WorldWideScience

Sample records for health assessment study

  1. 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.

  2. 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)

  3. 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)

  4. 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.

  5. 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.

  6. 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 ...

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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…

  12. 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.

  13. 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...

  14. 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…

  15. Fish Health Study Ashtabula River Natural Resource Damage Assessment

    Science.gov (United States)

    Blazer, V.S.; Iwanowicz, L.R.; Baumann, P.C.

    2006-01-01

    INTRODUCTION The Ashtabula River is located in northeast Ohio, flowing into Lake Erie at Ashtabula, Ohio. Tributaries include Fields Brook, Hubbard Run, Strong Brook, and Ashtabula Creek. The bottom sediments, bank soils and biota of Fields Brook have been severely contaminated by unregulated discharges of hazardous substances. Hazardous substances have migrated downstream from Fields Brook to the Ashtabula River and Harbor, contaminating bottom sediments, fish and wildlife. There are presently more than 1,000,000 cubic yards of contaminated sediment in the Ashtabula River and Harbor, much of which originated from Fields Brook. Contaminants include polychlorinated biphenyls (PCBs), chlorinated benzenes, chlorinated ethenes, hexachlorobutadiene, polyaromatic hydrocarbons (PAHs), other organic chemicals, heavy metals and low level radionuclides. A Preassessment Screen, using existing data, was completed for the Ashtabula River and Harbor on May 18, 2001. Among the findings was that the fish community at Ashtabula contained approximately 45 percent fewer species and 52 percent fewer individuals than the Ohio EPA designated reference area, Conneaut Creek. The Ashtabula River and Conneaut Creek are similar in many respects, with the exception of the presence of contamination at Ashtabula. The difference in the fish communities between the two sites is believed to be at least partially a result of the hazardous substance contamination at Ashtabula. In order to investigate this matter further, the Trustees elected to conduct a study of the status and health of the aquatic biological communities of the Ashtabula River and Conneaut Creek in 2002-2004. The following document contains brief method descriptions (more detail available in attached Appendix A) and a summary of the data used to evaluate the health status of brown bullheads (Ameiurus nebulosus) and largemouth bass (Micropterus salmoides) collected from the above sites.

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

    African Journals Online (AJOL)

    SERVER

    2007-07-18

    Jul 18, 2007 ... by such data to allow health and public policy decision makers to take evidence based decisions which .... North America and accounts for 25% of total medical ... such information to decision makers and the use of such.

  17. Human Health Risk Assessment: A case study application of principles in dose response assessment

    Science.gov (United States)

    This case study application workshop will build on fundamental concepts and techniques in risk assessment presented and archived at previous TRAC meeting workshops. Practical examples from publicly available, peer reviewed risk assessments will be used as teaching aids. Course ...

  18. International survey on attitudes toward ethics in health technology assessment: An exploratory study

    NARCIS (Netherlands)

    Arellano, L.E.; Willett, J.M.; Borry, P.

    2011-01-01

    Objectives: The objective of this exploratory study was to survey international health technology assessment (HTA) professionals to determine attitudes toward ethics in HTA. Methods: An exploratory, quantitative, cross-sectional study design was developed. The sample population (n = 636) was

  19. A Critical Review of Studies on Health Needs Assessment of Elderly in the World

    Directory of Open Access Journals (Sweden)

    Sima Ghasemi

    2017-06-01

    Full Text Available Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults’ perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning.

  20. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    LENUS (Irish Health Repository)

    Moorhead, Anne

    2011-03-31

    Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices\\/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups\\' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland. Methods\\/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices\\/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals\\' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices\\/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  1. Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

    Directory of Open Access Journals (Sweden)

    Murphy Kathy

    2011-03-01

    Full Text Available Abstract Background Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a community related public health nurses; (b school public health nurses; (c GPs and practice nurses (primary care; and (d occupational health nurses (workplace from both Northern Ireland and the Republic of Ireland. Methods/Design This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components: 1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings. 2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status. 3. Survey (primarily online but also paper-based - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status. 4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children. Discussion This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may

  2. 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

  3. Radiation exposure assessment for Portsmouth Naval Shipyard health studies

    International Nuclear Information System (INIS)

    Daniels, R. D.; Taulbee, T. D.; Chen, P.

    2004-01-01

    Occupational radiation exposures of 13,475 civilian nuclear shipyard workers were investigated as part of a retrospective mortality study. Estimates of annual, cumulative and collective doses were tabulated for future dose-response analysis. Record sets were assembled and amended through range checks, examination of distributions and inspection. Methods were developed to adjust for administrative overestimates and dose from previous employment. Uncertainties from doses below the recording threshold were estimated. Low-dose protracted radiation exposures from submarine overhaul and repair predominated. Cumulative doses are best approximated by a hybrid log-normal distribution with arithmetic mean and median values of 20.59 and 3.24 mSv, respectively. The distribution is highly skewed with more than half the workers having cumulative doses 95% having doses <100 mSv. The maximum cumulative dose is estimated at 649.39 mSv from 15 person-years of exposure. The collective dose was 277.42 person-Sv with 96.8% attributed to employment at Portsmouth Naval Shipyard. (authors)

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

    Directory of Open Access Journals (Sweden)

    Wang Yang

    2009-10-01

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

  5. Development of a health literacy assessment for young adult college students: a pilot study.

    Science.gov (United States)

    Harper, Raquel

    2014-01-01

    The purpose of this study was to develop a comprehensive health literacy assessment tool for young adult college students. Participants were 144 undergraduate students. Two hundred and twenty-nine questions were developed, which were based on concepts identified by the US Department of Health and Human Services, the World Health Organization, and health communication scholars. Four health education experts reviewed this pool of items and helped select 87 questions for testing. Students completed an online assessment consisting of these 87 questions in June and October of 2012. Item response theory and goodness-of-fit values were used to help eliminate nonperforming questions. Fifty-one questions were selected based on good item response theory discrimination parameter values. The instrument has 51 questions that look promising for measuring health literacy in college students, but needs additional testing with a larger student population to see how these questions continue to perform.

  6. The Study of Self-Assessed Health among Elderly Women in Shiraz and Yasuj Cities

    Directory of Open Access Journals (Sweden)

    Majid Movahed

    2016-06-01

    Full Text Available Introduction: Women are facing inequalities including health, thus their health deserves attention. Investigating people’s health status from their viewpoints is an important measure in terms of public health of society and an indicator to determine the efficiency of health system.  This study aimed at evaluating the self-assessed health of older women living in Shiraz and Yasuj. Methods: This was a cross-sectional study on elderly females over 65 years living in Shiraz and Yasuj. A questionnaire was applied to collect data from 380 subjects who were selected by cluster random sampling method. Data analysis was performed through SPSS software in two levels of descriptive and inferential. Results: The mean score of total self-assessed health was 72.02±13.6, and 63.8% evaluated their health status as moderate.  The mean scores for physical health, anxiety, social function, and depression subscales were 14.52± 4.97, 18.02±5.77, 18.29±4.48, 21.11 ±4.27, respectively. Age, education, marital status, disease history, and self-esteem were significantly associated with self-assessed health. R2 determination coefficient also indicates that 31.8% of changes in self-assessed health scores are explained by self-esteem, disease history, education, and marital status. Conclusion: Infrastructure to maintain the traditional values in the field of social relations and strengthen the family ties between the elderly and their family members can increase their self-esteem by reducing social isolation, and help them improve their health, especially in psychological dimension.  

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

    International Nuclear Information System (INIS)

    Ongel, Aybike; Sezgin, Fatih

    2016-01-01

    In recent decades, noise pollution caused by industrialization and increased motorization has become a major concern around the world because of its adverse effects on human well-being. Therefore, transportation agencies have been implementing noise abatement measures in order to reduce road traffic noise. However, limited attention is given to noise in environmental assessment of road transportation systems. This paper presents a framework for a health impact assessment model for road transportation noise emissions. The model allows noise impacts to be addressed with the health effects of air pollutant and greenhouse gas emissions from road transportation. The health damages assessed in the model include annoyance, sleep disturbance, and cardiovascular disease in terms of acute myocardial infarction. The model was applied in a case study in Istanbul in order to evaluate the change in health risks from the implementation of noise abatement strategies. The noise abatement strategies evaluated include altering pavement surfaces in order to absorb noise and introducing speed limits. It was shown that significant improvements in health risks can be achieved using open graded pavement surfaces and introducing speed limits on highways. - Highlights: • Transportation noise has a significant effect on health. • Noise should be included in the environmental assessment of transportation systems. • Traffic noise abatement measures include noise reducing pavements and speed limits. • Noise abatement measures help reduce the health risks of transportation noise. • Speed limit reduction on uncongested roads is an effective way to reduce health risks.

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

    Energy Technology Data Exchange (ETDEWEB)

    Ongel, Aybike, E-mail: aybike.ongel@eng.bahcesehir.edu.tr [Bahcesehir University, Department of Civil Engineering, Istanbul 34353 (Turkey); Sezgin, Fatih, E-mail: fatih.sezgin@ibb.gov.tr [Istanbul Metropolitan Municipality, Environmental Protection Agency, Istanbul 34169 (Turkey)

    2016-01-15

    In recent decades, noise pollution caused by industrialization and increased motorization has become a major concern around the world because of its adverse effects on human well-being. Therefore, transportation agencies have been implementing noise abatement measures in order to reduce road traffic noise. However, limited attention is given to noise in environmental assessment of road transportation systems. This paper presents a framework for a health impact assessment model for road transportation noise emissions. The model allows noise impacts to be addressed with the health effects of air pollutant and greenhouse gas emissions from road transportation. The health damages assessed in the model include annoyance, sleep disturbance, and cardiovascular disease in terms of acute myocardial infarction. The model was applied in a case study in Istanbul in order to evaluate the change in health risks from the implementation of noise abatement strategies. The noise abatement strategies evaluated include altering pavement surfaces in order to absorb noise and introducing speed limits. It was shown that significant improvements in health risks can be achieved using open graded pavement surfaces and introducing speed limits on highways. - Highlights: • Transportation noise has a significant effect on health. • Noise should be included in the environmental assessment of transportation systems. • Traffic noise abatement measures include noise reducing pavements and speed limits. • Noise abatement measures help reduce the health risks of transportation noise. • Speed limit reduction on uncongested roads is an effective way to reduce health risks.

  9. PARALLEL MODELS OF ASSESSMENT: INFANT MENTAL HEALTH AND THERAPEUTIC ASSESSMENT MODELS INTERSECT THROUGH EARLY CHILDHOOD CASE STUDIES.

    Science.gov (United States)

    Gart, Natalie; Zamora, Irina; Williams, Marian E

    2016-07-01

    Therapeutic Assessment (TA; S.E. Finn & M.E. Tonsager, 1997; J.D. Smith, 2010) is a collaborative, semistructured model that encourages self-discovery and meaning-making through the use of assessment as an intervention approach. This model shares core strategies with infant mental health assessment, including close collaboration with parents and caregivers, active participation of the family, a focus on developing new family stories and increasing parents' understanding of their child, and reducing isolation and increasing hope through the assessment process. The intersection of these two theoretical approaches is explored, using case studies of three infants/young children and their families to illustrate the application of TA to infant mental health. The case of an 18-month-old girl whose parents fear that she has bipolar disorder illustrates the core principles of the TA model, highlighting the use of assessment intervention sessions and the clinical approach to preparing assessment feedback. The second case follows an infant with a rare genetic syndrome from ages 2 to 24 months, focusing on the assessor-parent relationship and the importance of a developmental perspective. Finally, assessment of a 3-year-old boy illustrates the development and use of a fable as a tool to provide feedback to a young child about assessment findings and recommendations. © 2016 Michigan Association for Infant Mental Health.

  10. Assessing the health impact of transnational corporations: a case study on McDonald's Australia.

    Science.gov (United States)

    Anaf, Julia; Baum, Frances E; Fisher, Matt; Harris, Elizabeth; Friel, Sharon

    2017-02-06

    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. We adapted existing Health Impact Assessment methods to assess McDonald's activities. Data identifying potential impacts were sourced through document analysis, including McDonald's corporate literature; media analysis and semi-structured interviews. We commissioned a spatial and socioeconomic analysis of McDonald's restaurants in Australia through Geographic Information System technology. The data was mapped against a corporate health impact assessment framework which included McDonald's Australia's political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers' health related behaviours. We identified both positive and detrimental aspects of McDonald's Australian operations across the scope of the CHIA framework. We found that McDonald's outlets were slightly more likely to be located in areas of lower socioeconomic status. McDonald's workplace conditions were found to be more favourable than those in many other countries which reflects compliance with Australian employment regulations. The breadth of findings revealed the need for governments to strengthen regulatory mechanisms that are conducive to health; the opportunity for McDonald's to augment their corporate social responsibility initiatives and bolster reputational endorsement; and civil society actors to inform their advocacy towards health and equity outcomes from TNC operations. Our study indicates that undertaking a corporate health impact assessment is possible, with the different methods revealing sufficient information to

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

    Science.gov (United States)

    2012-01-01

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

  12. Comparison of tools for assessing the methodological quality of primary and secondary studies in health technology assessment reports in Germany

    Directory of Open Access Journals (Sweden)

    Walter, Ulla

    2010-01-01

    Full Text Available Health care policy background: Findings from scientific studies form the basis for evidence-based health policy decisions. Scientific background: Quality assessments to evaluate the credibility of study results are an essential part of health technology assessment reports and systematic reviews. Quality assessment tools (QAT for assessing the study quality examine to what extent study results are systematically distorted by confounding or bias (internal validity. The tools can be divided into checklists, scales and component ratings. Research questions: What QAT are available to assess the quality of interventional studies or studies in the field of health economics, how do they differ from each other and what conclusions can be drawn from these results for quality assessments? Methods: A systematic search of relevant databases from 1988 onwards is done, supplemented by screening of the references, of the HTA reports of the German Agency for Health Technology Assessment (DAHTA and an internet search. The selection of relevant literature, the data extraction and the quality assessment are carried out by two independent reviewers. The substantive elements of the QAT are extracted using a modified criteria list consisting of items and domains specific to randomized trials, observational studies, diagnostic studies, systematic reviews and health economic studies. Based on the number of covered items and domains, more and less comprehensive QAT are distinguished. In order to exchange experiences regarding problems in the practical application of tools, a workshop is hosted. Results: A total of eight systematic methodological reviews is identified as well as 147 QAT: 15 for systematic reviews, 80 for randomized trials, 30 for observational studies, 17 for diagnostic studies and 22 for health economic studies. The tools vary considerably with regard to the content, the performance and quality of operationalisation. Some tools do not only include the

  13. Comparison of tools for assessing the methodological quality of primary and secondary studies in health technology assessment reports in Germany.

