER model has been further implemented with a dermal absorption algorithm and the model default input values have been changed to reflect the Chinese exposure scenarios. It is envisaged that the modified SNIFFER model could be used to derive GAC for more contaminants, more Regions, and more land uses. Further research to enhance the reliability and acceptability of the GAC is needed in regional/national surveys in diet and working patterns.

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

    Science.gov (United States)

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Sebastien Borguet

    2011-01-01

    Full Text Available The goal of module performance analysis is to reliably assess the health of the main components of an aircraft engine. A predictive maintenance strategy can leverage this information to increase operability and safety as well as to reduce costs. Degradation undergone by an engine can be divided into gradual deterioration and accidental events. Kalman filters have proven very efficient at tracking progressive deterioration but are poor performers in the face of abrupt events. Adaptive estimation is considered as an appropriate solution to this deficiency. This paper reports the evaluation of the detection capability of an adaptive diagnosis tool on the basis of simulated scenarios that may be encountered during the operation of a commercial turbofan engine. The diagnosis tool combines a Kalman filter and a secondary system that monitors the residuals. This auxiliary component implements a generalised likelihood ratio test in order to detect abrupt events.

  19. Assessment of health risks from exposure to ionizing radiation

    International Nuclear Information System (INIS)

    Beebe, G.W.

    1982-01-01

    Rapid development in the assessment of health risks from exposure to ionizing radiation has produced an impressive array of risk differentials of presumed biologic significance. In the human data these differentials involve: (1) the variety of cancer, especially its size; (2) host factors, especially age; (3) time following exposure; (4) magnitude of dose; and (5) type of radiation. From experimental work we may presume that dose-rate also plays a role, especially for sparsely ionizing radiation. Current research is extending the scope of differentials with respect to these and other variables, including cell type and concomitant environmental risk factors, and testing dose-response models suggested by experimental and theoretical work. As facts to be explained, differentials in risk may lead to hypotheses to be explored experimentally and improve our understanding of how ionizing radiation causes cancer. 74 references

  20. Women's knowledge in Madagascar: a health needs assessment study.

    Science.gov (United States)

    Dell, Evelyn M; Erikson, S L; Andrianirina, E; Smith, Gabrielle

    2012-01-01

    Nutritional and hygienic practices contribute to high morbidity and mortality rates related to malnutrition in Madagascar. This study, a research effort that brought together charitable organisations, non-governmental organisations (NGOs) and university collaborators, investigates women's health knowledge in the Anosy region of Madagascar. The needs assessment sought to characterise women's knowledge and understanding of nutrition and hygiene. Eight focus groups of 13-60 women each were conducted in the seven most impoverished communes of the Anosy region (n=373). Participants were recruited with the aid of a UK-Malagasy partnered NGO, Azafady. Study findings show that women fully understand the interplay between poor nutrition, hygiene and malnutrition but are unable to change everyday practices because the barriers to better nutrition and hygiene seem beyond their control. These findings may be used to prioritise projects and research seeking to improve nutrition and hygiene, thus reducing malnutrition in the Anosy region.

  1. Assessing the use of computers in industrial occupational health departments.

    Science.gov (United States)

    Owen, J P

    1995-04-01

    Computers are widely used in business and industry and the benefits of computerizing occupational health (OH) departments have been advocated by several authors. The requirements for successful computerization of an OH department are reviewed. Having identified the theoretical benefits, the real picture in industry is assessed by surveying 52 firms with over 1000 employees in a large urban area. Only 15 (29%) of the companies reported having any OH service, of which six used computers in the OH department, reflecting the business priorities of most of the companies. The types of software systems used and their main use are examined, along with perceived benefits or disadvantages. With the decreasing costs of computers and increasingly 'user-friendly' software, there is a real cost benefit to be gained from using computers in OH departments, although the concept may have to be 'sold' to management.

  2. Technology integration performance assessment using lean principles in health care.

    Science.gov (United States)

    Rico, Florentino; Yalcin, Ali; Eikman, Edward A

    2015-01-01

    This study assesses the impact of an automated infusion system (AIS) integration at a positron emission tomography (PET) center based on "lean thinking" principles. The authors propose a systematic measurement system that evaluates improvement in terms of the "8 wastes." This adaptation to the health care context consisted of performance measurement before and after integration of AIS in terms of time, utilization of resources, amount of materials wasted/saved, system variability, distances traveled, and worker strain. The authors' observations indicate that AIS stands to be very effective in a busy PET department, such as the one in Moffitt Cancer Center, owing to its accuracy, pace, and reliability, especially after the necessary adjustments are made to reduce or eliminate the source of errors. This integration must be accompanied by a process reengineering exercise to realize the full potential of AIS in reducing waste and improving patient care and worker satisfaction. © The Author(s) 2014.

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

    Science.gov (United States)

    Nove, Andrea; Cometto, Giorgio; Campbell, James

    2017-11-09

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

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

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    2007-08-01

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

  5. Functioning assessment vs. conventional medical assessment: a comparative study on health professionals’ clinical decision-making and the fit with patient’s own perspective of health

    NARCIS (Netherlands)

    Stallinga, Gonda; Roodbol, Petrie; Annema, Coby; Jansen, Gerard; Wynia, Klaske

    2013-01-01

    Aims and objectives. To compare a functioning assessment based on the International Classification of Functioning, Disability and Health (ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals’ clinical decision-making and the fit with

  6. Functioning assessment vs. conventional medical assessment : a comparative study on health professionals' clinical decision-making and the fit with patient's own perspective of health

    NARCIS (Netherlands)

    Stallinga, Hillegonda A.; Roodbol, Petrie F.; Annema, Coby; Jansen, Gerard J.; Wynia, Klaske

    Aims and objectives. To compare a functioning assessment based on the International Classification of Functioning, Disability and Health (ICF) with a conventional medical assessment, in terms of their respective consequences for health professionals' clinical decision-making and the fit with

  7. Investigating underlying principles to guide health impact assessment.

    Science.gov (United States)

    Fakhri, Ali; Maleki, Mohammadreza; Gohari, Mahmoodreza; Harris, Patrick

    2014-06-01

    Many countries conduct Health Impact Assessment (HIA) of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. This study was conducted in three stages: 1) Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2) The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3) Finally, these principles were agreed by experts using nominal group technique. The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Determining the principles of HIA from peer-reviewed papers provides an opportunity for guiding

  8. INFLUENCE OF HEALTH TECHNOLOGY ASSESSMENT AND ITS MEASUREMENT.

    Science.gov (United States)

    Hailey, David; Werkö, Sophie; Rosén, Måns; Macpherson, Karen; Myles, Susan; Gallegos Rivero, Verónica; Hipólito-Olivares, Cecilia; Sihvo, Sinikka; Pwu, Jasmine; Yang, Wen-Wen; Chen, Yong-Chen; Perez Galán, Ana; Aleman, Alicia; Villamil, Elena

    2016-01-01

    The aim of this study was to obtain information on methods used to measure health technology assessment (HTA) influence, decisions that were influenced, and outcomes linked to HTA. Electronic databases were used to locate studies in which HTA influence had been demonstrated. Inclusion criteria were studies that reliably reported consideration by decision makers of HTA findings; comparative studies of technology use before and after HTA; and details of changes in policy, health outcomes, or research that could be credibly linked to an HTA. Fifty-one studies were selected for review. Settings were national (24), regional (12), both national and regional (3) hospitals (9), and multinational (3). The most common approach to appraisal of influence was review of policy or administrative decisions following HTA recommendations (51 percent). Eighteen studies (35 percent) reported interview or survey findings, thirteen (26 percent) reviewed administrative data, and six considered the influence of primary studies. Of 142 decisions informed by HTA, the most common types were on routine clinical practice (67 percent of studies), coverage (63 percent), and program operation (37 percent). The most frequent indications of HTA influence were on decisions related to resource allocation (59 percent), change in practice pattern (31 percent), and incorporation of HTA details in reference material (18 percent). Few publications assessed the contribution of HTA to changing patient outcomes. The literature on HTA influence remains limited, with little on longer term effects on practice and outcomes. The reviewed publications indicated how HTA is being used in different settings and approaches to measuring its influence that might be more widely applied, such as surveys and monitoring administrative data.