    Science.gov (United States)

    Dreier, Maren; Borutta, Birgit; Stahmeyer, Jona; Krauth, Christian; Walter, Ulla

    2010-06-14

    HEALTH CARE POLICY BACKGROUND: Findings from scientific studies form the basis for evidence-based health policy decisions. Quality assessments to evaluate the credibility of study results are an essential part of health technology assessment reports and systematic reviews. Quality assessment tools (QAT) for assessing the study quality examine to what extent study results are systematically distorted by confounding or bias (internal validity). The tools can be divided into checklists, scales and component ratings. What QAT are available to assess the quality of interventional studies or studies in the field of health economics, how do they differ from each other and what conclusions can be drawn from these results for quality assessments? A systematic search of relevant databases from 1988 onwards is done, supplemented by screening of the references, of the HTA reports of the German Agency for Health Technology Assessment (DAHTA) and an internet search. The selection of relevant literature, the data extraction and the quality assessment are carried out by two independent reviewers. The substantive elements of the QAT are extracted using a modified criteria list consisting of items and domains specific to randomized trials, observational studies, diagnostic studies, systematic reviews and health economic studies. Based on the number of covered items and domains, more and less comprehensive QAT are distinguished. In order to exchange experiences regarding problems in the practical application of tools, a workshop is hosted. A total of eight systematic methodological reviews is identified as well as 147 QAT: 15 for systematic reviews, 80 for randomized trials, 30 for observational studies, 17 for diagnostic studies and 22 for health economic studies. The tools vary considerably with regard to the content, the performance and quality of operationalisation. Some tools do not only include the items of internal validity but also the items of quality of reporting and

  14. Modern needs in health technology assessment: a study of comparative effectiveness

    Directory of Open Access Journals (Sweden)

    A. V. Pavlysh

    2013-01-01

    Full Text Available Health technology assessment is a key component of healthcare decision making in most of the developed countries. Comparative effectiveness research as one of the elements of such assessment is becoming increasingly important in recent years. It is based on the effectiveness analysis of health technologies in real clinical practice setting. The authors have analyzed publications dedicated to these issues and showed the main methods of such study, its peculiarities, advantages and disadvantages. It has been revealed that the most frequently used designs of expert analysis are observational and pragmatic randomized studies. The main recommendations on analyzing comparative effectiveness are given in view of the literary data.

  15. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    Noble, B.F.; Bronson, J.E.

    2005-01-01

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  16. Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study.

    Science.gov (United States)

    Léon, Grégory; Ouimet, Mathieu; Lavis, John N; Grimshaw, Jeremy; Gagnon, Marie-Pierre

    2013-03-21

    Evidence-informed health policymaking logically depends on timely access to research evidence. To our knowledge, despite the substantial political and societal pressure to enhance the use of the best available research evidence in public health policy and program decision making, there is no study addressing availability of peer-reviewed research in Canadian health ministries. To assess availability of (1) a purposive sample of high-ranking scientific journals, (2) bibliographic databases, and (3) health library services in the fourteen Canadian health ministries. From May to October 2011, we conducted a cross-sectional survey among librarians employed by Canadian health ministries to collect information relative to availability of scientific journals, bibliographic databases, and health library services. Availability of scientific journals in each ministry was determined using a sample of 48 journals selected from the 2009 Journal Citation Reports (Sciences and Social Sciences Editions). Selection criteria were: relevance for health policy based on scope note information about subject categories and journal popularity based on impact factors. We found that the majority of Canadian health ministries did not have subscription access to key journals and relied heavily on interlibrary loans. Overall, based on a sample of high-ranking scientific journals, availability of journals through interlibrary loans, online and print-only subscriptions was estimated at 63%, 28% and 3%, respectively. Health Canada had a 2.3-fold higher number of journal subscriptions than that of the provincial ministries' average. Most of the organisations provided access to numerous discipline-specific and multidisciplinary databases. Many organisations provided access to the library resources described through library partnerships or consortia. No professionally led health library environment was found in four out of fourteen Canadian health ministries (i.e. Manitoba Health, Northwest

  17. Health, safety and environmental unit performance assessment model under uncertainty (case study: steel industry).

    Science.gov (United States)

    Shamaii, Azin; Omidvari, Manouchehr; Lotfi, Farhad Hosseinzadeh

    2017-01-01

    Performance assessment is a critical objective of management systems. As a result of the non-deterministic and qualitative nature of performance indicators, assessments are likely to be influenced by evaluators' personal judgments. Furthermore, in developing countries, performance assessments by the Health, Safety and Environment (HSE) department are based solely on the number of accidents. A questionnaire is used to conduct the study in one of the largest steel production companies in Iran. With respect to health, safety, and environment, the results revealed that control of disease, fire hazards, and air pollution are of paramount importance, with coefficients of 0.057, 0.062, and 0.054, respectively. Furthermore, health and environment indicators were found to be the most common causes of poor performance. Finally, it was shown that HSE management systems can affect the majority of performance safety indicators in the short run, whereas health and environment indicators require longer periods of time. The objective of this study is to present an HSE-MS unit performance assessment model in steel industries. Moreover, we seek to answer the following question: what are the factors that affect HSE unit system in the steel industry? Also, for each factor, the extent of impact on the performance of the HSE management system in the organization is determined.

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

    Science.gov (United States)

    Connor, J; Rodgers, A; Priest, P

    1999-11-01

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

  19. 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...

  20. Sudbury soils study : human health and ecological risk assessment : a case study in science, process and perception

    International Nuclear Information System (INIS)

    Wren, C.

    2009-01-01

    This presentation discussed the public relations and public opinion strategies used as part of a soils study conducted to assess the risk of mining activities in the Sudbury region to human health and the environment. The human health risk assessment (HHRA) study was conducted and administered by a multi-stakeholder technical committee attended by the public. The study was comprised of extensive soil collection and analysis; a review of historical soils data; and extensive human health and ecological risk assessments. Extensive sampling was also conducted on air, dust, and locally-produced foods. A public advisory committee was formed to disseminate scientific information to the community. Scientific data obtained in the study were reviewed by experts in various fields. Results of the study were also peer-reviewed by an independent expert review panel comprised of leading specialists in human health, toxicology, speciation, and risk assessment. The study showed that the identified risks were over-estimated in the interest of protecting human health. It was concluded that the HHRA's findings were generally accepted by the public. tabs., figs

  1. Health Risk Assessment of Harmful Chemicals: Case Study in a Petrochemical Industry

    Directory of Open Access Journals (Sweden)

    M. Motovagheh

    2011-01-01

    Full Text Available Background and aims In the most chemical process industries, workers are exposed to various chemicals and working with these chemicals without considering safety and health considerations can lead to different harmful symptoms. For deciding about control measures and reducing risk to acceptable level , it is necessary to assess the health risk of exposing to harmful chemicals by aid of specific risk assessment techniques in the process industries. The purpose of this study was to assess the health risks arising from the exposures to chemicals in a petrochemical industry.  methods A simple and applied method was used for health risk assessment of chemicals in a petrochemical industry. Firstly job tasks and work process were determined and then different chemicals in each tasks identified and risk ranking was calculated in each job task by aid of hazard and exposure rate.   Results The result showed that workers are exposed to 10 chemicals including Methyl ethyl ketone, Epichlorohydrin, Sulfuric acid, Phenol, Chlorobenzene, Toluene, Isopropanol, Methylene chloride, Chlorideric Acid and Acetone during their work in plant. From these chemicals, the highest risk level was for Epichlorohydrin in the jobs of tank and utility operations and maintenance workers. The next high risk level was for Epichlorohydrin in technical inspecting and Methyl ethyl ketone in Tank and utility operations operator.     Conclusion Hazard information and monitoring data of chemical agents in the chemical industries can be used for assessing health risks from exposures to chemicals and ranking jobs by their risk level. These data can be used for resource allocation for control measures and reducing risk level to acceptable level.    

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

    Science.gov (United States)

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

    2017-09-01

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

  3. Assessing the Use of Mobile Health Technology by Patients: An Observational Study in Primary Care Clinics.

    Science.gov (United States)

    Ramirez, Veronica; Johnson, Emily; Gonzalez, Cesar; Ramirez, Vanessa; Rubino, Barbara; Rossetti, Gina

    2016-04-19

    There is significant potential for mobile health technology to improve health outcomes for patients with chronic diseases. However, there is a need for further development of mobile health technology that would help to improve the health of lower-income communities. The study objective was to assess mobile phone and app usage among a culturally diverse patient population, and to determine whether patients would be interested in using mobile health technology to help manage their chronic diseases. An observational study was conducted with patients of the Internal Medicine resident primary care clinics of Los Angeles County and University of Southern California (LAC+USC) Medical Center. Self-reported information regarding demographics, current mobile phone usage, current mobile health app and social media usage, barriers to using mobile phones or mobile health apps, and interest in using a mobile health app was collected. Ninety-one percent of patients owned a mobile phone, with 76% (169/223) of these reporting having a mobile phone with Internet capability. Fifty-seven percent of subjects used mobile apps on their mobile phones, and 32% (41/130) of these used mobile apps related to their health. Eighty-six percent (207/241) of respondents voiced interest in using a mobile app to improve their health, and 40% (88/221) stated they would use such an app daily. Patients stated they would find the mobile health app most useful for nutrition, exercise, and obtaining general information on medical conditions. Despite the fact that the majority of our primary care patients were of lower socioeconomic status, they utilized mobile phones with Internet and mobile app capabilities to a great extent. There was substantial interest among our patients in using mobile health technology to both manage chronic disease and improve overall health. Given that cultural, educational, and socioeconomic disparities strongly correlate with higher rates of chronic diseases such as obesity

  4. Systematic Review Protocol to Assess the Effectiveness of Usability Questionnaires in mHealth App Studies.

    Science.gov (United States)

    Zhou, Leming; Bao, Jie; Parmanto, Bambang

    2017-08-01

    Usability questionnaires have a wide use in mobile health (mHealth) app usability studies. However, no systematic review has been conducted for assessing the effectiveness of these questionnaires. This paper describes a protocol for conducting a systematic review of published questionnaire-based mHealth app usability studies. In this systematic review, we will select recently published (2008-2017) articles from peer-reviewed journals and conferences that describe mHealth app usability studies and implement at least one usability questionnaire. The search strategy will include terms such as "mobile app" and "usability." Multiple databases such as PubMed, CINAHL, IEEE Xplore, ACM Digital Library, and INSPEC will be searched. There will be 2 independent reviewers in charge of screening titles and abstracts as well as determining those articles that should be included for a full-text review. The third reviewer will act as a mediator between the other 2 reviewers. Moreover, a data extraction form will be created and used during the full article data analysis. Notably, the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines will be followed in reporting this protocol. A preliminary search produced 1271 articles, 40 of which are duplicate records. The inclusion-exclusion criteria are being strictly followed in performing the ongoing study selection. Usability questionnaires are an important tool in mHealth app usability studies. This review will summarize the usability questionnaires used in published research articles while assessing the efficacy of these questionnaires in determining the usability of mHealth apps. ©Leming Zhou, Jie Bao, Bambang Parmanto. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.08.2017.

  5. Integrating a health-related-quality-of-life module within electronic health records: a comparative case study assessing value added

    Directory of Open Access Journals (Sweden)

    Shea Christopher M

    2012-03-01

    Full Text Available Abstract Background Health information technology (HIT applications that incorporate point-of-care use of health-related quality of life (HRQL assessments are believed to promote patient-centered interactions between seriously ill patients and physicians. However, it is unclear how willing primary care providers are to use such HRQL HIT applications. The specific aim of this study was to explore factors that providers consider when assessing the value added of an HRQL application for their geriatric patients. Methods Three case studies were developed using the following data sources: baseline surveys with providers and staff, observations of staff and patients, audio recordings of patient-provider interactions, and semi-structured interviews with providers and staff. Results The primary factors providers considered when assessing value added were whether the HRQL information from the module was (1 duplicative of information gathered via other means during the encounter; (2 specific enough to be useful and/or acted upon, and; (3 useful for enough patients to warrant time spent reviewing it for all geriatric patients. Secondary considerations included level of integration of the HRQL and EHR, impact on nursing workflow, and patient reluctance to provide HRQL information. Conclusions Health-related quality of life modules within electronic health record systems offer the potential benefit of improving patient centeredness and quality of care. However, the modules must provide benefits that are substantial and prominent in order for physicians to decide that they are worthwhile and sustainable. Implications of this study for future research include the identification of perceived "costs" as well as a foundation for operationalizing the concept of "usefulness" in the context of such modules. Finally, developers of these modules may need to make their products customizable for practices to account for variation in EHR capabilities and practice

  6. Assessing environmental features related to mental health: a reliability study of visual streetscape images.

    Science.gov (United States)

    Wu, Yu-Tzu; Nash, Paul; Barnes, Linda E; Minett, Thais; Matthews, Fiona E; Jones, Andy; Brayne, Carol

    2014-10-22

    An association between depressive symptoms and features of built environment has been reported in the literature. A remaining research challenge is the development of methods to efficiently capture pertinent environmental features in relevant study settings. Visual streetscape images have been used to replace traditional physical audits and directly observe the built environment of communities. The aim of this work is to examine the inter-method reliability of the two audit methods for assessing community environments with a specific focus on physical features related to mental health. Forty-eight postcodes in urban and rural areas of Cambridgeshire, England were randomly selected from an alphabetical list of streets hosted on a UK property website. The assessment was conducted in July and August 2012 by both physical and visual image audits based on the items in Residential Environment Assessment Tool (REAT), an observational instrument targeting the micro-scale environmental features related to mental health in UK postcodes. The assessor used the images of Google Street View and virtually "walked through" the streets to conduct the property and street level assessments. Gwet's AC1 coefficients and Bland-Altman plots were used to compare the concordance of two audits. The results of conducting the REAT by visual image audits generally correspond to direct observations. More variations were found in property level items regarding physical incivilities, with broad limits of agreement which importantly lead to most of the variation in the overall REAT score. Postcodes in urban areas had lower consistency between the two methods than rural areas. Google Street View has the potential to assess environmental features related to mental health with fair reliability and provide a less resource intense method of assessing community environments than physical audits.