  9. Investigating Underlying Principles to Guide Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Ali Fakhri

    2014-06-01

    Full Text Available Background Many countries conduct Health Impact Assessment (HIA of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods This study was conducted in three stages: 1 Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2 The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3 Finally, these principles were agreed by experts using nominal group technique. Results The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion Determining the principles of HIA from

  10. Firefighter health and fitness assessment: a call to action.

    Science.gov (United States)

    Storer, Thomas W; Dolezal, Brett A; Abrazado, Marlon L; Smith, Denise L; Batalin, Maxim A; Tseng, Chi-Hong; Cooper, Christopher B

    2014-03-01

    Sudden cardiac deaths experienced by firefighters in the line of duty account for the largest proportion of deaths annually. Several fire service standards for fitness and wellness have been recommended but currently only 30% of U.S. fire departments are implementing programs for this purpose. The Department of Homeland Security Science and Technology Directorate has initiated the Physiological Health Assessment System for Emergency Responders (PHASER) program aiming to reduce these line-of-duty deaths through an integration of medical science and sensor technologies. Confirming previous reports, PHASER comprehensive risk assessment has identified lack of physical fitness with propensity for overexertion as a major modifiable risk factor. We sought to determine if current levels of fitness and cardiovascular disease (CVD) risk factors in a contemporary cohort of firefighters were better than those reported over the past 30 years. Fifty-one firefighters from a Southern California department were characterized for physical fitness and CVD risk factors using standard measures. Overall, physical fitness and risk factors were not different from previous reports of firefighter fitness and most subjects did not achieve recommended fitness standards. Considering the lack of widespread implementation of wellness/fitness programs in the U.S. fire service together with our findings that low physical fitness and the presence of CVD risk factors persist, we issue a call to action among health and fitness professionals to assist the fire service in implementing programs for firefighters that improve fitness and reduce CVD risk factors. Fitness professionals should be empowered to work with fire departments lending their expertise to guide programs that achieve these objectives, which may then lead to reduced incidence of sudden cardiac death or stroke.

  11. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  12. Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users' perspectives.

    Science.gov (United States)

    Mohammed, Shafiu; Bermejo, Justo Lorenzo; Souares, Aurélia; Sauerborn, Rainer; Dong, Hengjin

    2013-12-01

    Responsiveness of health care services in low and middle income countries has been given little attention. Despite being introduced over a decade ago in many developing countries, national health insurance schemes have yet to be evaluated in terms of responsiveness of health care services. Although this responsiveness has been evaluated in many developed countries, it has rarely been done in developing countries. The concept of responsiveness is multi-dimensional and can be measured across various domains including prompt attention, dignity, communication, autonomy, choice of provider, quality of facilities, confidentiality and access to family support. This study examines the insured users' perspectives of their health care services' responsiveness. This retrospective, cross-sectional survey took place between October 2010 and March 2011. The study used a modified out-patient questionnaire from a responsiveness survey designed by the World Health Organization (WHO). Seven hundred and ninety six (796) enrolees, insured for more than one year in Kaduna State-Nigeria, were interviewed. Generalized ordered logistic regression was used to identify factors that influenced the users' perspectives on responsiveness to health services and quantify their effects. Communication (55.4%), dignity (54.1%), and quality of facilities (52.0%) were rated as "extremely important" responsiveness domains. Users were particularly contented with quality of facilities (42.8%), dignity (42.3%), and choice of provider (40.7%). Enrolees indicated lower contentment on all other domains. Type of facility, gender, referral, duration of enrolment, educational status, income level, and type of marital status were most related with responsiveness domains. Assessing the responsiveness of health care services within the NHIS is valuable in investigating the scheme's implementation. The domains of autonomy, communication and prompt attention were identified as priority areas for action to improve

  13. The Atrial Fibrillation Health Literacy Information Technology System: Pilot Assessment.

    Science.gov (United States)

    Magnani, Jared W; Schlusser, Courtney L; Kimani, Everlyne; Rollman, Bruce L; Paasche-Orlow, Michael K; Bickmore, Timothy W

    2017-01-01

    Atrial fibrillation (AF) is a highly prevalent heart rhythm condition that has significant associated morbidity and requires chronic treatment. Mobile health (mHealth) technologies have the potential to enhance multiple aspects of AF care, including education, monitoring of symptoms, and encouraging and tracking medication adherence. We have previously implemented and tested relational agents to improve outcomes in chronic disease and sought to develop a smartphone-based relational agent for improving patient-centered outcomes in AF. The objective of this study was to pilot a smartphone-based relational agent as preparation for a randomized clinical trial, the Atrial Fibrillation Health Literacy Information Technology Trial (AF-LITT). We developed the relational agent for use by a smartphone consistent with our prior approaches. We programmed the relational agent as a computer-animated agent to simulate a face-to-face conversation and to serve as a health counselor or coach specific to AF. Relational agent's dialogue content, informed by a review of literature, focused on patient-centered domains and qualitative interviews with patients with AF, encompassed AF education, common symptoms, adherence challenges, and patient activation. We established that the content was accessible to individuals with limited health or computer literacy. Relational agent content coordinated with use of the smartphone AliveCor Kardia heart rate and rhythm monitor. Participants (N=31) were recruited as a convenience cohort from ambulatory clinical sites and instructed to use the relational agent and Kardia for 30 days. We collected demographic, social, and clinical characteristics and conducted baseline and 30-day assessments of health-related quality of life (HRQoL) with the Atrial Fibrillation Effect on Quality of life (AFEQT) measure; self-reported medication adherence with the Morisky 8-item Medication Adherence Scale (MMAS-8); and patient activation with the Patient Activation

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

    Science.gov (United States)

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

    2013-01-01

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

  15. A Collaborative Effort to Assess Environmental Health in ...

    Science.gov (United States)

    The Region 3 “Making a Visible Difference in Communities” (MVD) initiative for Southeast Newport News, VA has taken a community-centric, place-based approach to identifying and delivering service to the area’s residents and the city as a whole. Beginning with a CARE (Community Action for a Renewed Environment) Level 1 cooperative agreement (a grant with substantial government involvement and required outputs) in 2011, Region 3 funding helped to establish the Southeast CARE Coalition (“the Coalition”), and quickly formed a bond with the organization. Two years later, Region 3, the US EPA Office of Research and Development (ORD) and the Coalition embarked on a scientific, socio-demographic Regional Sustainable Environmental Science (RESES) research project to assess local pollutant sources and their potential impacts to the community. These efforts helped EPA select Newport News as an MVD community, resulting in an expanded partnership that now includes the City of Newport News. Through this association and the MVD designation, the partners have identified and prioritized environmental and other concerns (e.g., improving air and water quality, adapting to extreme weather, promoting equitable development, improving transportation). Newport News has recently held workshops and training on topics such as environmental health, asthma, weather events, and equitable development, and continues to improve the community’s health, its knowledge of the relevant e

  16. Health, Safety and Environmental Risk Assessment in Laboratory Sites

    Directory of Open Access Journals (Sweden)

    2012-05-01

    Full Text Available Introduction: ”Exposing to danger” or in other words, “risk” is a process which is led to an uncertain result in every field. Project risks are uncertain contingent events or situations that if they occur will have positive or negative effects on project’s objectives. Todays, research and educational process and more complicated and the professional risk management become much more difficult, as a result. .Material and Method: In this research, the health and safety issues have been studied and analyzed using ISO 14121 and the environmental issues by EMEA to determine the risk level separately for research laboratories and to prioritize corrective measure in each field (school. .Result: The finding in this study showed that from all the main risks within the rage of 38-86 percent have been decreased. Moreover average of the risk level for the health, safety and environment cases showed a significant decrease (Pvalue<0.0001 by implement controlling and protective countermeasures compariy to the priority state without any measures. . Conclusion: The risk assessment with hazards control strategy based on ISO 14121 is a compatible method in laboratory site as universities and other reasearch sites.

  17. 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.

  18. CURRENT ENVIRONMENT FOR INTRODUCING HEALTH TECHNOLOGY ASSESSMENT IN GREECE.

    Science.gov (United States)

    Kani, Chara; Kourafalos, Vasilios; Litsa, Panagiota

    2017-01-01

    The aim of this study was to describe the current regulatory environment in Greece to evaluate the potential introduction of health technology assessment (HTA) for medicinal products for human use. Data sources consist of national legislation on pricing and reimbursement of health technologies to identify the potential need of establishing HTA and its relevant structure. The pricing procedure regarding medicinal products for human use is based on an external reference pricing mechanism which considers the average of the three lowest Euorpean Union prices. Currently, a formal HTA procedure has not been applied in Greece, and the only prerequisite used for the reimbursement of medicinal products for human use is their inclusion in the Positive Reimbursement List. To restrict pharmaceutical expenditure, a variety of measures-such as clawback mechanisms, rebates, monthly budget caps per physician, generics penetration targeting-have been imposed, aiming mainly to regulate the price level rather than control the introduction of medicinal products for human use in the Greek pharmaceutical market. Greece has the opportunity to rapidly build capacity, implement, and take advantage of the application of HTA mechanisms by clearly defining the goals, scope, systems, context, stakeholders, and methods that will be involved in the local HTA processes, taking into account the country's established e-prescription system and the recently adapted legislative framework.

  19. Consumer involvement in the health technology assessment program.

    Science.gov (United States)

    Royle, Jane; Oliver, Sandy

    2004-01-01

    This study aims to describe a cycle of development leading to sustainable methods for involving consumers in the management of a program commissioning health technology assessment. Staff time was dedicated to developing procedures for recruiting and briefing consumers to participate in prioritizing, commissioning, and reporting research. Resources and support were developed in light of early feedback from consumers and those working with them. These were piloted and amended before being used routinely. Over 4 years, procedures and resources have been developed to support six consumers attending seven to eight prioritization meetings a year; thirty to forty-five consumers each year commenting on research need for particular topics; thirty consumers a year commenting on research proposals, and twenty a year commenting on research reports. The procedures include clear job descriptions, induction and development days, clear briefing materials, payment for substantial tasks, and regularly seeking feedback to improve procedures. Explicit, inclusive, and reproducible methods for supporting consumer involvement that satisfy National Health Service policy recommendations for involving consumers in research require dedicated staff time to support a cycle of organizational development.

  20. Ethical issues of obesity surgery--a health technology assessment.

    Science.gov (United States)

    Saarni, Samuli I; Anttila, Heidi; Saarni, Suoma E; Mustajoki, Pertti; Koivukangas, Vesa; Ikonen, Tuija S; Malmivaara, Antti

    2011-09-01

    New surgical technologies may challenge societal values, and their adoption may lead to ethical challenges. Despite proven cost-effectiveness, obesity (bariatric) surgery and its public funding have been questioned on ethical arguments relating to, for example, the self-inflicted or non-disease nature of obesity. Our aim was to analyze the ethical issues relevant to bariatric surgery. A comprehensive health technology assessment was conducted on bariatric surgery for morbid obesity using the EUnetHTA method, including a fully integrated ethical analysis. The ethical arguments suggesting that obesity should not be surgically treated because it is self-inflicted were rejected. Medicalization of obesity may have both positive and negative effects that impact the various stakeholders differently, thus being difficult to balance. Informing bariatric surgery patients and actively supporting their autonomy is exceptionally important, as the benefits and harms of both obesity and bariatric surgery are complex, and the outcome depends on how well the patient understands and adheres to the life-long changes in eating habits required. Justice considerations are important in organizing surgical treatment of obesity, as the obese are discriminated against in many ways and obesity is more common in socioeconomically disadvantaged populations who might have problems of access to treatments. Obesity should be treated like other diseases in health care, and obesity surgery rationed like other cost-effective treatments. Positive actions to ensure patient autonomy and just access to surgical treatments may be warranted.

  1. INTEGRATING HEALTH TECHNOLOGY ASSESSMENT PRINCIPLES IN FORMULARY MANAGEMENT.

    Science.gov (United States)

    Teng, Monica; Khoo, Ai Leng; Zhao, Ying Jiao; Lin, Liang; Lim, Boon Peng

    2016-01-01

    Effective formulary management in healthcare institutions safeguards rational drug use and optimizes health outcomes. We implemented a formulary management program integrating the principles of health technology assessment (HTA) to improve the safe, appropriate, and cost-effective use of medicine in Singapore. A 3-year formulary management program was initiated in 2011 in five public healthcare institutions. This program was managed by a project team comprising HTA researchers. The project team worked with institutional pharmacy and therapeutics (P&T) committees to: (i) develop tools for formulary drug review and decision making; (ii) enhance the HTA knowledge and skills of formulary pharmacists and members of P&T committees; (iii) devise a prioritization framework to overcome resource constraints and time pressure; and (iv) conceptualize and implement a framework to review existing formulary. Tools that facilitate drug request submission, drug review, and decision making were developed for formulary drug inclusion. A systematic framework to review existing formulary was also developed and tested in selected institutions. A competency development plan was rolled out over 2 years to enhance formulary pharmacists' proficiency in systematic literature search and review, meta-analysis, and pharmacoeconomic evaluation. The plan comprised training workshops and on-the-job knowledge transfer between the project team and institutional formulary pharmacists through collaborating on selected drug reviews. A resource guide that consolidated the tools and templates was published to encourage the adoption of best practices in formulary management. Based on the concepts of HTA, we implemented an evidence-based approach to optimize formulary management.

  2. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    Lybeck, N.; Tawfik, M.; Coble, J.; Bond, L.J.

    2012-01-01

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

  3. Developing a servicelearning module for oral health: A needs assessment

    Directory of Open Access Journals (Sweden)

    R Ebrahim

    2017-03-01

    Full Text Available Background. Service learning (SL as a pedagogy in higher education must be differentiated from other services with a primarily philanthropic intent. Dental therapy and oral hygiene students at Sefako Makgatho Health Sciences University, School of Oral Health Sciences, Pretoria, South Africa visit community sites during their 2nd year of study. However, the current curricula would need restructuring for alignment with the espoused pedagogy and standards of SL. Such an SL curriculum design would thus allow for the provision of meaningful services to communities as an integral component of these programmes.Objective. To explore (i perceptions of 2nd-year oral health students; and (ii opinions of academics with regard to the need for an SL module.Methods. Purposive sampling was used to conduct two focus group discussions with academics involved in curriculum development (n=11 and students who had previous exposure to communities (n=10. A survey containing open-ended questions was completed by 9 academics, who would implement the proposed SL module. Frequencies were calculated and data from the open questions were analysed for emergent themes.Results. Most academics (89%, n=8 indicated that working effectively with others as members of a team and developing cultural sensitivity were achievable from an SL module. Two themes emerged from the focus groups, i.e. (i enhanced teaching and learning – students could apply theoretical and clinical training in an authentic setting; and (ii standardisation of training – an SL module would ensure consistency when engaging with communities.Conclusion. The needs assessment was valuable to inform the development and implementation of the SL module.

  4. An Assessment of Integrated Health Management (IHM) Frameworks

    International Nuclear Information System (INIS)

    Lybeck, N.; Tawfik, M.; Bond, L.; Coble, J.

    2012-01-01

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

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

    Science.gov (United States)

    Skouloudis, Andreas N; Kassomenos, Pavlos

    2014-08-01

    The use of emerging technologies for environmental monitoring with satellite and in-situ sensors have become essential instruments for assessing the impact of environmental pollution on human health, especially in areas that require high spatial and temporal resolution. This was until recently a rather difficult problem. Regrettably, with classical approaches the spatial resolution is frequently inadequate in reporting environmental causes and health effects in the same time scale. This work examines with new tools different levels of air-quality with sensor monitoring with the aim to associate those with severe health effects. The process established here facilitates the precise representation of human exposure with the population attributed in a fine spatial grid and taking into account environmental stressors of human exposure. These stressors can be monitored with innovative sensor units with a temporal resolution that accurately describes chronic and acute environmental burdens. The current understanding of the situation in densely populated areas can be properly analyzed, before commitments are made for reductions in total emissions as well as for assessing the effects of reduced trans-boundary fluxes. In addition, the data processed here with in-situ sensors can assist in establishing more effective regulatory policies for the protection of vulnerable population groups and the satellite monitoring instruments permit abatement strategies that are close to real-time over large geographical areas. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Assessment of Environmental Sustainability in Health Care Organizations

    Directory of Open Access Journals (Sweden)

    María Carmen Carnero

    2015-06-01

    Full Text Available Healthcare organizations should set a standard in corporate social responsibility and encourage environmental sustainability, since protection of the environment implies the development of preventive measures in healthcare. Environmental concern has traditionally focused on manufacturing plants. However, a Health Care Organization (HCO is the only type of company which generates all existing classes of waste, and 20% is dangerous, being infectious, toxic or radioactive in nature. Despite the extensive literature analysing environmental matters, there is no objective model for assessing the environmental sustainability of HCOs in such a way that the results may be compared over time for an organization, and between different organizations, to give a comparison or benchmarking tool for HCOs. This paper presents a Multi-Criteria Decision Analysis model integrating a Fuzzy Analytic Hierarchy Process and utility theory, to evaluate environmental sustainability in HCOs. The model uses criteria assessed as a function of the number of annual treatments undertaken. The model has been tested in two HCOs of very different sizes.