  7. Integration of health technology assessment recommendations into organizational and clinical practice: A case study in Catalonia.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Sánchez, Emília; Pons, Joan M V

    2006-01-01

    Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy makers. This research sought to understand factors affecting the uptake of HTA recommendations to support decision making with respect to the introduction of three health technologies. Using a multidimensional framework, based upon a combination of theoretical models, a case study was conducted. A total of twenty-eight semistructured interviews were done with physicians from fifteen hospitals and other stakeholders in Catalonia. Interview content was analyzed iteratively and classified according to theoretical dimensions and contextual factors. At the sociopolitical level, factors related to the organization and financing of the health system were found to affect the utilization of HTA recommendations. At the healthcare organization level, existing collaborations between the hospital and the HTA agency favored the integration of recommendations into practices. Formalism in the organization also influenced the utilization of HTA recommendations. At the professional level, the high degree of autonomy of specialists, the importance of peers and collegial control, and the definition of professional roles and responsibilities influenced physicians' willingness to integrate HTA recommendations into their practice. This study offers a comprehensive framework to understand the complex dynamics that affect adoption of health technologies in organizational and professional practices. The findings suggest some avenues to promote the integration of HTA recommendations into practices and, thus, increase the utilization of scientific evidence to support decision making in health care.

  8. Medico-ecological study and health impact assessment of hydro-electric projects in Malaysia

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Karen [Institute for Medical Research, Kuala Lumpur (Malaysia)

    1997-12-31

    The objectives of this studies were to determine i) if there was any potential health risks in terms of spread of vector-borne and other communicable diseases resulting from the changes in the environment due to creation of large bodies of water as consequence of the construction of dams, ii) diseases of public health importance in populations affected by such projects. Nine pre-impoundment studies had been carried out and potential impact of the change in environment on discases and health of the affected populations in each areas was evaluated. Risk of infections to the dam construction workers also assessed. Recommendations on mitigation measures were made for each situation so that adequate provisions could be made to improve the health conditions of these populations especially those who would be resettled as a result of impoundment . Prevention and control measures on transmission of infection, including vector control were proposed. The potential medico-ecological hazards encountered by immigrants and visitors to the area on completion of the hydro project were also envisaged.

  9. Medico-ecological study and health impact assessment of hydro-electric projects in Malaysia

    International Nuclear Information System (INIS)

    Karen Lai

    1996-01-01

    The objectives of this studies were to determine i) if there was any potential health risks in terms of spread of vector-borne and other communicable diseases resulting from the changes in the environment due to creation of large bodies of water as consequence of the construction of dams, ii) diseases of public health importance in populations affected by such projects. Nine pre-impoundment studies had been carried out and potential impact of the change in environment on discases and health of the affected populations in each areas was evaluated. Risk of infections to the dam construction workers also assessed. Recommendations on mitigation measures were made for each situation so that adequate provisions could be made to improve the health conditions of these populations especially those who would be resettled as a result of impoundment . Prevention and control measures on transmission of infection, including vector control were proposed. The potential medico-ecological hazards encountered by immigrants and visitors to the area on completion of the hydro project were also envisaged

  10. Framework for assessing the capacity of a health ministry to conduct health policy processes--a case study from Tajikistan.

    Science.gov (United States)

    Mirzoev, Tolib N; Green, Andrew; Van Kalliecharan, Ricky

    2015-01-01

    An adequate capacity of ministries of health (MOH) to develop and implement policies is essential. However, no frameworks were found assessing MOH capacity to conduct health policy processes within developing countries. This paper presents a conceptual framework for assessing MOH capacity to conduct policy processes based on a study from Tajikistan, a former Soviet republic where independence highlighted capacity challenges. The data collection for this qualitative study included in-depth interviews, document reviews and observations of policy events. Framework approach for analysis was used. The conceptual framework was informed by existing literature, guided the data collection and analysis, and was subsequently refined following insights from the study. The Tajik MOH capacity, while gradually improving, remains weak. There is poor recognition of wider contextual influences, ineffective leadership and governance as reflected in centralised decision-making, limited use of evidence, inadequate actors' participation and ineffective use of resources to conduct policy processes. However, the question is whether this is a reflection of lack of MOH ability or evidence of constraining environment or both. The conceptual framework identifies five determinants of robust policy processes, each with specific capacity needs: policy context, MOH leadership and governance, involvement of policy actors, the role of evidence and effective resource use for policy processes. Three underlying considerations are important for applying the capacity to policy processes: the need for clear focus, recognition of capacity levels and elements, and both ability and enabling environment. The proposed framework can be used in assessing and strengthening of the capacity of different policy actors. Copyright © 2013 John Wiley & Sons, Ltd.

  11. 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

  12. 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

  13. Health, Safety and Environment (HSE assessment of neighborhoods: A case study in Tehran Municipality

    Directory of Open Access Journals (Sweden)

    Narmin Hassanzadeh- Rangi

    2014-09-01

    Full Text Available Urbanization is growing rapidly in recent centuries. This phenomenon can cause many changes in various aspects of human life including the economy, education and public health This study was conducted to assess the Health, Safety and Environment (HSE problems in Tehran neighborhoods. A new instrument was developed based on the results of a literature review and formulated during a pilot study. Through cluster sampling, 10 neighborhoods were selected based from 374 neighborhoods of Tehran. Six observers completed observational items during the field studies. Secondary data were used to obtain non-observation characteristics. Standard descriptive statistics were used to compare the HSE characteristics in sampled neighborhoods. Furthermore, control chart was used to as a decision rule to identify specific variation among sampled neighborhoods. Niavaran neighborhood had the best HSE status (52.80%±25.03 whereas Khak Sefid neighborhood had the worst one (20.09%±27.51. Standard deviations of HSE characteristics were high in different parts of a neighborhood. Statistical analysis indicated that significant differences in HSE characteristics exist among sampled neighborhoods. HSE status was in warning situation in both rich and poor neighborhoods. Community-based interventions were suggested as health promotion programs to involve and empower people in neighborhoods.

  14. Using Statistical and Probabilistic Methods to Evaluate Health Risk Assessment: A Case Study

    Directory of Open Access Journals (Sweden)

    Hongjing Wu

    2014-06-01

    Full Text Available The toxic chemical and heavy metals within wastewater can cause serious adverse impacts on human health. Health risk assessment (HRA is an effective tool for supporting decision-making and corrective actions in water quality management. HRA can also help people understand the water quality and quantify the adverse effects of pollutants on human health. Due to the imprecision of data, measurement error and limited available information, uncertainty is inevitable in the HRA process. The purpose of this study is to integrate statistical and probabilistic methods to deal with censored and limited numbers of input data to improve the reliability of the non-cancer HRA of dermal contact exposure to contaminated river water by considering uncertainty. A case study in the Kelligrews River in St. John’s, Canada, was conducted to demonstrate the feasibility and capacity of the proposed approach. Five heavy metals were selected to evaluate the risk level, including arsenic, molybdenum, zinc, uranium and manganese. The results showed that the probability of the total hazard index of dermal exposure exceeding 1 is very low, and there is no obvious evidence of risk in the study area.

  15. Assessment of Health Needs in Children with Congenital Upper Limb Differences in Nicaragua: Community Case Study

    Directory of Open Access Journals (Sweden)

    Maria F. Canizares

    2017-05-01

    Full Text Available Congenital anomalies are prevalent in Nicaragua, and disability is estimated to be 10% in the general population. We studied children with congenital upper limb differences, as they are vulnerable to disability. This case study documents a collaborative effort between American and Nicaraguan orthopedic surgeons to determine unmet health needs of children with congenital upper limb differences at Hospital Manuel de Jesus Rivera (“La Mascota” Hospital in Nicaragua, with the goal of developing programs that successfully address these needs within the context of the priorities of the community. Participants were recruited during one of the biannual pediatric hand specialty clinics held by a partnership of pediatric hand surgeons and occupational therapists under the auspices of Health Volunteers Overseas (La Brigada de las Manos, or “La Brigada” and Nicaraguan orthopedic surgeons. Structured interviews were performed with 34 parents or caregivers of patients with the diagnosis of a congenital upper limb difference. Parents were asked to rank the social, economic, environmental, and biological factors that determine health according to priority. Using the Hanlon Method for prioritizing health problems, in consultation with local providers and the program director of La Brigada, five needs were identified: (1 improvements in access to specialized care from hand surgeons and (2 rehabilitation specialists; (3 improvements in upper extremity function; (4 access to transportation; and (5 improvement in physical activity and sports participation. Based on the results of this needs assessment, we learned that some of the needs were already part of the ongoing work of the partnership, but in addition, more needs became evident; for that reason, local health care providers and members of La Brigada identified potential solutions to these needs and are currently working to translate these in future interventions.

  16. Soil or Dust for Health Risk Assessment Studies in Urban Environment.

    Science.gov (United States)

    Gabarrón, M; Faz, A; Acosta, J A

    2017-10-01

    To identify the best material (soil or dust) to be selected for health-risk assessment studies, road dust and urban soil from three cities with different population densities were collected, and size fractions were analysed for metal content (Pb, Zn, Cu, Cd, Cr, Co, and Ni). Results showed similar distribution of the size particles among cities, predominating fractions between 75 and 2000 μm in road dust and particles below 75 μm in soil. Metals were mainly bound to PM10 in both soil and road dust increasing the risk of adverse health effects, overall through inhalation exposure. The risk assessment showed that the most hazardous exposure pathway was the ingestion via, followed by dermal absorption and inhalation route. Values of hazard quotient showed that the risk for children due to the ingestion and dermal absorption was higher than adults, and slightly larger at PM10 comparing to <75-μm fraction for the inhalation route. Higher risk values were found for road dust, although any hazard index or cancer risk index value did not overreach the safe value of 10 -6 .

  17. Assessing risk of bias in studies that evaluate health care interventions

    DEFF Research Database (Denmark)

    Page, Matthew J.; Boutron, Isabelle; Hansen, Camilla

    2018-01-01

    Methods to assess risk of bias in a way that is reliable, reproducible and transparent to readers, have evolved over time. Viswanathan et al. recently provided updated recommendations for assessing risk of bias in systematic reviews of health care interventions. We comment on their recommendations...

  18. Does consideration and assessment of effects on health equity affect the conclusions of systematic reviews? A methodology study.

    Science.gov (United States)

    Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter

    2012-01-01

    Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews.

  19. Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care : A Proof-of-Principle Study

    NARCIS (Netherlands)

    van der Krieke, Lian; Emerencia, Ando C; Bos, Elisabeth H; Rosmalen, Judith Gm; Riese, Harriëtte; Aiello, Marco; Sytema, Sjoerd; de Jonge, Peter

    2015-01-01

    BACKGROUND: Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However,

  20. Rapid assessment response (RAR study: drug use and health risk - Pretoria, South Africa

    Directory of Open Access Journals (Sweden)

    Trautmann Franz

    2011-06-01

    Full Text Available Abstract Background Within a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research. Methods A Rapid Assessment and Response (RAR methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI participants, 63 drug user KI participants (49 males, 14 females and 21 KI service providers (8 male, 13 female. Results and Discussion Adverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information. Conclusions The implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to

  1. Indian Psychiatric Society multicentric study on assessment of health-care needs of patients with severe mental illnesses

    OpenAIRE

    Grover, Sandeep; Avasthi, Ajit; Shah, Sandip; Lakdawala, Bhavesh; Chakraborty, Kaustav; Nebhinani, Naresh; Kallivayalil, Roy Abraham; Dalal, Pranob K.; Sinha, Vishal; Khairkar, Praveen; Mukerjee, Divya G.; Thara, R.; Behere, Prakash; Chauhan, Nidhi; Thirunavukarasu, M.

    2015-01-01

    Aim: To assess the health-care needs of the patients with severe mental disorders. Materials and Methods: Patients with the diagnosis of a severe mental disorder (schizophrenia and related psychotic disorders, bipolar disorder, recurrent depressive disorder, major depressive disorder and obsessive compulsive disorder) were assessed using Camberwell Assessment of Need-Research version (CAN-R) Scale and indigenously designed Supplementary Needs Assessment Scale (SNAS). Results: The study includ...

  2. 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.

  3. Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people.

    Science.gov (United States)

    Quinn, Virginia P; Nash, Rebecca; Hunkeler, Enid; Contreras, Richard; Cromwell, Lee; Becerra-Culqui, Tracy A; Getahun, Darios; Giammattei, Shawn; Lash, Timothy L; Millman, Andrea; Robinson, Brandi; Roblin, Douglas; Silverberg, Michael J; Slovis, Jennifer; Tangpricha, Vin; Tolsma, Dennis; Valentine, Cadence; Ward, Kevin; Winter, Savannah; Goodman, Michael

    2017-12-27

    The Study of Transition, Outcomes and Gender (STRONG) was initiated to assess the health status of transgender people in general and following gender-affirming treatments at Kaiser Permanente health plans in Georgia, Northern California and Southern California. The objectives of this communication are to describe methods of cohort ascertainment and data collection and to characterise the study population. A stepwise methodology involving computerised searches of electronic medical records and free-text validation of eligibility and gender identity was used to identify a cohort of 6456 members with first evidence of transgender status (index date) between 2006 and 2014. The cohort included 3475 (54%) transfeminine (TF), 2892 (45%) transmasculine (TM) and 89 (1%) members whose natal sex and gender identity remained undetermined from the records. The cohort was matched to 127 608 enrollees with no transgender evidence (63 825 women and 63 783 men) on year of birth, race/ethnicity, study site and membership year of the index date. Cohort follow-up extends through the end of 2016. About 58% of TF and 52% of TM cohort members received hormonal therapy at Kaiser Permanente. Chest surgery was more common among TM participants (12% vs 0.3%). The proportions of transgender participants who underwent genital reconstruction surgeries were similar (4%-5%) in the two transgender groups. Results indicate that there are sufficient numbers of events in the TF and TM cohorts to further examine mental health status, cardiovascular events, diabetes, HIV and most common cancers. STRONG is well positioned to fill existing knowledge gaps through comparisons of transgender and reference populations and through analyses of health status before and after gender affirmation treatment. Analyses will include incidence of cardiovascular disease, mental health, HIV and diabetes, as well as changes in laboratory-based endpoints (eg, polycythemia and bone density), overall and in relation to

  4. Health impact assessment in multinationals: A case study of the Royal Dutch/Shell Group

    International Nuclear Information System (INIS)

    Birley, Martin

    2005-01-01

    Health impact assessment is part of the risk management process of multinational corporations/companies. Sexually transmitted infections, including HIV/AIDS, and the 'paradox of plenty' are used as examples of the challenges they face. The 'business case' for impact assessment is explained. The policies, procedures, standards, and activities used by Shell to manage such risks are described. An approach to capacity building and competency development is presented that applies to both company staff and external contractors

  5. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  6. [Attaching importance to study on acute health risk assessment and adaptation of air pollution and climate change].

    Science.gov (United States)

    Shi, X M

    2017-03-10

    Air pollution and climate change have become key environmental and public health problems around the world, which poses serious threat to human health. How to assess and mitigate the health risks and increase the adaptation of the public have become an urgent topic of research in this area. The six papers in this issue will provide important and rich information on design, analysis method, indicator selection and setting about acute health risk assessment and adaptation study of air pollution and climate change in China, reflecting the advanced conceptions of multi-center and area-specific study and multi-pollutant causing acute effect study. However, the number and type of the cities included in these studies were still limited. In future, researchers should further expand detailed multi-center and multi-area study coverage, conduct area specific predicting and early warning study and strengthen adaptation study.

  7. A study of automated self-assessment in a primary care student health centre setting.

    Science.gov (United States)

    Poote, Aimee E; French, David P; Dale, Jeremy; Powell, John

    2014-04-01

    We evaluated the advice given by a prototype self-assessment triage system in a university student health centre. Students attending the health centre with a new problem used the automated self-assessment system prior to a face-to-face consultation with the general practitioner (GP). The system's rating of urgency was available to the GP, and following the consultation, the GP recorded their own rating of the urgency of the patient's presentation. Full data were available for 154 of the 207 consultations. Perfect agreement, where both the GP and the self-assessment system selected the same category of advice, occurred in 39% of consultations. The association between the GP assessment and the self-assessment rankings of urgency was low but significant (rho = 0.19, P = 0.016). The self-assessment system tended to be risk averse compared to the GP assessments, with advice for more urgent level of care seeking being recommended in 86 consultations (56%) and less urgent advice in only 8 (5%). This difference in assessment of urgency was significant (P self-assessment system was more risk averse than the GPs, which resulted in a high proportion of patients being triaged as needing emergency or immediate care, the self-assessment system successfully identified a proportion of patients who were felt by the GP to have a self-limiting condition that did not need a consultation. In its prototype form, the self-assessment system was not a replacement for clinician assessment and further refinement is necessary.

  8. CONTRIBUTION OF STAKEHOLDER ENGAGEMENT TO THE IMPACT OF A HEALTH TECHNOLOGY ASSESSMENT: AN IRISH CASE STUDY.

    Science.gov (United States)

    Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor

    2017-01-01

    The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.

  9. Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD : A Delphi Panel Study among Dutch Experts

    NARCIS (Netherlands)

    van den Akker, Edmée F M M; van't Hul, Alex J.; Birnie, Erwin; Chavannes, Niels H.; Rutten-van Mölken, Maureen P M H; In't Veen, Johannes C C M

    2017-01-01

    A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary

  10. 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...

  11. Environmental health risk assessment of ambient lead levels in Lisbon, Portugal: A full chain study approach

    DEFF Research Database (Denmark)

    Casimiro, E.; Philippe Ciffroy, P.; Serpa, P.

    2011-01-01

    to calculate the Pb levels in the various body systems. Our results showed a low health risk from Pb exposures. It also identified that ingestion of leafy vegetables (i.e. lettuce, cabbage, and spinach) and fruits contribute the most to total Pb blood levels. This full chain assessment approach of the 2FUN...

  12. Assessment of students’ satisfaction with nursing studies at the Faculty of Health Science, Warsaw Medical University. Pilot study

    Directory of Open Access Journals (Sweden)

    Joanna Gotlib

    2014-06-01

    Full Text Available Introduction:: The analysis of the opinions of students regarding their level of satisfaction with their studies constitutes one of the basic elements of global assessment of the quality of teaching at university-level schools. Aim of the research: : To analyse the assessment of satisfaction of students with the learning content and teaching methods in the field of nursing at the Faculty of Health Science, Medical University of Warsaw. Material and methods:: The study enrolled 200 full-time (ST and part-time (NST students, including 195 women (F and 5 men (M. The mean age was 34 years and the questionnaire return rate was 55%. This was a voluntary and anonymous questionnaire study, with a questionnaire developed by the authors including 27 close-ended questions. The students received the questionnaire in the form of a link to an e-form. Statistical analysis was performed using Statsoft Statistica 10.0 (licensed to Medical University of Warsaw and Mann-Whitney U test (significance level: p < 0.05. Results:: The majority of ST and NST students were satisfied with studying Nursing at Medical University of Warsaw. The vast majority of the study participants reported that the number of hours of lectures was sufficient, with ST students reporting thois significantly more often (p < 0.05. The students from both groups reported that the number of hours of seminars, classes and professional training sessions was sufficient (p = NS. The vast majority of the ST and NST students expressed a preference to choose theoretical classes and seminars on their own, in accordance with their interests and the character of their job. Compared to the ST students, the NST students significantly more often (p < 0.05 declared that the curriculum did not include a sufficient number of hours of the following courses: Contracting Health Benefits, Law in Health Protection and European Nursing. Conclusions: : Teaching in the field in Nursing met with the expectations of

  13. Different methods for ethical analysis in health technology assessment: an empirical study.

    Science.gov (United States)

    Saarni, Samuli I; Braunack-Mayer, Annette; Hofmann, Bjørn; van der Wilt, Gert Jan

    2011-10-01

    Ethical analysis can highlight important ethical issues related to implementing a technology, values inherent in the technology itself, and value-decisions underlying the health technology assessment (HTA) process. Ethical analysis is a well-acknowledged part of HTA, yet seldom included in practice. One reason for this is lack of knowledge about the properties and differences between the methods available. This study compares different methods for ethical analysis within HTA. Ethical issues related to bariatric (obesity) surgery were independently evaluated using axiological, casuist, principlist, and EUnetHTA models for ethical analysis within HTA. The methods and results are presented and compared. Despite varying theoretical underpinnings and practical approaches, the four methods identified similar themes: personal responsibility, self-infliction, discrimination, justice, public funding, and stakeholder involvement. The axiological and EUnetHTA models identified a wider range of arguments, whereas casuistry and principlism concentrated more on analyzing a narrower set of arguments deemed more important. Different methods can be successfully used for conducting ethical analysis within HTA. Although our study does not show that different methods in ethics always produce similar results, it supports the view that different methods of ethics can yield relevantly similar results. This suggests that the key conclusions of ethical analyses within HTA can be transferable between methods and countries. The systematic and transparent use of some method of ethics appears more important than the choice of the exact method.

  14. STAKEHOLDER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT NATIONAL LEVEL: A STUDY FROM IRAN.

    Science.gov (United States)

    Yazdizadeh, Bahareh; Shahmoradi, Safoura; Majdzadeh, Reza; Doaee, Shila; Bazyar, Mohammad; Souresrafil, Aghdas; Olyaeemanesh, Alireza

    2016-01-01

    This study was carried out to evaluate the opinions of stakeholders on their roles in health technology assessment (HTA) in Iran and to determine the barriers and facilitators existing in the organizations to help increase their involvement in the HTA program. The study was conducted in two stages, semi-structured interviews, and "policy dialogue" with stakeholders. The data were analyzed through the framework approach. The interviews were held with ten stakeholder representatives from various organizations. In addition, Twenty-one representatives participated in the policy dialogue. Based on the findings, all the stakeholder organizations considered themselves as interest groups in all the stages of the HTA process; however, their tendencies and methods of involvement differed from one another. According to the participants, the most important issue to be considered in the context of HTA was that the structures, stages, and procedures of the HTA process must be made transparent. Stakeholder involvement in the HTA program cannot readily take place. Various stakeholders have different interests, responsibilities, infrastructures, and barriers. If a program does not meet these considerations, its chances of succeeding will substantially decrease. Therefore, to prevent overlooking the needs and expectations of stakeholders from the HTA process, it is essential to create opportunities in which their thoughts and ideas are taken into account.

  15. Assessing Opinions in Community Leadership Networks to Address Health Inequalities: A Case Study from Project IMPACT

    Science.gov (United States)

    McCauley, M. P.; Ramanadhan, S.; Viswanath, K.

    2015-01-01

    This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in "Milltown", the New…

  16. The use of biomonitoring data in exposure and human health risk assessment: benzene case study.

    Science.gov (United States)

    Arnold, Scott M; Angerer, Juergen; Boogaard, Peter J; Hughes, Michael F; O'Lone, Raegan B; Robison, Steven H; Schnatter, A Robert

    2013-02-01

    Abstract A framework of "Common Criteria" (i.e. a series of questions) has been developed to inform the use and evaluation of biomonitoring data in the context of human exposure and risk assessment. The data-rich chemical benzene was selected for use in a case study to assess whether refinement of the Common Criteria framework was necessary, and to gain additional perspective on approaches for integrating biomonitoring data into a risk-based context. The available data for benzene satisfied most of the Common Criteria and allowed for a risk-based evaluation of the benzene biomonitoring data. In general, biomarker (blood benzene, urinary benzene and urinary S-phenylmercapturic acid) central tendency (i.e. mean, median and geometric mean) concentrations for non-smokers are at or below the predicted blood or urine concentrations that would correspond to exposure at the US Environmental Protection Agency reference concentration (30 µg/m(3)), but greater than blood or urine concentrations relating to the air concentration at the 1 × 10(-5) excess cancer risk (2.9 µg/m(3)). Smokers clearly have higher levels of benzene exposure, and biomarker levels of benzene for non-smokers are generally consistent with ambient air monitoring results. While some biomarkers of benzene are specific indicators of exposure, the interpretation of benzene biomonitoring levels in a health-risk context are complicated by issues associated with short half-lives and gaps in knowledge regarding the relationship between the biomarkers and subsequent toxic effects.

  17. The use of biomonitoring data in exposure and human health risk assessment: benzene case study

    Science.gov (United States)

    Angerer, Juergen; Boogaard, Peter J.; Hughes, Michael F.; O’Lone, Raegan B.; Robison, Steven H.; Robert Schnatter, A.

    2013-01-01

    A framework of “Common Criteria” (i.e. a series of questions) has been developed to inform the use and evaluation of biomonitoring data in the context of human exposure and risk assessment. The data-rich chemical benzene was selected for use in a case study to assess whether refinement of the Common Criteria framework was necessary, and to gain additional perspective on approaches for integrating biomonitoring data into a risk-based context. The available data for benzene satisfied most of the Common Criteria and allowed for a risk-based evaluation of the benzene biomonitoring data. In general, biomarker (blood benzene, urinary benzene and urinary S-phenylmercapturic acid) central tendency (i.e. mean, median and geometric mean) concentrations for non-smokers are at or below the predicted blood or urine concentrations that would correspond to exposure at the US Environmental Protection Agency reference concentration (30 µg/m3), but greater than blood or urine concentrations relating to the air concentration at the 1 × 10−5 excess cancer risk (2.9 µg/m3). Smokers clearly have higher levels of benzene exposure, and biomarker levels of benzene for non-smokers are generally consistent with ambient air monitoring results. While some biomarkers of benzene are specific indicators of exposure, the interpretation of benzene biomonitoring levels in a health-risk context are complicated by issues associated with short half-lives and gaps in knowledge regarding the relationship between the biomarkers and subsequent toxic effects. PMID:23346981

  18. IMPORTANCE OF CONTEXTUAL DATA IN PRODUCING HEALTH TECHNOLOGY ASSESSMENT RECOMMENDATIONS: A CASE STUDY.

    Science.gov (United States)

    Poder, Thomas G; Bellemare, Christian A

    2018-01-01

    Contextual data and local expertise are important sources of data that cannot be ignored in hospital-based health technology assessment (HTA) processes. Despite a lack of or unconvincing evidence in the scientific literature, technology can be recommended in a given context. We illustrate this using a case study regarding biplane angiography for vascular neurointervention. A systematic literature review was conducted, along with an analysis of the context in our setting. The outcomes of interest were radiation doses, clinical complications, procedure times, purchase cost, impact on teaching program, the confidence of clinicians in the technology, quality of care, accessibility, and the volume of activity. A committee comprising managers, clinical experts, physicians, physicists and HTA experts was created to produce a recommendation regarding biplane technology acquisition to replace a monoplane device. The systematic literature review yielded nine eligible articles for analysis. Despite a very low level of evidence in the literature, the biplane system appears to reduce ionizing radiation and medical complications, as well as shorten procedure time. Contextual data indicated that the biplane system could improve operator confidence, which could translate into reduced risk, particularly for complex procedures. In addition, the biplane system can support our institution in its advanced procedures teaching program. Given the advantages provided by the biplane technology in our setting, the committee has recommended its acquisition. Contextual data were of utmost importance in this recommendation. Moreover, this technology should be implemented alongside a responsibility to collect outcome data to optimize clinical protocol in the doses of ionizing delivered.