  7. Health Risk Assessment of Groundwater Arsenic Pollution in Southern Taiwan

    Science.gov (United States)

    Liang, Ching-Ping

    2015-04-01

    This study investigates the risk of arsenic (As) exposure to the residents in Pingtung Plain of Taiwan, where more than 50% of people extracts groundwater to meet the drinking purpose and monitoring groundwater shows that a considerable portion of groundwater has an As concentration of more than safe drinking water guideline of 10μg/L-1. Exposure and risk assessment are carried out in accordance with the provisional daily intake (PTDI) recommended by the FAO/WHO as well as hazard quotient and cancer risk standards based on the US Environmental Protection Agency. The variability of body weights and drinking water consumption scenarios are considered in exposure and risk assessment. Results shows that daily intake exceeds 2.1μg day-1 kg-1 BW for 2% of population, HQ level above unity for 20% , and can risk greater than 10-6 for 80%. These results implies that drinking water directly from groundwater will place many people at the risk of exposure and any efforts to supply safe drinking water is imperial for governing in order to protect the human health of inhabitants in Pingtung Plain.

  8. Health risk assessment for radium discharged in produced waters

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Meinhold, A.F.; Nagy, J.

    1991-01-01

    Produced water generated during the production of oil and gas can contain enhanced levels of radium. This naturally occurring radioactive material (NORM) is discharged into freshwater streams, estuarine, coastal and outer continental shelf waters. Large volumes of produced waters are discharged to coastal waters along the Gulf Coast of Louisiana. The Gulf of Mexico is an important producer of fish and shellfish, and there is concern that radium discharged to coastal Louisiana could contaminate fish and shellfish used by people for food, and present a significant increase in cancer risk. This paper describes a screening-level assessment of the potential cancer risks posed by radium discharged to coastal Louisiana in oil-field produced waters. This screening analysis was performed to determine if a more comprehensive and realistic assessment is necessary, and because of the conservative assumptions embedded in the analysis overestimates the risk associated with the discharge of radium in produced waters. Two isotopes of radium (Ra-226 and Ra-228) are the radionuclides of most concern in produced water in terms of potential human health effects

  9. Assessing the health impact of transnational corporations: a case study on McDonald?s Australia

    OpenAIRE

    Anaf, Julia; Baum, Frances E.; Fisher, Matt; Harris, Elizabeth; Friel, Sharon

    2017-01-01

    Background The practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald?s Australia to test methods for assessing the health impacts of one TNC within Australia. Methods We adapted existing Health Impact Assessment methods to assess M...

  10. Software Tools to Support the Assessment of System Health

    Science.gov (United States)

    Melcher, Kevin J.

    2013-01-01

    This presentation provides an overview of three software tools that were developed by the NASA Glenn Research Center to support the assessment of system health: the Propulsion Diagnostic Method Evaluation Strategy (ProDIMES), the Systematic Sensor Selection Strategy (S4), and the Extended Testability Analysis (ETA) tool. Originally developed to support specific NASA projects in aeronautics and space, these software tools are currently available to U.S. citizens through the NASA Glenn Software Catalog. The ProDiMES software tool was developed to support a uniform comparison of propulsion gas path diagnostic methods. Methods published in the open literature are typically applied to dissimilar platforms with different levels of complexity. They often address different diagnostic problems and use inconsistent metrics for evaluating performance. As a result, it is difficult to perform a one ]to ]one comparison of the various diagnostic methods. ProDIMES solves this problem by serving as a theme problem to aid in propulsion gas path diagnostic technology development and evaluation. The overall goal is to provide a tool that will serve as an industry standard, and will truly facilitate the development and evaluation of significant Engine Health Management (EHM) capabilities. ProDiMES has been developed under a collaborative project of The Technical Cooperation Program (TTCP) based on feedback provided by individuals within the aircraft engine health management community. The S4 software tool provides a framework that supports the optimal selection of sensors for health management assessments. S4 is structured to accommodate user ]defined applications, diagnostic systems, search techniques, and system requirements/constraints. One or more sensor suites that maximize this performance while meeting other user ]defined system requirements that are presumed to exist. S4 provides a systematic approach for evaluating combinations of sensors to determine the set or sets of

  11. Health and aging: development of the Irish Longitudinal Study on Ageing health assessment.

    Science.gov (United States)

    Cronin, Hilary; O'Regan, Clare; Finucane, Ciaran; Kearney, Patricia; Kenny, Rose Anne

    2013-05-01

    To assist researchers planning studies similar to The Irish Longitudinal Study on Ageing (TILDA), concerning the development of the health assessment component, to promote use of the archived data set, to inform researchers of the methods employed, and to complement the accompanying article on normative values. Prospective, longitudinal study of older adults. Republic of Ireland. Eight thousand five hundred four community-dwelling adults who participated in wave 1 of the TILDA study. The main areas of focus for the TILDA health assessments are neurocardiovascular instability, locomotion, and vision. The article describes the scientific rationale for the choice of assessments and seeks to determine the potential advantages of incorporating novel biomeasures and technologies in population-based studies to advance understanding of aging-related disorders. The detailed description of the physical measures will facilitate cross-national comparative research and put into context the normative values outlined in the subsequent article. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  12. Assessing Community Leadership: Understanding Community Capacity for Health Improvement.

    Science.gov (United States)

    Castle, Billie; Wendel, Monica; Kelly Pryor, Brandy N; Ingram, Monique

    The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to

  13. Variation in Health Technology Assessment and Reimbursement Processes in Europe.

    Science.gov (United States)

    Akehurst, Ronald L; Abadie, Eric; Renaudin, Noël; Sarkozy, François

    2017-01-01

    It has been suggested that differences in health technology assessment (HTA) processes among countries, particularly within Europe, have led to inequity in patient access to new medicines. To provide an up-to-date snapshot analysis of the present status of HTA and reimbursement systems in select European countries, and to investigate the implications of these processes, especially with regard to delays in market and patient access. HTA and reimbursement processes were assessed through a review of published and gray literature, and through a series of interviews with HTA experts. To quantify the impact of differences among countries, we conducted case studies of 12 products introduced since 2009, including 10 cancer drugs. In addition to the differences in HTA and reimbursement processes among countries, the influence of particular sources of information differs among HTA bodies. The variation in the time from the authorization by the European Medicines Agency to the publication of HTA decisions was considerable, both within and among countries, with a general lack of transparency as to why some assessments take longer than others. In most countries, market access for oncology products can occur outside the HTA process, with sales often preceding HTA decisions. It is challenging even for those with considerable personal experience in European HTA processes to establish what is really happening in market access for new drugs. We recommend that efforts should be directed toward improving transparency in HTA, which should, in turn, lead to more effective processes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. CRRIS, Health Risk Assessment from Atmospheric Releases of Radionuclides

    International Nuclear Information System (INIS)

    1999-01-01

    1 - Description of program or function: CRRIS consists of eight fully integrated computer codes which calculate environmental transport of atmospheric releases of radionuclides and resulting doses and health risks to individuals or populations. Each code may be used alone for various assessment applications. Because of its modular structure, CRRIS allows assessments to be tailored to the user's needs. Radionuclides are handled by CRRIS either in terms of the released radionuclides or the exposure radionuclides which consist of both the released nuclides and decay products that build up during environmental transport. Atmospheric dispersion calculations are performed by the ANEMOS computer code for distances less than 100 km and the RETADD-II computer code regional-scale distances. Both codes estimate annual-average air concentrations and ground deposition rates by location. SUMIT will translate and scale multiple ANEMOS runs onto a master grid. TERRA reads radionuclide air concentrations and deposition rates to estimate concentrations of radionuclides in food and surface soil. Radiologic decay and ingrowth, soil leaching, and transport through the food chain are included in the calculations. MLSOIL computes an effective radionuclide ground-surface concentration to be used in computing external health effects. The five-layer model of radionuclide transport through soil in MLSOIL provides an alternative to the single-layer model used in TERRA. DFSOIL computes dose factors used in MLSOIL to compute doses from the five soil layers and from the ground surface. ANDROS reads environmental concentrations of radionuclides computed by the other CRRIS codes and produces tables of doses and risks to individuals or populations from atmospheric releases of radionuclides. 2 - Method of solution: SUMIT performs geometric interpolation. TERRA and MLSOIL are terrestrial transport compartment models. DFSOIL computes soil-layer-specific dose factors based on the point-kernel method

  15. Health literacy demands of written health information materials: an assessment of cervical cancer prevention materials.