  19. A life cycle assessment framework combining nutritional and environmental health impacts of diet: a case study on milk

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Heller, Martin C.; Fulgoni III, Victor L.

    2016-01-01

    of less healthy foods (sugar-sweetened beverages). Further studies are needed to test whether this conclusion holds within a more comprehensive assessment of environmental and nutritional health impacts. Conclusions This case study provides the first quantitative epidemiology-based estimate......Purpose While there has been considerable effort to understand the environmental impact of a food or diet, nutritional effects are not usually included in food-related life cycle assessment (LCA). Methods We developed a novel Combined Nutritional and Environmental Life Cycle Assessment (CONE......-LCA) framework that evaluates and compares in parallel the environmental and nutritional effects of foods or diets. We applied this framework to assess human health impacts, expressed in Disability Adjusted Life Years (DALYs), in a proof-of conceptcase study that investigated the environmental and nutritional...

  20. Diet assessment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil: Development of a food frequency questionnaire

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    Maria del Carmen Bisi Molina

    2013-04-01

    Full Text Available OBJECTIVE: The objective of this article is to present the development of the Food Frequency Questionaire used in the Longitudinal Study of Adult Health-Brazil and analyze how diet exposes individuals to cardiovascular diseases and type 2 diabetes Mellitus. METHODS: The Longitudinal Study of Adult Health-Brazil dietary assessment instrument is based on a previously validated Food Frequency Questionaire and the final list of items took into consideration a study done in the six Longitudinal Study of Adult Health-Brazil investigation centers. RESULTS: New foods/preparations were included in the Food Frequency Questionaire with their respective portions, totaling 114 items. The perspectives of dietary analysis and cardiovascular diseases and diabetes are presented in Longitudinal Study of Adult Health-Brazil. CONCLUSION: A new instrument was developed to cover the regional particularities of the study population.

  1. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study.

    Science.gov (United States)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit; Vedsted, Peter

    2015-12-01

    Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Hazard Ranking Methodology for Assessing Health Impacts of Unconventional Natural Gas Development and Production: The Maryland Case Study.

    Directory of Open Access Journals (Sweden)

    Meleah D Boyle

    Full Text Available The recent growth of unconventional natural gas development and production (UNGDP has outpaced research on the potential health impacts associated with the process. The Maryland Marcellus Shale Public Health Study was conducted to inform the Maryland Marcellus Shale Safe Drilling Initiative Advisory Commission, State legislators and the Governor about potential public health impacts associated with UNGDP so they could make an informed decision that considers the health and well-being of Marylanders. In this paper, we describe an impact assessment and hazard ranking methodology we used to assess the potential public health impacts for eight hazards associated with the UNGDP process. The hazard ranking included seven metrics: 1 presence of vulnerable populations (e.g. children under the age of 5, individuals over the age of 65, surface owners, 2 duration of exposure, 3 frequency of exposure, 4 likelihood of health effects, 5 magnitude/severity of health effects, 6 geographic extent, and 7 effectiveness of setbacks. Overall public health concern was determined by a color-coded ranking system (low, moderately high, and high that was generated based on the overall sum of the scores for each hazard. We provide three illustrative examples of applying our methodology for air quality and health care infrastructure which were ranked as high concern and for water quality which was ranked moderately high concern. The hazard ranking was a valuable tool that allowed us to systematically evaluate each of the hazards and provide recommendations to minimize the hazards.

  3. The Self-Assessment Process and Impacts on the Health Information Management Program Performance: A Case Study

    Science.gov (United States)

    Spohn, Renae

    2015-01-01

    This study examined how health information management (HIM) educational programs can use the Malcolm Baldrige National Quality Award Model (MBNQAM) educational criteria to meet the self-assessment requirement for Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) accreditation. An existing instrument, Quantum Performance Group's Organizational Assessment Survey authored by Dr. Mark Blazey, was used in this study. The instrument was designed to self-assess the entire organization. Results of the study demonstrate how the MBNQAM can be used to successfully self-assess HIM programs. This research adds to the body of literature surrounding the application of the MBNQAM for HIM programs and provides new information to deans, administrators, and educators that may be useful, as an added component, when self-assessing HIM programs. The results of this study will help to establish a foundation for HIM programs to strengthen the self-assessment process, providing a strong starting point for strategic planning prioritization for HIM program improvement initiatives. The improved process will help in maturing the HIM program while fulfilling accreditation requirements for self-assessment. As additional HIM programs formalize the self-assessment process, benchmarking opportunities with other HIM programs will be created. PMID:26755899

  4. Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study

    Directory of Open Access Journals (Sweden)

    Fleming Lora E

    2011-04-01

    Full Text Available Abstract Background Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population. Methods In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost of the handheld administration method was recorded and compared to approaches available in the extant literature. Results Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings. Conclusions Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data

  5. Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study.

    Science.gov (United States)

    Caban-Martinez, Alberto J; Clarke, Tainya C; Davila, Evelyn P; Fleming, Lora E; Lee, David J

    2011-04-01

    Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population. In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish) recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost) of the handheld administration method was recorded and compared to approaches available in the extant literature. Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings. Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data. These technological research modalities are useful in the

  6. 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.

  7. Electronic health record-based assessment of cardiovascular health: The stroke prevention in healthcare delivery environments (SPHERE study

    Directory of Open Access Journals (Sweden)

    Randi E. Foraker

    2016-12-01

    Full Text Available <3% of Americans have ideal cardiovascular health (CVH. The primary care encounter provides a setting in which to conduct patient-provider discussions of CVH. We implemented a CVH risk assessment, visualization, and decision-making tool that automatically populates with electronic health record (EHR data during the encounter in order to encourage patient-centered CVH discussions among at-risk, yet under-treated, populations. We quantified five of the seven CVH behaviors and factors that were available in The Ohio State University Wexner Medical Center's EHR at baseline (May–July 2013 and compared values to those ascertained at one-year (May–July 2014 among intervention (n = 109 and control (n = 42 patients. The CVH of women in the intervention clinic improved relative to the metrics of body mass index (16% to 21% ideal and diabetes (62% to 68% ideal, but not for smoking, total cholesterol, or blood pressure. Meanwhile, the CVH of women in the control clinic either held constant or worsened slightly as measured using those same metrics. Providers need easy-to-use tools at the point-of-care to help patients improve CVH. We demonstrated that the EHR could deliver such a tool using an existing American Heart Association framework, and we noted small improvements in CVH in our patient population. Future work is needed to assess how to best harness the potential of such tools in order to have the greatest impact on the CVH of a larger patient population.

  8. A framework to assess management performance in district health systems: a qualitative and quantitative case study in Iran.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Gholipour, Kamal; Iezadi, Shabnam; Farahbakhsh, Mostafa; Ghiasi, Akbar

    2018-01-01

    The aim was to design a district health management performance framework for Iran's healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI). Also content validity ratio (CVR) was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.

  9. A framework to assess management performance in district health systems: a qualitative and quantitative case study in Iran

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2018-04-01

    Full Text Available The aim was to design a district health management performance framework for Iran’s healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI. Also content validity ratio (CVR was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.

  10. The impact of using visual images of the body within a personalized health risk assessment: an experimental study.

    Science.gov (United States)

    Hollands, Gareth J; Marteau, Theresa M

    2013-05-01

    To examine the motivational impact of the addition of a visual image to a personalized health risk assessment and the underlying cognitive and emotional mechanisms. An online experimental study in which participants (n = 901; mean age = 27.2 years; 61.5% female) received an assessment and information focusing on the health implications of internal body fat and highlighting the protective benefits of physical activity. Participants were randomized to receive this in either (a) solely text form (control arm) or (b) text plus a visual image of predicted internal body fat (image arm). Participants received information representing one of three levels of health threat, determined by how physically active they were: high, moderate or benign. Main outcome measures were physical activity intentions (assessed pre- and post-intervention), worry, coherence and believability of the information. Intentions to undertake recommended levels of physical activity were significantly higher in the image arm, but only amongst those participants who received a high-threat communication. Believability of the results received was greater in the image arm and mediated the intervention effect on intentions. The addition of a visual image to a risk assessment led to small but significant increases in intentions to undertake recommended levels of physical activity in those at increased health risk. Limitations of the study and implications for future research are discussed. What is already known on this subject? Health risk information that is personalized to the individual may more strongly motivate risk-reducing behaviour change. Little prior research attention has been paid specifically to the motivational impact of personalized visual images and underlying mechanisms. What does this study add? In an experimental design, it is shown that receipt of visual images increases intentions to engage in risk-reducing behaviour, although only when a significant level of threat is presented. The

  11. Comprehensive assessment of health education and health promotion in five non-communicable disease demonstration districts in China: a cross-sectional study.

    Science.gov (United States)

    Xu, Qiaohua; Huang, Yuelong; Chen, Biyun

    2017-12-26

    This study aims to develop assessment indicators of health education and promotion for non-communicable disease (NCD) demonstration districts in China and to identify significant factors associated with NCD health education and promotion work. Three complementary techniques were used to conduct this study in Hunan Province, China, between late 2013 and 2015. The Delphi technique was used to develop weighted assessment indicators, followed by the rank sum ratio (RSR) to normalise the weights through rank conversion. Lastly, the technique for order of preference by similarity to ideal solution was conducted to assess five randomly selected NCD demonstration districts representing five different orientations in the province. A total of 24 assessment indicators were constructed covering the following sections: organisational management, fund support, personnel supplies, health education and promotion, people's awareness of NCDs, management and control of patients with NCD, satisfaction with health education and promotion and health literacy of residents. Five districts were selected as samples for evaluation (Furong District, Ziyang District, Shaodong County, Shuangfeng County and Luxi County). Performance varied among the sites, with Furong District greatly surpassing the other sites, especially in fund support, media promotion, technical support for publicity materials, community promotion and supportive environment supplies. The latter four factors were also much greater in the second-ranked Luxi County site than those in the other sites (except Furong District). There were gaps in health education and promotion work in NCD demonstration districts in Hunan Province. The districts that performed better had obvious advantages in fund support, media promotion, technical support, community promotion and supportive environment supplies. Our study provided both a methodological reference and an assessment indicator framework for similar future studies. © Article author

  12. Assessing for domestic violence in sexual health environments: a qualitative study.

    Science.gov (United States)

    Horwood, Jeremy; Morden, Andrew; Bailey, Jayne E; Pathak, Neha; Feder, Gene

    2018-03-01

    Domestic violence and abuse (DVA) is a major clinical challenge and public health issue. Sexual health services are an important potential site of DVA intervention. The Assessing for Domestic Violence in Sexual Health Environments (ADViSE) intervention aimed to improve identification and management of DVA in sexual healthcare settings and is a modified version of the Identification and Referral to Improve Safety (IRIS) general practice programme. Our qualitative evaluation aimed to explore the experiences of staff participating in an IRIS ADViSE pilot. Interviews were conducted with 17 sexual health clinic staff and DVA advocate workers. Interviews were audio recorded, transcribed, anonymised and analysed thematically. Staff prioritised enquiring about DVA and tailored their style of enquiry to the perceived characteristics of patients, current workload and individual clinical judgements. Responding to disclosures of abuse was divided between perceived low-risk cases (with quick onwards referral) and high-risk cases (requiring deployment of institution safeguarding procedures), which were viewed as time consuming and could create tensions with patients. Ongoing training and feedback, commissioner recognition, adequate service-level agreements and reimbursements are required to ensure sustainability and wider implementation of IRIS ADViSE. Challenges of delivering and sustaining IRIS ADViSE included the varied styles of enquiry, as well as tensions and additional time pressure arising from disclosure of abuse. These can be overcome by modifying initial training, providing regular updates and stronger recognition (and resources) at policy and commissioning levels. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Audit study of the new hospitalization for assessment scheme for forensic mental health in Japan.