    Science.gov (United States)

    Helitzer, Deborah; Hollis, Christine; Cotner, Jane; Oestreicher, Nancy

    2009-01-01

    Health literacy requires reading and writing skills as well as knowledge of health topics and health systems. Materials written at high reading levels with ambiguous, technical, or dense text, often place great comprehension demands on consumers with lower literacy skills. This study developed and used an instrument to analyze cervical cancer prevention materials for readability, comprehensibility, suitability, and message design. The Suitability Assessment of Materials (SAM) was amended for ease of use, inclusivity, and objectivity with the encouragement of the original developers. Other novel contributions were specifically related to "comprehensibility" (CAM). The resulting SAM + CAM was used to score 69 materials for content, literacy demand, numeric literacy, graphics, layout/typography, and learning stimulation variables. Expert reviewers provided content validation. Inter-rater reliability was "substantial" (kappa = .77). The mean reading level of materials was 11th grade. Most materials (68%) scored as "adequate" for comprehensibility, suitability, and message design; health education brochures scored better than other materials. Only one-fifth were ranked "superior" for ease of use and comprehensibility. Most written materials have a readability level that is too high and require improvement in ease of use and comprehensibility for the majority of readers.

  16. Health technology assessment and health policy today a multifaceted view of their unstable crossroads

    CERN Document Server

    del Llano-Señarís, Juan E

    2015-01-01

    This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA's features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consoli...

  17. Technical Consultation of the Hubble Space Telescope (HST) System Health Assessment: Analysis of HST Health

    Science.gov (United States)

    Gentz, Steven J.; Heard, Brent N.; Hodson, Robert F.; Pettit, Duane H.; Pandolf, John E.; Azzolini, John D.; Dennehy, Cornelius J.; Farley, Rodger E.; Kirchman, Frank J.; Spidaliere, Peter D.

    2005-01-01

    The NESC conducted an abridged independent examination of available information and personnel interviews to evaluate the current and anticipated state of the spacecraft subsystems and the parameters that describe the HST's health. These examinations included the projected timeliness of a robotic SM and whether the GSFC baseline concept is likely to provide the capability to extend the useful scientific life of the HST by an additional 5 years. The NESC team collected a broad spectrum of pertinent HST Program analyses, reports, briefings, and the results of the IPAO and the Aerospace Corporation AOA assessments as they relate to the degradation of the HST s health. This review included the state of the HST subsystems having the potential to impact the viability of the HST, but will not be serviced under the baseline robotic SM.

  18. A holistic model for the selection of environmental assessment indicators to assess the impact of industrialization on indigenous health.

    Science.gov (United States)

    Kryzanowski, Julie A; McIntyre, Lynn

    2011-01-01

    Mainstream environmental assessment (EA) methodologies often inadequately address health, social and cultural impacts of concern for Canadian indigenous communities affected by industrialization. Our objective is to present a holistic, culturally-appropriate framework for the selection of indigenous health indicators for baseline health assessment, impact prediction, or monitoring of impacts over time. We used a critical population health approach to explore the determinants of health and health inequities in indigenous communities and conceptualize the pathways by which industrialization affects these determinants. We integrated and extended key elements from three indigenous health frameworks into a new holistic model for the selection of indigenous EA indicators. The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Potential applications are discussed using case study examples involving indigenous communities affected by industrialization. Industrialization can worsen indigenous health inequities by perpetuating the health, social and cultural impacts of historic environmental dispossession. To mitigate impacts, EA should explicitly recognize linkages between environmental dispossession and the determinants of health and health inequities and meaningfully involve indigenous communities in the process.

  19. Health assessment of French university students and risk factors associated with mental health disorders.

    Directory of Open Access Journals (Sweden)

    Antoine Tran

    Full Text Available The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms.Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs. The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression.A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly.The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by

  20. Health assessment of French university students and risk factors associated with mental health disorders.

    Science.gov (United States)

    Tran, Antoine; Tran, Laurie; Geghre, Nicolas; Darmon, David; Rampal, Marion; Brandone, Diane; Gozzo, Jean-Michel; Haas, Hervé; Rebouillat-Savy, Karine; Caci, Hervé; Avillach, Paul

    2017-01-01

    The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression. A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly. The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by implementing targeted

  1. Electrical Stimulation for Pressure Injuries: A Health Technology Assessment

    Science.gov (United States)

    Lambrinos, Anna; Falk, Lindsey; Ali, Arshia; Holubowich, Corinne; Walter, Melissa

    2017-01-01

    Background Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. Methods We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non–randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct a primary economic evaluation. Finally, we conducted qualitative interviews with patients and caregivers about their experiences with pressure injuries, currently available treatments, and (if applicable) electrical stimulation. Results Nine randomized controlled trials and two non–randomized controlled trials were found from the systematic search. There was no significant difference in complete pressure injury healing between adjunct electrical stimulation and standard wound care. There was a significant difference in wound surface area reduction favouring electrical stimulation compared with standard wound care. The only study on cost-effectiveness of electrical stimulation was partially applicable to the patient population of interest. Therefore, the cost-effectiveness of electrical stimulation cannot be determined. We estimate that the cost of publicly funding electrical stimulation for pressure injuries would be $0.77 to $3.85 million yearly for the next 5

  2. Electrical Stimulation for Pressure Injuries: A Health Technology Assessment.

    Science.gov (United States)

    2017-01-01

    Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non-randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct a primary economic evaluation. Finally, we conducted qualitative interviews with patients and caregivers about their experiences with pressure injuries, currently available treatments, and (if applicable) electrical stimulation. Nine randomized controlled trials and two non-randomized controlled trials were found from the systematic search. There was no significant difference in complete pressure injury healing between adjunct electrical stimulation and standard wound care. There was a significant difference in wound surface area reduction favouring electrical stimulation compared with standard wound care.The only study on cost-effectiveness of electrical stimulation was partially applicable to the patient population of interest. Therefore, the cost-effectiveness of electrical stimulation cannot be determined. We estimate that the cost of publicly funding electrical stimulation for pressure injuries would be $0.77 to $3.85 million yearly for the next 5 years.Patients and caregivers

  3. School-Based Mental Health Professionals' Bullying Assessment Practices: A Call for Evidence-Based Bullying Assessment Guidelines

    Science.gov (United States)

    Blake, Jamilia; Banks, Courtney S.; Patience, Brenda A.; Lund, Emily M.

    2014-01-01

    A sample of 483 school-based mental health professionals completed a survey about the training they have received related to conducting bullying assessments in schools, competence in conducting an assessment of bullying, and the bullying assessment methods they used. Results indicate that school counselors were usually informed about incidents of…

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

    Science.gov (United States)

    Locatelli, Marine

    2016-05-01

    In public health, nurses are concerned with the global health of populations. A recently qualified nurse, interested in this area of health, enhanced her skills with a master's degree specialising in the links between the environment and health. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. The public health workforce: An assessment in the Netherlands

    NARCIS (Netherlands)

    Jambroes, M.

    2015-01-01

    The public health workforce is a key resource of population health. How many people work in public health in the Netherlands, what are their characteristics and who does what? Remarkably, such information about the size and composition of the public health workforce in the Netherlands is lacking. A

  6. Healthe Kids: An Assessment of Program Performance and Participation

    Science.gov (United States)

    Dean, Bonnie B.; Kindermann, Sylvia L.; Carson, Tabetha; Gavin, Jan; Frerking, Melissa; Bergren, Martha Dewey

    2014-01-01

    Many states in the United States have mandated school health screenings for early identification and referral to professional services for a set of health conditions. Healthe Kids, a community-based program, began offering school-based health screenings to Missouri elementary schools in March 2007. The purpose of the article is to provide a…

  7. A preliminary assessment of the health status of feral populations of ...

    African Journals Online (AJOL)

    A 'snapshot' evaluation of the health status of feral populations of the brackish water catfish, Chrysichthys nigrodigitatus, was carried out in 2006 at four locations in the Lagos lagoon complex, with varying levels of anthropogenic impacts, using a modified Health Assessment Index (HAI) protocol. Fish health was assessed ...

  8. Chemical Mixtures Health Risk Assessment of Environmental Contaminants: Concepts, Methods, Applications

    Science.gov (United States)

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

  9. Chemical Mixtures Health Risk Assessment of Environmental Contaminants: Concepts, Methods, And Applications

    Science.gov (United States)

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

  10. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Science.gov (United States)

    2011-06-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number CDC-2011-0008] Assessing the Current Research, Policy, and Practice Environment in Public Health... information helpful to assess the current research, policy, and practice environment in public health genomics...

  11. Health Literacy Assessment of the STOFHLA: Paper versus Electronic Administration Continuation Study

    Science.gov (United States)

    Chesser, Amy K.; Keene Woods, Nikki; Wipperman, Jennifer; Wilson, Rachel; Dong, Frank

    2014-01-01

    Low health literacy is associated with poor health outcomes. Research is needed to understand the mechanisms and pathways of its effects. Computer-based assessment tools may improve efficiency and cost-effectiveness of health literacy research. The objective of this preliminary study was to assess if administration of the Short Test of Functional…

  12. Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

    Energy Technology Data Exchange (ETDEWEB)

    Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)

    1990-12-31

    The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

  13. Assessing Health Impacts of Air Pollution in Kashan 2011

    Directory of Open Access Journals (Sweden)

    Masoud Motalleby

    2015-08-01

    Full Text Available Abstract Background: The air pollutants such as CO, SO2, NO2, O3, and particulate matters have harmful effects on public health. Determination of the actual concentration of the pollutants and description of air quantity and quality contents in comparison of standard conditions and timely informing people to regulate control programs is essential. Kashan is exposed to the winds contain-ing the suspended particulate matters due to the proximity of the desert. Moreover, the growth of population, factories and industries in the city are artifical resources of the air pollution. Hence, assessment and monitoring of air pollution standard condition in kashan is crucial. Materials and Methods: In this cross-sectional and descriptive study, the concentration of CO, SO2, NO2, O3, and suspended particulate matters less than 10 microns (PM10 measured according to WHO standards in Panzdah-e-Khordad station of Kashan in 2011. The annual mean and maximum rates, the mean and maximum rate of summer and winter, and annual percentile 98%, determined for each pollutant and used in AirQ software. Then, the number of death and disease attributed to each pollutant was calculated. Results: The results demonstrate that the cumulative number of deaths attributed to PM10, NO2, SO2, and O3 was 100, 22, 82, and 54, respectively. Conclusion: In total, the suspended particulate matters have the most effects on death and disease resulted from the air pollution. Hence, managing the resources of particulate matters and SO2 pollutants has many effects on reducing the adverse health effects of air pollution in Kashan.

  14. Assessment vs. appraisal of ethical aspects of health technology assessment: can the distinction be upheld?

    Directory of Open Access Journals (Sweden)

    Sandman, Lars

    2014-11-01

    Full Text Available [english] An essential component of health technology assessment (HTA is the assessment of ethical aspects. In some healthcare contexts, tasks are strictly relegated to different expert groups: the HTA-agencies are limited to assessment of the technology and other actors within the health care sector are responsible for appraisal and recommendations. Ethical aspects of health technologies are considered with reference to values or norms in such a way that may be prescriptive, or offer guidance as to how to act or relate to the issue in question. Given this internal prescriptivity, the distinction between assessment and appraisal seems difficult to uphold, unless the scrutiny stops short of a full ethical analysis of the technology. In the present article we analyse the distinction between assessment and appraisal, using as an example ethical aspects of implementation of GPS-bracelets for people with dementia. It is concluded that for HTA-agencies with a strictly delineated assessment role, the question of how to deal with the internal prescriptivity of ethics may be confusing. A full ethical analysis might result in a definite conclusion as to whether the technology in question is ethically acceptable or not, thereby limiting choices for decision-makers, who are required to uphold certain ethical values and norms. At the same time, depending on the exact nature of such a conclusion, different action strategies can be supported. A positive appraisal within HTA could result in a decision on implementation, or of the technology, thereby making it available to patients, or decisions to and even the use of the technology (even if someone else will have to fund it. A neutral appraisal, giving no definite answer as to whether implementation is recommended or not, could result in a towards the technology. A negative appraisal could result in a decision to or even implementation. This paper presents an overview of the implications of different outcomes

  15. Health Needs Assessment of Older People in an Agricultural Plantation

    Directory of Open Access Journals (Sweden)

    Normah Che Din

    2014-09-01

    Conclusion: Psychological factors had the main influence on health functioning of the older people of FELDA. Physical health needs of the older people in FELDA were determined mainly by psychological, nutritional, and lifestyle factors, whereas mental health needs were determined mainly by psychological, socioeconomic, and social factors. FELDA has vast resources to utilize for the running and maintaining of health programs for their older people as well as for evaluating and monitoring the effectiveness of health programs.

  16. Family context assessment in a public health study.

    Science.gov (United States)

    Velasco, David; Sánchez de Miguel, Manuel; Egurza, Maitane; Arranz, Enrique; Aranbarri, Aritz; Fano, Eduardo; Ibarluzea, Jesús

    2014-01-01

    To analyze the factorial structure of a new instrument to assess the quality of the family context (Etxadi-Gangoiti Scale) in a sample from the Gipuzkoa cohort of the Environment and Childhood (Infancia y Medio Ambiente [INMA]) study. Families in a sample of 433 two-year-old children were assessed in a home visit with subsequent analysis of the factorial structure and psychometric properties of the data. An exploratory factorial analysis (principal axis factoring and varimax rotation) and a confirmatory factorial analysis were carried out; partial confirmation of the original factorial structure of the instrument was obtained, which revealed the following factorial structures. Subscale (1): promotion of cognitive and linguistic development, social skills, psychomotor skills, and pretend play and imitation; subscale (2): promotion of independence and self-esteem, provision of optimal frustration, social and emotional quality of the relationship, and absence of physical punishment; subscale (3): paternal involvement, low exposure to family conflict, low frequency of family conflict, relationship with the extended family, social support, diversity of experiences, low frequency of stressful events, and low parental perception of stress. The structure of the original instrument structure was partially confirmed, which was attributed to the characteristics of the sample. We stress the importance of the variability obtained in the evaluation of the families, as well as of adequate indicators of reliability in such evaluation. The new instrument could be used in public health to identify deficient family contexts and to design preventive interventions focused on parenting skills. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Health risk assessment of chemical pollutants in a petrochemical complex

    Directory of Open Access Journals (Sweden)

    F Golbabaie

    2012-12-01

    Full Text Available   Background and Aims: workers in petrochemical industries are exposed to various contaminants and are facing to serious hazards, therefore a comprehensive risk assessment program for identification of hazardous chemicals that affect human health and also determination of hazardous tasks and processes is necessary.     Methods : This descriptive cross-sectional study was conducted in three stages. First stage consisted of identifying hazardous chemicals and determination of chemicals risk ratio, the second stage included the evaluation of worker's exposure to hazardous chemicals, and the third stage was estimating the relative risk of blood cancer caused by exposure to benzene through epidemiological studies.     Results: With regard to risk assessment method, 40 chemicals were identified in this Petrochemical Company. Among them, Benzene introduced as the most hazardous chemical. The results of the second stage showed that site man workers in noon shift work and in aromatic site with mean exposure 4.29 ppm had the highest exposure to benzene. The results of estimated leukemia relative risk stage in benzene exposure, the highest relative risk in workers related to site man workers in aromatic units with cumulative benzene exposure of 4.149 ppm. Years that obtained the relative risk of 2.3. The statistical test results showed that the relationship between worker's exposure to benzene and their job was significant(p<0/001     Conclusion : This study showed that benzene with a risk ratio of 4.5 -5 have 5th rank in risk levels and this indicates that preventative actions regarding to this hazardous and carcinogenic chemical must be started as soon as possible.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  19. North Carolina Family Assessment Scale: Measurement Properties for Youth Mental Health Services

    Science.gov (United States)

    Lee, Bethany R.; Lindsey, Michael A.