    Science.gov (United States)

    Shiina, Akihiro; Iyo, Masaomi; Hirata, Toyoaki; Igarashi, Yoshito

    2015-06-22

    To clarify the components of hospitalization for assessment (HfA) and the management changes from the beginning of the scheme to the present. This study is composed of two surveys. In 2013 survey, we created two paper questionnaires (facility and case questionnaires) for psychiatrists working in psychiatric hospitals accepting HfA patients. Questionnaires were sent to 205 hospitals that were identified as accepting the HfA cases, and responses were requested via mail. The facility questionnaire was designed to clarify the following specifications and characteristics of each facility: the facility organizer (public sector or private hospital), and the number of beds, psychiatrists, psychiatric nurses, occupational therapists, psychiatric social workers, psychotherapists, public health nurses, and patients treated through HfA during the survey period. The case questionnaire was then used to collect data of the patients under HfA based on the Medical Treatment and Supervision (MTS) Act who were discharged between July 1, 2012 and June 30, 2013. Gathered information included: legal information of each case, demographic data, past history of the offenders, issued offense and the relationship to the victim, information regarding past psychiatric testimonies, psychiatric diagnoses, contents of the treatment during HfA, information regarding seclusion and restraint during the HfA, the verdict of the District Court panel, and so forth. Next, we compared those results with relevant data obtained in 2007. The 2007 survey comprised data of HfA patients from July 15, 2005 (the date the MTS Act was enforced) to January 15, 2007. We obtained 171 cases, approximately a half of whole contemporary cases of HfA, from 134 facilities, of which 46 were national, prefectural, or semi-official hospitals, and 88 were private hospitals, in 2013 survey. The majority of subjects were male, schizophrenic, and experienced previous psychiatric treatment. The most frequent type of the offense was

  14. Knowledge mobilization in the context of health technology assessment: an exploratory case study

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    Fournier Monique F

    2012-04-01

    Full Text Available Abstract Background Finding measures to enhance the dissemination and implementation of their recommendations has become part of most health technology assessment (HTA bodies' preoccupations. The Quebec government HTA organization in Canada observed that some of its projects relied on innovative practices in knowledge production and dissemination. A research was commissioned in order to identify what characterized these practices and to establish whether they could be systematized. Methods An exploratory case study was conducted during summer and fall 2010 in the HTA agency in order to determine what made the specificity of its context, and to conceptualize an approach to knowledge production and dissemination that was adapted to the mandate and nature of this form of HTA organization. Six projects were selected. For each, the HTA report and complementary documents were analyzed, and semi-structured interviews were carried out. A narrative literature review of the most recent literature reviews of the principal knowledge into practice frameworks (2005-2010 and of articles describing such frameworks (2000-2010 was undertaken. Results and discussion Our observations highlighted an inherent difficulty as regards applying the dominant knowledge translation models to HTA and clinical guidance practices. For the latter, the whole process starts with an evaluation question asked in a problematic situation for which an actionable answer is expected. The objective is to produce the evidence necessary to respond to the decision-maker's request. The practices we have analyzed revealed an approach to knowledge production and dissemination, which was multidimensional, organic, multidirectional, dynamic, and dependent on interactions with stakeholders. Thus, HTA could be considered as a knowledge mobilization process per se. Conclusions HTA's purpose is to solve a problem by mobilizing the types of evidence required and the concerned actors, in order to

  15. e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China.

    Science.gov (United States)

    Li, Junhua; Seale, Holly; Ray, Pradeep; Wang, Quanyi; Yang, Peng; Li, Shuang; Zhang, Yi; Macintyre, C Raina

    2013-03-13

    To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). PRIMARY AND SECONDARY MEASURES: For the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers' exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient

  16. Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol

    Directory of Open Access Journals (Sweden)

    Laan Eva K

    2012-03-01

    Full Text Available Abstract Background Physical inactivity, unhealthy dietary habits, smoking and high alcohol consumption are recognized risk factors for cardiovascular disease and cancer. Web-based health risk assessments with tailored feedback seem promising in promoting a healthy lifestyle. This study evaluates the effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour, conducted in a worksite setting. Methods/Design The web-based health risk assessment starts with a questionnaire covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. Prognostic models are used to estimate individual cardiovascular risks. In case of high risk further biometric and laboratory evaluation is advised. All participants receive individually-tailored feedback on their responses to the health risk assessment questionnaire. The study uses a quasi-experimental design with a waiting list control group. Data are collected at baseline (T0 and after six months (T1. Within each company, clusters of employees are allocated to either the intervention or the control group. Primary outcome is lifestyle behaviour, expressed as the sum of five indicators namely physical activity, nutrition, smoking behaviour, alcohol consumption, and symptoms of burnout. Multilevel regression analysis will be used to answer the main research question and to correct for clustering effects. Baseline differences between the intervention and control group in the distribution of characteristics with a potential effect on lifestyle change will be taken into account in further analyses using propensity scores. Discussion This study will increase insight into the effectiveness of health risk assessments with tailored feedback and into conditions that may modify the effectiveness. This information can be used to design effective interventions for lifestyle behaviour change among employees. Trial

  17. Study Protocol on Ecological Momentary Assessment of Health-Related Quality of Life using a Smartphone Application

    Directory of Open Access Journals (Sweden)

    Silvana Mareva

    2016-07-01

    routine HRQoL assessment. The direct comparison of real-time and retrospective measures in this study will provide important novel insight into the efficacy of mHealth applications for HRQoL assessment. If shown to be valid, reliable and feasible for the collection of HRQoL data, mHealth applications may have future potential for facilitating clinical assessment, patient-physician communication, and monitoring individual HRQoL over course of treatment.

  18. Study Protocol on Ecological Momentary Assessment of Health-Related Quality of Life Using a Smartphone Application.

    Science.gov (United States)

    Mareva, Silvana; Thomson, David; Marenco, Pietro; Estal Muñoz, Víctor; Ott, Caroline V; Schmidt, Barbara; Wingen, Tobias; Kassianos, Angelos P

    2016-01-01

    -time and retrospective measures in this study will provide important novel insight into the efficacy of mHealth applications for HRQoL assessment. If shown to be valid, reliable and feasible for the collection of HRQoL data, mHealth applications may have future potential for facilitating clinical assessment, patient-physician communication, and monitoring individual HRQoL over course of treatment.

  19. Drinking water studies: a review on heavy metal, application of biomarker and health risk assessment (a special focus in Malaysia).

    Science.gov (United States)

    Ab Razak, Nurul Hafiza; Praveena, Sarva Mangala; Aris, Ahmad Zaharin; Hashim, Zailina

    2015-12-01

    Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  20. The use of biomonitoring data in exposure and human health risk assessment: benzene case study

    OpenAIRE

    Arnold, Scott M.; Angerer, Juergen; Boogaard, Peter J.; Hughes, Michael F.; O?Lone, Raegan B.; Robison, Steven H.; Robert Schnatter, A.

    2013-01-01

    A framework of ?Common Criteria? (i.e. a series of questions) has been developed to inform the use and evaluation of biomonitoring data in the context of human exposure and risk assessment. The data-rich chemical benzene was selected for use in a case study to assess whether refinement of the Common Criteria framework was necessary, and to gain additional perspective on approaches for integrating biomonitoring data into a risk-based context. The available data for benzene satisfied most of th...

  1. Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

    Science.gov (United States)

    Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

    2015-07-01

    Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

  2. Virtual gaming simulation of a mental health assessment: A usability study.

    Science.gov (United States)

    Verkuyl, Margaret; Romaniuk, Daria; Mastrilli, Paula

    2018-05-18

    Providing safe and realistic virtual simulations could be an effective way to facilitate the transition from the classroom to clinical practice. As nursing programs begin to include virtual simulations as a learning strategy; it is critical to first assess the technology for ease of use and usefulness. A virtual gaming simulation was developed, and a usability study was conducted to assess its ease of use and usefulness for students and faculty. The Technology Acceptance Model provided the framework for the study, which included expert review and testing by nursing faculty and nursing students. This study highlighted the importance of assessing ease of use and usefulness in a virtual game simulation and provided feedback for the development of an effective virtual gaming simulation. The study participants said the virtual gaming simulation was engaging, realistic and similar to a clinical experience. Participants found the game easy to use and useful. Testing provided the development team with ideas to improve the user interface. The usability methodology provided is a replicable approach to testing virtual experiences before a research study or before implementing virtual experiences into curriculum. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit

    2015-01-01

    and subsequent non-participation in breast cancer screening. Methods This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50–69 years) for the first organised breast cancer screening programme -3 years later in the Central...... Denmark Region in 2008–2009. Results A U-shaped association was observed for physical health assessment as women with the highest (PR = 1.28, 95% CI: 1.06–1.55), and the lowest (PR = 1.41, 95% CI: 1.18–1.68) physical health scores were less likely to participate in the programme than women with physical...... health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR = 1.44, 95% CI: 1.22–1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores...

  4. Audit study of the new hospitalization for assessment scheme for forensic mental health in Japan

    Science.gov (United States)

    Shiina, Akihiro; Iyo, Masaomi; Hirata, Toyoaki; Igarashi, Yoshito

    2015-01-01

    AIM: To clarify the components of hospitalization for assessment (HfA) and the management changes from the beginning of the scheme to the present. METHODS: This study is composed of two surveys. In 2013 survey, we created two paper questionnaires (facility and case questionnaires) for psychiatrists working in psychiatric hospitals accepting HfA patients. Questionnaires were sent to 205 hospitals that were identified as accepting the HfA cases, and responses were requested via mail. The facility questionnaire was designed to clarify the following specifications and characteristics of each facility: the facility organizer (public sector or private hospital), and the number of beds, psychiatrists, psychiatric nurses, occupational therapists, psychiatric social workers, psychotherapists, public health nurses, and patients treated through HfA during the survey period. The case questionnaire was then used to collect data of the patients under HfA based on the Medical Treatment and Supervision (MTS) Act who were discharged between July 1, 2012 and June 30, 2013. Gathered information included: legal information of each case, demographic data, past history of the offenders, issued offense and the relationship to the victim, information regarding past psychiatric testimonies, psychiatric diagnoses, contents of the treatment during HfA, information regarding seclusion and restraint during the HfA, the verdict of the District Court panel, and so forth. Next, we compared those results with relevant data obtained in 2007. The 2007 survey comprised data of HfA patients from July 15, 2005 (the date the MTS Act was enforced) to January 15, 2007. RESULTS: We obtained 171 cases, approximately a half of whole contemporary cases of HfA, from 134 facilities, of which 46 were national, prefectural, or semi-official hospitals, and 88 were private hospitals, in 2013 survey. The majority of subjects were male, schizophrenic, and experienced previous psychiatric treatment. The most frequent

  5. Time motion study using mixed methods to assess service delivery by frontline health workers from South India: methods.

    Science.gov (United States)

    Singh, Samiksha; Upadhyaya, Sanjeev; Deshmukh, Pradeep; Dongre, Amol; Dwivedi, Neha; Dey, Deepak; Kumar, Vijay

    2018-04-02

    In India, amidst the increasing number of health programmes, there are concerns about the performance of frontline health workers (FLHW). We assessed the time utilisation and factors affecting the work of frontline health workers from South India. This is a mixed methods study using time and motion (TAM) direct observations and qualitative enquiry among frontline/community health workers. These included 43 female and 6 male multipurpose health workers (namely, auxiliary nurse midwives (ANMs) and male-MPHWs), 12 nutrition and health workers (Anganwadi workers, AWWs) and 53 incentive-based community health workers (accredited social health activists, ASHAs). We conducted the study in two phases. In the formative phase, we conducted an in-depth inductive investigation to develop observation checklists and qualitative tools. The main study involved deductive approach for TAM observations. This enabled us to observe a larger sample to capture variations across non-tribal and tribal regions and different health cadres. For the main study, we developed GPRS-enabled android-based application to precisely record time, multi-tasking and field movement. We conducted non-participatory direct observations (home to home) for consecutively 6 days for each participant. We conducted in-depth interviews with all the participants and 33 of their supervisors and relevant officials. We conducted six focus group discussions (FGDs) with ASHAs and one FGD with ANMs to validate preliminary findings. We established a mechanism for quality assurance of data collection and analysis. We analysed the data separately for each cadre and stratified for non-tribal and tribal regions. On any working day, the ANMs spent median 7:04 h, male-MPHWs spent median 5:44 h and AWWs spent median 6:50 h on the job. The time spent on the job was less among the FLHWs from tribal areas as compared to those from non-tribal areas. ANMs and AWWs prioritised maternal and child health, while male-MPHWs were

  6. The 'Hothaps' programme for assessing climate change impacts on occupational health and productivity: an invitation to carry out field studies.

    Science.gov (United States)

    Kjellstrom, Tord; Gabrysch, Sabine; Lemke, Bruno; Dear, Keith

    2009-11-11

    The 'high occupational temperature health and productivity suppression' programme (Hothaps) is a multi-centre health research and prevention programme aimed at quantifying the extent to which working people are affected by, or adapt to, heat exposure while working, and how global heating during climate change may increase such effects. The programme will produce essential new evidence for local, national and global assessment of negative impacts of climate change that have largely been overlooked. It will also identify and evaluate preventive interventions in different social and economic settings.Hothaps includes studies in any part of the world where hourly heat exposure exceeds physiological stress limits that may affect workers. This usually happens at temperatures above 25 degrees C, depending on humidity, wind movement and heat radiation. Working people in low and middle-income tropical countries are particularly vulnerable, because many of them are involved in heavy physical work, either outdoors in strong sunlight or indoors without effective cooling. If high work intensity is maintained in workplaces with high heat exposure, serious health effects can occur, including heat stroke and death.Depending on the type of occupation, the required work intensity, and the level of heat stress, working people have to slow down their work in order to reduce internal body heat production and the risk of heat stroke. Thus, unless preventive interventions are used to reduce the heat stress on workers, their individual health and productivity will be affected and economic output per work hour will be reduced. Heat also influences other daily physical activities, unrelated to work, in all age groups. Poorer people without access to household or workplace cooling devices are most likely to be affected.The Hothaps programme includes a pilot study, heat monitoring of selected workplaces, qualitative studies of perceived heat impacts and preventative interventions

  7. 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

  8. 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.

  9. A Global Study on Lone Mothers: Exploring the Associations of Self-Assessed General Health with Motherhood Types and Gender Inequality in 32 Countries

    NARCIS (Netherlands)

    Witvliet, Margot I.; Arah, Onyebuchi A.; Stronks, Karien; Kunst, Anton E.