    2010-01-01

    Objective: The purpose of this study is to assess the reliability and validity of the North Carolina Family Assessment Scale (NCFAS) among families involved with youth mental health services. Methods: Using NCFAS data collected by child mental health intake workers with 158 families, factor analysis was conducted to assess factor structure, and…

  20. Reimbursement of pharmaceuticals: reference pricing versus health technology assessment.

    Science.gov (United States)

    Drummond, Michael; Jönsson, Bengt; Rutten, Frans; Stargardt, Tom

    2011-06-01

    Reference pricing and health technology assessment are policies commonly applied in order to obtain more value for money from pharmaceuticals. This study focussed on decisions about the initial price and reimbursement status of innovative drugs and discussed the consequences for market access and cost. Four countries were studied: Germany, The Netherlands, Sweden and the United Kingdom. These countries have operated one, or both, of the two policies at certain points in time, sometimes in parallel. Drugs in four groups were considered: cholesterol-lowering agents, insulin analogues, biologic drugs for rheumatoid arthritis and "atypical" drugs for schizophrenia. Compared with HTA, reference pricing is a relatively blunt instrument for obtaining value for money from pharmaceuticals. Thus, its role in making reimbursement decisions should be limited to drugs which are therapeutically equivalent. HTA is a superior strategy for obtaining value for money because it addresses not only price but also the appropriate indications for the use of the drug and the relation between additional value and additional costs. However, given the relatively higher costs of conducting HTAs, the most efficient approach might be a combination of both policies.

  1. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  2. Medical assessment of the health effects of short leisure trips.

    Science.gov (United States)

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

    2004-12-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  4. Valdez air health study - Exposure monitoring and risk assessment

    International Nuclear Information System (INIS)

    Murray, D.R.; Mikkelsen, R.

    1991-01-01

    In Valdez, Alaska there is concern about exposure of the public to benzene and other light hydrocarbons emitted during the loading of tankers from the Trans-Alaska Pipeline. As part of an overall risk assessment, the Valdez Air Health Study, a personal, indoor and outdoor air sampling program patterned after EPA's TEMA Study was designed and carried out. A unique feature of the study is that, during sampling periods, SF 6 tracer was released at the terminal site to represent terminal hydrocarbon emissions to provide a basis for directly quantitating any contribution of terminal emissions to personal exposure. Sixty citizens at Valdez were selected to wear vests containing sampling equipment for 24-hour periods summer and winter. At the homes of 30 of the participants simultaneous indoor and outdoor samples for hydrocarbons and tracer were collected during the period that each participant collected personal air samples. The paper reviews the design of the program, details of the procedures used, results of the August, 1990 program and preliminary results from the February-March, 1991 program

  5. Human health risk assessment related to cyanotoxins exposure.

    Science.gov (United States)

    Funari, Enzo; Testai, Emanuela

    2008-01-01

    This review focuses on the risk assessment associated with human exposure to cyanotoxins, secondary metabolites of an ubiquitous group of photosynthetic procariota. Cyanobacteria occur especially in eutrophic inland and coastal surface waters, where under favorable conditions they attain high densities and may form blooms and scums. Cyanotoxins can be grouped according to their biological effects into hepatotoxins, neurotoxins, cytotoxins, and toxins with irritating potential, also acting on the gastrointestinal system. The chemical and toxicological properties of the main cyanotoxins, relevant for the evaluation of possible risks for human health, are presented. Humans may be exposed to cyanotoxins via several routes, with the oral one being by far the most important, occurring by ingesting contaminated drinking water, food, some dietary supplements, or water during recreational activities. Acute and short-term toxic effects have been associated in humans with exposure to high levels of cyanotoxins in drinking and bathing waters. However, the chronic exposure to low cyanotoxin levels remains a critical issue. This article identifies the actual risky exposure scenarios, provides toxicologically derived reference values, and discusses open issues and research needs.

  6. Development of the eHealth Literacy Assessment Toolkit, eHLA

    DEFF Research Database (Denmark)

    Lauritzen, Dorthe Furstrand; Kayser, Lars

    2015-01-01

    In a world with rising focus on the use of eHealth, the match between the competences of the individual and the demands of eHealth systems becomes increasingly important, thus making assessment of eHealth literacy as a measure of user competences a vital element. We propose the eHealth Literacy...

  7. Employee Health Service for Teaching and Nonteaching Staff: A Needs Assessment.

    Science.gov (United States)

    Long, Bonita C.; And Others

    1986-01-01

    A needs assessment was conducted to identify the health needs of school district employees in planning a comprehensive employee health service. Survey questionnaires were analyzed to determine characteristics of those individuals who may be at greatest health risk. Results indicate that degree of stress can differentiate health risk predictors.…

  8. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

    Science.gov (United States)

    Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

    2018-01-01

    Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

  9. Assessment of Service Availability and Health Care Workers ...

    African Journals Online (AJOL)

    Health care workers' (HCWs') opinions about sexual and reproductive health ... women ignore information they receive about HIV and pregnancy prevention. ... for young women; all recognized the importance of condoms for dual protection.

  10. Mapping research on health systems in Europe: a bibliometric assessment.

    NARCIS (Netherlands)

    Velasco Garrido, M.; Hansen, J.; Busse, R.

    2011-01-01

    Objective: Europe's health care decision-makers are facing an increasingly complex and rapidly changing landscape. It is crucial that health care problems are addressed with evidence-informed policy and that evidence finding is aimed at those topics most urgent on policy agendas. Research on health

  11. Assessment of partogram use during labour in Rujumbura Health ...

    African Journals Online (AJOL)

    Objectives: To establish extent of use of a partogram, health facility and health workers' factors that affected its use during labour plus the relationship between foetal Apgar score and its use. Materials and Methods: A cross-sectional study involving observations, record reviews and interviewing of staff in 8 health facilities (4 ...

  12. Assessing Health Workers Knowledge on the Determinants of ...

    African Journals Online (AJOL)

    The participants were interviewed with a structured questionnaire used to elicit the knowledge of health workers on health determinants. Results: When individual factors were considered, a greater percentage of health workers, believed that safe drinking water (98.9%), where a person lives (96.6%) and a balanced diet, ...

  13. Health assessment of taxi drivers in the city of Tshwane

    Directory of Open Access Journals (Sweden)

    Tendani S. Ramukumba

    2016-11-01

    Conclusion: The findings implicate that the health status of taxi operators in Tshwane was a serious concern and urgent concerted effort is needed to engage in lifestyle modification of taxi drivers. The need for health promotion and formalised occupational health services was recommended.

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

    Directory of Open Access Journals (Sweden)

    Hansuvarova Evgenia Adolfovna

    2016-10-01

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

  15. Framework for Continuous Assessment and Improvement of Occupational Health and Safety Issues in Construction Companies

    OpenAIRE

    Mahmoudi, Shahram; Ghasemi, Fakhradin; Mohammadfam, Iraj; Soleimani, Esmaeil

    2014-01-01

    Background: Construction industry is among the most hazardous industries, and needs a comprehensive and simple-to-administer tool to continuously assess and promote its health and safety performance. Methods: Through the study of various standard systems (mainly Health, Safety, and Environment Management System; Occupational Health and Safety Assessment Series 180001; and British Standard, occupational health and safety management systems-Guide 8800), seven main elements were determined fo...

  16. Electronic Monitoring Systems to Assess Urinary Incontinence: A Health Technology Assessment.

    Science.gov (United States)

    2018-01-01

    Urinary incontinence is involuntary leakage of urine and can affect people of all ages. Incidence rises as people age, often because of reduced mobility or conditions affecting the nervous system, such as dementia and stroke. Urinary incontinence can be a distressing condition and can harm a person's physical, financial, social, and emotional well-being. People with urinary incontinence are susceptible to skin irritation, pressure sores, and urinary tract infections. Urinary incontinence is also associated with an increased risk of falls in older adults.This health technology assessment examined the effectiveness of, budget impact of, and patient values and preferences about electronic monitoring systems to assess urinary incontinence for residents of long-term care homes or geriatric hospital inpatients with complex conditions. A clinical evidence review of the published clinical literature was conducted to June 9, 2017. Critical appraisal of the clinical evidence included assessment of risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria to reflect the certainty of the evidence.We calculated the funding required for an electronic urinary incontinence monitoring system in the first year of implementation (when facilities would buy the systems) and in subsequent years.We interviewed six people with urinary incontinence and two caregivers, who described ways urinary incontinence affected daily life. We included one observational study in the clinical review. Most of the 31 participants in the observational study were female (78%) and required high levels of care, primarily because of cognitive impairment. The quality of evidence for all outcomes was very low owing to potential risk of bias and indirectness. We are consequently uncertain about how electronic monitoring systems affect management of urinary incontinence.For patients living in long-term care homes who are eligible for the technology, we

  17. Safety of genetically engineered foods: approaches to assessing unintended health effects

    National Research Council Canada - National Science Library

    Committee on Identifying and Assessing Unintended Effects of Genetically Engineered Foods on Human Health, National Research Council

    2004-01-01

    Assists policymakers in evaluating the appropriate scientific methods for detecting unintended changes in food and assessing the potential for adverse health effects from genetically modified products...