    2014-01-01

    Background: In a study of 32 mostly non-affluent countries, we aimed to i) compare lone mother's general health to the health of other women and ii) assess whether the association of health with gender inequality was stronger among lone mothers than among other women. Methods: World Health Survey

  10. A study to assess the knowledge about sexual health among male students of junior colleges of an urban area

    Directory of Open Access Journals (Sweden)

    Jayant Ramchandra Kalkute

    2015-01-01

    Full Text Available Background: Sexuality is an important part of personality of adolescents. The age of sexual debut is falling globally. The subject of adolescent sexuality is taboo in most societies. Since 2007 sexual health education program has been banned in six states including Maharashtra and Karnataka. This may lead to misconceptions about sexual heath knowledge and practices among young people. Objective: The aim was to assess the knowledge about sexual health among male students of junior colleges of an urban area and to evaluate the change in their knowledge after imparting sexual health education. Settings and Design: Pre-post-intervention study. Materials and Methods: All 245 male students of 11 th standard of all three educational streams of two junior colleges were included in the study. The data analysis was performed using Statistical Package for Social Sciences 18. Results: Science students had "adequate" knowledge about sexual health when compared to arts and commerce students (P = 0.004. Students whose parents were unskilled and semiskilled by occupation had "inadequate" knowledge about sexual health when compared with students whose parents were skilled by occupation (P < 0.05. Education of parents had positive effect on the knowledge about sexual health of students (P = 0.062. In posttest, the knowledge about sexual health of students was found to have increased significantly when compared to pretest. The mean posttest score was 12.61 (standard deviation [SD] 3.12, which was significantly higher than the mean pretest score of 6.34 (SD 3.23 (P < 0.001. Students from nuclear families had "adequate" knowledge about sexual health when compared to students from joint families (P = 0.158 Conclusion: Imparting knowledge about sexual health in adolescent age will be beneficial to the students in avoiding risky sexual behavior. Such educational programs must be given due importance to achieve desirable behavior change among them.

  11. Assessing the link between implementation fidelity and health outcomes for a trial of intensive case management by community health workers: a mixed methods study protocol.

    Science.gov (United States)

    Schmidt, Barbara; Watt, Kerrianne; McDermott, Robyn; Mills, Jane

    2017-07-17

    Better systems of care are required to address chronic disease in Indigenous people to ensure they can access all their care needs. Health research has produced evidence about effective models of care and chronic disease strategies to address Indigenous health, however the transfer of research findings into routine clinical practice has proven challenging. Complex interventions, such as those related to chronic disease, have many components that are often poorly implemented and hence rarely achieve implementation fidelity. Implementation fidelity is "the degree to which programs are implemented as intended by the program developer". Knowing if an intervention was implemented as planned is fundamental to knowing what has contributed to the success of an intervention. The aim of this study is to adapt the implementation fidelity framework developed by Keith et al. and apply it to the intervention implemented in phase 1 of the Getting Better at Chronic Care in North Queensland study. The objectives are to quantify the level of implementation fidelity achieved during phase 1 of the study, measure the association between implementation fidelity and health outcomes and to explore the features of the primary health care system that contributed to improved health outcomes. A convergent parallel mixed methods study design will be used to develop a process for assessing implementation fidelity. Information collected via a questionnaire and routine data generated during phase 1 of the study will be used to explain the context for the intervention in each site and develop an implementation fidelity score for each component of the intervention. A weighting will be applied to each component of the intervention to calculate the overall implementation score for each participating community. Statistical analysis will assess the level of association between implementation fidelity scores and health outcomes. Health services research seeks to find solutions to social and technical

  12. 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.

  13. Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment.

    Science.gov (United States)

    Li, Junxin; Cacchione, Pamela Z; Hodgson, Nancy; Riegel, Barbara; Keenan, Brendan T; Scharf, Mathew T; Richards, Kathy C; Gooneratne, Nalaka S

    2017-02-01

    To examine the cross-sectional associations between self-reported postlunch napping and structured cognitive assessments in Chinese older adults. Cross-sectional cohort study. China. Individuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974). Interview-based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self-reported or interview-based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non-nappers (0 minutes), short nappers (90 minutes). Postlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P napping was significantly associated with better cognition than non- (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration. A cross-sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross-sectional design and self-reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  14. Assessing the benefits of OHER (Office of Health and Environmental Research) research: Three case studies

    Energy Technology Data Exchange (ETDEWEB)

    Nesse, R.J.; Callaway, J.M.; Englin, J.E.; Klan, M.S.; Nicholls, A.K.; Serot, D.E.

    1987-09-01

    This research was undertaken to estimate the societal benefits and costs of selected past research performed for the Office of Health and Environmental Research (OHER) of the US Department of Energy (DOE). Three case studies of representative OHER and DOE research were performed. One of these, the acid rain case study, includes research conducted elsewhere in DOE. The other two cases were the OHER marine research program and the development of high-purity germanium that is used in radiation detectors. The acid rain case study looked at the research benefits and costs of furnace sorbent injection and duct injection, technologies that might reduce acid deposition precursors. Both appear to show benefits in excess of costs. We examined in detail one of the OHER marine research program's accomplishments - the increase in environmental information used by the Outer Continental Shelf leasing program to manage bidding for off-shore oil drilling. The results of an econometric model show that environmental information of the type supported by OHER is unequivocally linked to government and industry leasing decisions. The germanium case study indicated that the benefits of germanium radiation detectors were significant.

  15. Assessing the reliability of the short form 12 (SF-12) health survey in adults with mental health conditions: a report from the wellness incentive and navigation (WIN) study.

    Science.gov (United States)

    Huo, Tianyao; Guo, Yi; Shenkman, Elizabeth; Muller, Keith

    2018-02-13

    Although Short Form (SF)-12 × 2® has been extensively studied and used as a valid measure of health-related quality of life in a variety of population groups, no systematic studies have described the reliability of the measure in patients with behavioral conditions or serious mental illness (SMI). We assessed the internal consistency, split-half reliability and annual test-retest correlations in a sample of 1587 participants with either a combination of physical and behavioral conditions or SMI. The Mosier's alpha was 0.70 for the Physical Composite Scale (PCS) and 0.69 for the Mental Health Composite Scale (MCS), indicating good internal consistency. We observed strong correlations between physical functioning, physical role and body pain scales (r = 0.55-0.56), and between social functioning, emotional role, and mental health (r = 0.53-0.58). We calculated split-half reliabilities to be 0.74 for physical functioning, 0.75 for physical role, 0.73 for emotional role and 0.65 for mental health respectively. We assessed the annual test-retest correlation using intraclass correlation (ICC) and found an ICC of 0.61 for PCS and 0.57 for MCS composite scores, adjusting for age, sex, race/ethnicity, and CRG. We found no decline in the correlations between baseline and the following study years until year 3. Our results encourage using SF-12v2® to assess health-related quality of life in the Medicaid population with combined physical and behavioral conditions or similar cohorts. The WIN study was registered with clinicaltrials.gov on April 22, 2015. NCT02440906 . Retrospectively registered.

  16. Assessing the consequences of gestational diabetes mellitus on offspring's cardiovascular health: MySweetHeart Cohort study protocol, Switzerland.

    Science.gov (United States)

    Di Bernardo, Stefano; Mivelaz, Yvan; Epure, Adina Mihaela; Vial, Yvan; Simeoni, Umberto; Bovet, Pascal; Estoppey Younes, Sandrine; Chiolero, Arnaud; Sekarski, Nicole

    2017-11-14

    Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis. This is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2-7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned. Ethical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016-00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals

  17. Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

    Science.gov (United States)

    Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

    2018-05-01

    There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced

  18. Applying the High Reliability Health Care Maturity Model to Assess Hospital Performance: A VA Case Study.

    Science.gov (United States)

    Sullivan, Jennifer L; Rivard, Peter E; Shin, Marlena H; Rosen, Amy K

    2016-09-01

    The lack of a tool for categorizing and differentiating hospitals according to their high reliability organization (HRO)-related characteristics has hindered progress toward implementing and sustaining evidence-based HRO practices. Hospitals would benefit both from an understanding of the organizational characteristics that support HRO practices and from knowledge about the steps necessary to achieve HRO status to reduce the risk of harm and improve outcomes. The High Reliability Health Care Maturity (HRHCM) model, a model for health care organizations' achievement of high reliability with zero patient harm, incorporates three major domains critical for promoting HROs-Leadership, Safety Culture, and Robust Process Improvement ®. A study was conducted to examine the content validity of the HRHCM model and evaluate whether it can differentiate hospitals' maturity levels for each of the model's components. Staff perceptions of patient safety at six US Department of Veterans Affairs (VA) hospitals were examined to determine whether all 14 HRHCM components were present and to characterize each hospital's level of organizational maturity. Twelve of the 14 components from the HRHCM model were detected; two additional characteristics emerged that are present in the HRO literature but not represented in the model-teamwork culture and system-focused tools for learning and improvement. Each hospital's level of organizational maturity could be characterized for 9 of the 14 components. The findings suggest the HRHCM model has good content validity and that there is differentiation between hospitals on model components. Additional research is needed to understand how these components can be used to build the infrastructure necessary for reaching high reliability.

  19. 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...

  20. Nutrition and health status assessment of community-residing elderly in New York City: a pilot study.

    Science.gov (United States)

    Gilbride, J A; Amella, E J; Breines, E B; Mariano, C; Mezey, M

    1998-05-01

    Ninety-five percent of persons over the age of 65 years live in the community and benefit from community-based health and nutrition services. The purpose of this project was to evaluate diet, function, and mental health in 40 men and women aged 65 years and older who were residing in a large metropolitan community. Nutritional status was assessed using two 24-hour recalls, 5 days of food records, a food frequency, and anthropometric measurements. Participants responded to standardized activities of daily living and instrumental activities of daily living instruments and an investigator-developed, performance-based appraisal of food preparation and management. Cognition and mood were assessed using the Folstein Mini-Mental Examination and the Yesavage Depression Scale. The nutrient intakes for individuals were compared with the Recommended Dietary Allowances (RDAs) and the Food Guide Pyramid. Mean energy intake was 1,625 kcal (range = 787 to 2,910 kcal); 7 persons consumed more than 2,000 kcal. The mean vitamin and mineral intake for participants met the RDAs except for calcium, vitamin D, zinc, and magnesium intakes. The average percentages of carbohydrate, protein, and fat were 53%, 16%, and 30%, respectively. Nutritional assessments of subjects with and without congregate meals were contrasted. Six of the 13 congregate-meal participants were at nutritional risk, compared with 6 of 27 not receiving congregate meals. The interrelationships of diet, functional status, and mental health factors were examined along with recommendations for future data collection in similar studies.

  1. Countdown to 2015 country case studies: systematic tools to address the "black box" of health systems and policy assessment.

    Science.gov (United States)

    Singh, Neha S; Huicho, Luis; Afnan-Holmes, Hoviyeh; John, Theopista; Moran, Allisyn C; Colbourn, Tim; Grundy, Chris; Matthews, Zoe; Maliqi, Blerta; Mathai, Matthews; Daelmans, Bernadette; Requejo, Jennifer; Lawn, Joy E

    2016-09-12

    Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990-2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. The Policy and Programme Timeline tool shows that Tanzania's RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but

  2. 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

  3. The Brain Health Registry: An internet-based platform for recruitment, assessment, and longitudinal monitoring of participants for neuroscience studies.

    Science.gov (United States)

    Weiner, Michael W; Nosheny, Rachel; Camacho, Monica; Truran-Sacrey, Diana; Mackin, R Scott; Flenniken, Derek; Ulbricht, Aaron; Insel, Philip; Finley, Shannon; Fockler, Juliet; Veitch, Dallas

    2018-05-08

    Recruitment, assessment, and longitudinal monitoring of participants for neuroscience studies and clinical trials limit the development of new treatments. Widespread Internet use allows data capture from participants in an unsupervised setting. The Brain Health Registry, a website and online registry, collects data from participants and their study partners. The Brain Health Registry obtains self and study partner report questionnaires and neuropsychological data, including the Cogstate Brief Battery, Lumos Labs Neurocognitive Performance Test, and MemTrax Memory Test. Participants provide informed consent before participation. Baseline and longitudinal data were obtained from nearly 57,000 and 28,000 participants, respectively. Over 18,800 participants were referred to, and nearly 1800 were enrolled in, clinical Alzheimer's disease and aging studies, including five observational studies and seven intervention trials. Online assessments of participants and study partners provide useful information at relatively low cost for neuroscience studies and clinical trials and may ultimately be used in routine clinical practice. Copyright © 2018 the Alzheimer's Association. All rights reserved.

  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. Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in bangalore, India.

    Science.gov (United States)

    Babu, Giridhara R; Tejaswi, B; Kalavathi, M; Vatsala, G M; Murthy, G V S; Kinra, Sanjay; Neelon, Sara E Benjamin

    2015-02-20

    Screening and timely treatment of gestational hyperglycaemia (GH) is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women. We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used. We reported that gestational diabetes mellitus (GDM) screening was done in nearly all the health centres (96%). However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92%) of the doctors had poor knowledge (68%) about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time. Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them. Significance for public healthRising burden of hyperglycaemia in pregnancy is a cause for concern and is associated with short and long term deleterious consequences for mother and offspring. Hence, there is an urgent need to explore the screening practices for gestational hyperglycaemia (GH). The current study considers

  7. 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...

  8. The WHO/WTO study on trade and public health: a critical assessment.

    Science.gov (United States)

    Howse, Robert

    2004-04-01

    This article provides a brief critical examination of a 2002 report jointly issued by the World Health Organization and the World Trade Organization on WTO law and public health. The author argues that the report is in many respects misleading as to the content of WTO law, as interpreted by the Appellate Body of the WTO, its final court. In particular, the WHO/WTO report systematically understates or underestimates the margins of regulatory autonomy that WTO member states have to make regulations that protect public health.