  18. Comparison of models used for ecological risk assessment and human health risk assessment

    International Nuclear Information System (INIS)

    Ryti, R.T.; Gallegos, A.F.

    1994-01-01

    Models are used to derive action levels for site screening, or to estimate potential ecological or human health risks posed by potentially hazardous sites. At the Los Alamos National Laboratory (LANL), which is RCRA-regulated, the human-health screening action levels are based on hazardous constituents described in RCRA Subpart S and RESRAD-derived soil guidelines (based on 10 mRem/year) for radiological constituents. Also, an ecological risk screening model was developed for a former firing site, where the primary constituents include depleted uranium, beryllium and lead. Sites that fail the screening models are evaluated with site-specific human risk assessment (using RESRAD and other approaches) and a detailed ecological effect model (ECOTRAN). ECOTRAN is based on pharmacokinetics transport modeling within a multitrophic-level biological-growth dynamics model. ECOTRAN provides detailed temporal records of contaminant concentrations in biota, and annual averages of these body burdens are compared to equivalent site-specific runs of the RESRAD model. The results show that thoughtful interpretation of the results of these models must be applied before they can be used for evaluation of current risk posed by sites and the benefits of various remedial options. This presentation compares the concentrations of biological media in the RESRAD screening runs to the concentrations in ecological endpoints predicted by the ecological screening model. The assumptions and limitations of these screening models and the decision process where these are screening models are applied are discussed

  19. Improving interpretation of publically reported statistics on health and healthcare: the Figure Interpretation Assessment Tool (FIAT-Health).

    Science.gov (United States)

    Gerrits, Reinie G; Kringos, Dionne S; van den Berg, Michael J; Klazinga, Niek S

    2018-03-07

    Policy-makers, managers, scientists, patients and the general public are confronted daily with figures on health and healthcare through public reporting in newspapers, webpages and press releases. However, information on the key characteristics of these figures necessary for their correct interpretation is often not adequately communicated, which can lead to misinterpretation and misinformed decision-making. The objective of this research was to map the key characteristics relevant to the interpretation of figures on health and healthcare, and to develop a Figure Interpretation Assessment Tool-Health (FIAT-Health) through which figures on health and healthcare can be systematically assessed, allowing for a better interpretation of these figures. The abovementioned key characteristics of figures on health and healthcare were identified through systematic expert consultations in the Netherlands on four topic categories of figures, namely morbidity, healthcare expenditure, healthcare outcomes and lifestyle. The identified characteristics were used as a frame for the development of the FIAT-Health. Development of the tool and its content was supported and validated through regular review by a sounding board of potential users. Identified characteristics relevant for the interpretation of figures in the four categories relate to the figures' origin, credibility, expression, subject matter, population and geographical focus, time period, and underlying data collection methods. The characteristics were translated into a set of 13 dichotomous and 4-point Likert scale questions constituting the FIAT-Health, and two final assessment statements. Users of the FIAT-Health were provided with a summary overview of their answers to support a final assessment of the correctness of a figure and the appropriateness of its reporting. FIAT-Health can support policy-makers, managers, scientists, patients and the general public to systematically assess the quality of publicly reported

  20. CRED REA Coral Health and Disease Assessment at Hawaii Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 17 sites at...

  1. CRED REA Coral Health and Disease Assessment at Saipan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 8 sites at...

  2. CRED REA Coral Health and Disease Assessment at Kure Atoll, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at Kure...

  3. CRED REA Coral Health and Disease Assessment at Johnston Atoll, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  4. CRED REA Coral Health and Disease Assessment at Asuncion Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  5. CRED REA Coral Health and Disease Assessment at Maug Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at Maug...

  6. CRED REA Coral Health and Disease Assessment at Molokai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  7. CRED REA Coral Health and Disease Assessment at Midway Atoll, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  8. CRED REA Coral Health and Disease Assessment at Rose Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 12 sites at...

  9. CRED REA Coral Health and Disease Assessment at Rota Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at Rota...

  10. CRED REA Coral Health and Disease Assessment at Oahu, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at Oahu...

  11. CRED REA Coral Health and Disease Assessment at Uracas Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  12. Risk assessment - a research program aimed at health risks from air pollution in the general environment

    International Nuclear Information System (INIS)

    Lindahl-Kiessling, K.; Ahlborg, U.; Bylin, G.; Ehrenberg, L.; Hemminki, K.; Lindell, B.; Nilsson, Robert; Bostroem, C.E.; Swarn, U.

    1991-01-01

    The paper presents a new research program for assessment of health risks caused by air pollutants. It is important to develop general methods for quantitative risk assessments and to improve the scientific base materials. (KAE)

  13. CRED REA Coral Health and Disease Assessment at Jarvis Island, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  14. CRED REA Coral Health and Disease Assessment at Wake Atoll, Pacific Remote Island Areas in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 12 sites at...

  15. CRED REA Coral Health and Disease Assessment at Sarigan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  16. CRED REA Coral Health and Disease Assessment at Tinian Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 5 sites at...

  17. CRED REA Coral Health and Disease Assessment at Kingman Reef, Pacific Remote Island Areas in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 11 sites at...

  18. CRED REA Coral Health and Disease Assessment at Guguan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  19. CRED REA Coral Health and Disease Assessment at Ofu-Olosega Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  20. CRED REA Coral Health and Disease Assessment at Swains Atoll, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 8 sites at...

  1. CRED REA Coral Health and Disease Assessment at Ta'u Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at Ta'u...

  2. CRED REA Coral Health and Disease Assessment at Lehua Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  3. CRED REA Coral Health and Disease Assessment at Maui Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 11 sites at...

  4. CRED REA Coral Health and Disease Assessment at Guam, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  5. CRED REA Coral Health and Disease Assessment at Necker Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  6. CRED REA Coral Health and Disease Assessment at Pagan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  7. CRED REA Coral Health and Disease Assessment at Lisianski Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 9 sites at...

  8. CRED REA Coral Health and Disease Assessment at Aguijan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 1 sites at...

  9. CRED REA Coral Health and Disease Assessment at Alamagan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  10. CRED REA Coral Health and Disease Assessment at Agrihan Island, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  11. CRED REA Coral Health and Disease Assessment at Laysan Island, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 3 sites at...

  12. CRED REA Coral Health and Disease Assessment at Kaula Rock, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 2 sites at...

  13. CRED REA Coral Health and Disease Assessment at Tutuila Island, American Samoa in 2008

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 23 sites at...

  14. CRED REA Coral Health and Disease Assessment at Niihau Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  15. CRED REA Coral Health and Disease Assessment at French Frigate Shoals, Northwestern Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  16. CRED REA Coral Health and Disease Assessment at Lanai Island, Main Hawaiian Islands in 2006

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 6 sites at...

  17. Development of the Competency Assessment Tool-Mental Health, an instrument to assess core competencies for mental health care workers.

    Science.gov (United States)

    Clasen, Carla; Meyer, Cheryl; Brun, Carl; Mase, William; Cauley, Kate

    2003-01-01

    As the focus on accountability in health care increases, there has been a corresponding emphasis on establishing core competencies for health care workers. This article discusses the development of an instrument to establish core competencies for workers in inpatient mental health settings. Twenty-six competencies were identified and rated by mental health care personnel on two subscales: the importance of the competency and how much behavioral health care workers could benefit from training on the competency. The reliability of the scale and its contributions to the training, retention and recruitment of direct care workers for behavioral health are discussed.

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

    Directory of Open Access Journals (Sweden)

    О.V. Bagryantseva

    2016-03-01

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

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

    International Nuclear Information System (INIS)

    Sekizawa, Jun; Tanabe, Shinsuke

    2005-01-01

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

  20. Health on the Net Foundation: assessing the quality of health web pages all over the world.

    Science.gov (United States)

    Boyer, Célia; Gaudinat, Arnaud; Baujard, Vincent; Geissbühler, Antoine

    2007-01-01

    The Internet provides a great amount of information and has become one of the communication media which is most widely used [1]. However, the problem is no longer finding information but assessing the credibility of the publishers as well as the relevance and accuracy of the documents retrieved from the web. This problem is particularly relevant in the medical area which has a direct impact on the well-being of citizens. In this paper, we assume that the quality of web pages can be controlled, even when a huge amount of documents has to be reviewed. But this must be supported by both specific automatic tools and human expertise. In this context, we present various initiatives of the Health on the Net Foundation informing the citizens about the reliability of the medical content on the web.