  9. 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.

  10. 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.

  11. Primary care physicians’ perspectives on computer-based health risk assessment tools for chronic diseases: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Teja Voruganti

    2015-09-01

    Full Text Available Background Health risk assessment tools compute an individual’s risk of developing a disease. Routine use of such tools by primary care physicians (PCPs is potentially useful in chronic disease prevention. We sought physicians’ awareness and perceptions of the usefulness, usability and feasibility of performing assessments with computer-based risk assessment tools in primary care settings.Methods Focus groups and usability testing with a computer-based risk assessment tool were conducted with PCPs from both university-affiliated and community-based practices. Analysis was derived from grounded theory methodology.Results PCPs (n = 30 were aware of several risk assessment tools although only select tools were used routinely. The decision to use a tool depended on how use impacted practice workflow and whether the tool had credibility. Participants felt that embedding tools in the electronic medical records (EMRs system might allow for health information from the medical record to auto-populate into the tool. User comprehension of risk could also be improved with computer-based interfaces that present risk in different formats.Conclusions In this study, PCPs chose to use certain tools more regularly because of usability and credibility. Despite there being differences in the particular tools a clinical practice used, there was general appreciation for the usefulness of tools for different clinical situations. Participants characterised particular features of an ideal tool, feeling strongly that embedding risk assessment tools in the EMR would maximise accessibility and use of the tool for chronic disease management. However, appropriate practice workflow integration and features that facilitate patient understanding at point-of-care are also essential. 

  12. Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study

    Directory of Open Access Journals (Sweden)

    van den Akker EF

    2015-11-01

    Full Text Available Edmée FMM van den Akker,1 Alex J van ‘t Hul,2 Niels H Chavannes,3 Gert-Jan Braunstahl,1 Alie van Bruggen,1 Maureen PMH Rutten-van Mölken,4 Johannes CCM in ‘t Veen1 1Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, 2Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 4Department of Health Care Policy and Management, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands Background: Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care.Methods: An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting.Results: The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life.Conclusion: An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient’s health status. The

  13. Psychometric properties of the World Health Organization Disability Assessment Schedule used in the European Study of the Epidemiology of Mental Disorders

    NARCIS (Netherlands)

    Buist-Bouwman, M. A.; Ormel, J.; De Graaf, R.; Vilagut, G.; Alonso, J.; Van Sonderen, E.; Vollebergh, W. A. M.

    2008-01-01

    This study assessed the factor structure, internal consistency, and discriminatory validity of the World Health Organization Disability Assessment Schedule (WHODAS) version used in the European Study of the Epidemiology of Mental Disorders (ESEMeD). In total 8796 adults were assessed using the

  14. Human health risk assessment with spatial analysis: Study of a population chronically exposed to arsenic through drinking water from Argentina

    International Nuclear Information System (INIS)

    Navoni, J.A.; De Pietri, D.; Olmos, V.; Gimenez, C.; Bovi Mitre, G.

    2014-01-01

    Arsenic (As) is a ubiquitous element widely distributed in the environment. This metalloid has proven carcinogenic action in man. The aim of this work was to assess the health risk related to As exposure through drinking water in an Argentinean population, applying spatial analytical techniques in addition to conventional approaches. The study involved 650 inhabitants from Chaco and Santiago del Estero provinces. Arsenic in drinking water (Asw) and urine (UAs) was measured by hydride generation atomic absorption spectrophotometry. Average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR) were estimated, geo-referenced and integrated with demographical data by a health composite index (HI) applying geographic information system (GIS) analysis. Asw covered a wide range of concentration: from non-detectable (ND) to 2000 μg/L. More than 90% of the population was exposed to As, with UAs levels above the intervention level of 100 μg/g creatinine. GIS analysis described an expected level of exposure lower than the observed, indicating possible additional source/s of exposure to inorganic arsenic. In 68% of the locations, the population had a HQ greater than 1, and the CR ranged between 5·10 −5 and 2,1·10 −2 . An environmental exposure area through ADD geo-referencing defined a baseline scenario for space-time risk assessment. The time of residence, the demographic density and the potential health considered outcomes helped characterize the health risk in the region. The geospatial analysis contributed to delimitate and analyze the change tendencies of risk in the region, broadening the scopes of the results for a decision-making process. - Highlights: • Risk assessment (RA) to As using deterministic procedures • Integration of RA through deterministic procedures with GIS tools • Analysis of the time-space behavior of the risk area • Analysis of As effect outcomes through HI • Broaden the scopes of deterministic approaches

  15. Human health risk assessment with spatial analysis: Study of a population chronically exposed to arsenic through drinking water from Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Navoni, J.A., E-mail: jnavoni@ffyb.uba.ar [Cátedra de Toxicología y Química Legal, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Ciudad Autónoma de Buenos Aires (Argentina); De Pietri, D., E-mail: depietrid@hotmail.com [Dirección Nacional de Determinantes de la Salud e Investigación, Ministerio de Salud de la Nación, Av. 9 de Julio 1925, C1073ABA Ciudad Autónoma de Buenos Aires (Argentina); Olmos, V. [Cátedra de Toxicología y Química Legal, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Ciudad Autónoma de Buenos Aires (Argentina); Gimenez, C. [Cátedra Química Analítica I, Universidad Nacional del Chaco Austral. Cmte., Fernández 755 (3700), Pres. Roque Sáenz Peña, Chaco (Argentina); Bovi Mitre, G. [Grupo INQA (Investigación Química Aplicada) Facultad de Ciencias Agrarias, Universidad Nacional de Jujuy, Alberdi 47, piso 1, San Salvador de Jujuy, Jujuy CP 4600 (Argentina); and others

    2014-11-15

    Arsenic (As) is a ubiquitous element widely distributed in the environment. This metalloid has proven carcinogenic action in man. The aim of this work was to assess the health risk related to As exposure through drinking water in an Argentinean population, applying spatial analytical techniques in addition to conventional approaches. The study involved 650 inhabitants from Chaco and Santiago del Estero provinces. Arsenic in drinking water (Asw) and urine (UAs) was measured by hydride generation atomic absorption spectrophotometry. Average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR) were estimated, geo-referenced and integrated with demographical data by a health composite index (HI) applying geographic information system (GIS) analysis. Asw covered a wide range of concentration: from non-detectable (ND) to 2000 μg/L. More than 90% of the population was exposed to As, with UAs levels above the intervention level of 100 μg/g creatinine. GIS analysis described an expected level of exposure lower than the observed, indicating possible additional source/s of exposure to inorganic arsenic. In 68% of the locations, the population had a HQ greater than 1, and the CR ranged between 5·10{sup −5} and 2,1·10{sup −2}. An environmental exposure area through ADD geo-referencing defined a baseline scenario for space-time risk assessment. The time of residence, the demographic density and the potential health considered outcomes helped characterize the health risk in the region. The geospatial analysis contributed to delimitate and analyze the change tendencies of risk in the region, broadening the scopes of the results for a decision-making process. - Highlights: • Risk assessment (RA) to As using deterministic procedures • Integration of RA through deterministic procedures with GIS tools • Analysis of the time-space behavior of the risk area • Analysis of As effect outcomes through HI • Broaden the scopes of deterministic approaches.

  16. 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

  17. Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.

    NARCIS (Netherlands)

    Ansari, N.; Zainullah, P.; Kim, Y.M.; Tappis, H.; Kols, A.; Currie, S.; Haver, J; van Roosmalen, J.; Broerse, J.E.W.; Stekelenburg, J.

    2015-01-01

    Background: Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents

  18. Assessing post-abortion care in health facilities in Afghanistan : A cross-sectional study

    NARCIS (Netherlands)

    Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E. W.; Stekelenburg, Jelle

    2015-01-01

    Background: Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents

  19. Work-related stress risk assessment in Italy: the validation study of health safety and executive indicator tool.

    Science.gov (United States)

    Rondinone, Bruna Maria; Persechino, Benedetta; Castaldi, Tiziana; Valenti, Antonio; Ferrante, Pierpaolo; Ronchetti, Matteo; Iavicoli, Sergio

    2012-01-01

    In compliance with the Italian occupational health and safety regulatory framework, as provided by the Lgs. Decree 81/2008, the "work-related stress" risk assessment should follow the same principles as other risk assessments, in accordance with the European Agreement of 8 October 2004; therefore, validated and scientifically proven methodological tools are needed to conduct an adequate work-related stress risk assessment. The UK's Health Safety and Executive (HSE) Indicator Tool (IT) is used for assessing the risk of work-related stress. The aim of this study is to test the factor structure of IT as a measure of work-related stress in a sample of Italian workers. Data collected from 65 Italian organizations (6378 workers) was used for a Confirmatory Factor Analysis (CFA) on the 35-item seven-factor model. The results showed acceptable fit to the data (CFI .90; TLI .89, RMSEA .045). A second CFA was done to test a 35-item six-factor model (CFI .89, TLI .87, RMSEA .047). Both models were tested after removing six items (factor loadings less than .50.), resulting in a 29-item model. Here again, there was an acceptable fit to the data (29-item seven-factor model: CFI .93, TLI .91, RMSEA .044; 29-item six-factor model: CFI .92, TLI .90, RMSEA .046). These findings show that the HSE model satisfactorily adapts to use in a sample of Italian workers. One of the most important innovations introduced in the assessment of work-related stress with the HSE IT is the global approach for identifying work-related stress risk factors, aimed at establishing the best strategy from the viewpoints of prevention officers and also of workers.

  20. Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people's perceptions.

    Science.gov (United States)

    Price, Kay; Grimmer, Karen; Foot, Jan

    2017-12-01

    Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens. Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview. Data were then analysed using a qualitative content analysis approach. Results The purpose of the 75+HA was not well understood by participants. Participant responses reveal that where, when, who and how a primary health professional conducted the 75+HA affected what older people talked about, the guidance they sought to deal with issues and, in turn, the actioning of issues that were discussed during the 75+HA. Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require. What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues affecting community-dwelling older people's health and well being. The aim of the 75+HA is to consider a broad range of factors that could affect physical, psychological and social functioning, which, in turn, affects overall health, and the capacity of older people to live independently in the community. Underlying the 75+HA is the importance of detecting early functional decline to enable healthy aging. What does this paper add

  1. Wearable cardioverter defibrillators for the prevention of sudden cardiac arrest: a health technology assessment and patient focus group study

    Directory of Open Access Journals (Sweden)

    Ettinger S

    2017-11-01

    Full Text Available Sabine Ettinger,1 Michal Stanak,1 Piotr Szymański,2 Claudia Wild,1 Romana Tandara Haček,3 Darija Erčević,3 Renata Grenković,3 Mirjana Huić3 1Ludwig Boltzmann Institute for Health Technology Assessment, Vienna, Austria; 2Institute of Cardiology, Warsaw, Poland; 3Department for Development, Research and Health Technology Assessment, Agency for Quality and Accreditation in Health Care and Social Welfare, Zagreb, Croatia Aim: To summarize the evidence on clinical effectiveness and safety of wearable cardioverter defibrillator (WCD therapy for primary and secondary prevention of sudden cardiac arrest in patients at risk. Methods: We performed a systematic literature search in databases including MEDLINE via OVID, Embase, the Cochrane Library, and CRD (DARE, NHS-EED, HTA. The evidence obtained was summarized according to GRADE methodology. A health technology assessment (HTA was conducted using the HTA Core Model® for rapid relative effectiveness assessment. Primary outcomes for the clinical effectiveness domain were all-cause and disease-specific mortality. Outcomes for the safety domain were adverse events (AEs and serious adverse events (SAEs. A focus group with cardiac disease patients was conducted to evaluate ethical, organizational, patient, social, and legal aspects of the WCD use. Results: No randomized- or non-randomized controlled trials were identified. Non-comparative studies (n=5 reported AEs including skin rash/itching (6%, false alarms (14%, and palpitations/light-headedness/fainting (9% and discontinuation due to comfort/lifestyle issues (16–22%, and SAEs including inappropriate shocks (0–2%, unsuccessful shocks (0–0.7%, and death (0–0.3%. The focus group results reported that experiencing a sense of security is crucial to patients and that the WCD is not considered an option for weeks or even months due to expected restrictions in living a “normal” life. Conclusion: The WCD appears to be relatively safe for short

  2. Comparative health technology assessment of robotic-assisted, direct manual laparoscopic and open surgery: a prospective study.

    Science.gov (United States)

    Turchetti, Giuseppe; Pierotti, Francesca; Palla, Ilaria; Manetti, Stefania; Freschi, Cinzia; Ferrari, Vincenzo; Cuschieri, Alfred

    2017-02-01

    Despite many publications reporting on the increased hospital cost of robotic-assisted surgery (RAS) compared to direct manual laparoscopic surgery (DMLS) and open surgery (OS), the reported health economic studies lack details on clinical outcome, precluding valid health technology assessment (HTA). The present prospective study reports total cost analysis on 699 patients undergoing general surgical, gynecological and thoracic operations between 2011 and 2014 in the Italian Public Health Service, during which period eight major teaching hospitals treated the patients. The study compared total healthcare costs of RAS, DMLS and OS based on prospectively collected data on patient outcome in addition to healthcare costs incurred by the three approaches. The cost of RAS operations was significantly higher than that of OS and DMLS for both gynecological and thoracic operations (p DMLS. Total costs of general surgery RAS were significantly higher than those of OS (p DMLS general surgery. Indirect costs were significantly lower in RAS compared to both DMLS general surgery and OS gynecological surgery due to the shorter length of hospital stay of RAS approach (p < 0.001). Additionally, in all specialties compared to OS, patients treated by RAS experienced a quicker recovery and significantly less pain during the hospitalization and after discharge. The present HTA while confirming higher total healthcare costs for RAS operations identified significant clinical benefits which may justify the increased expenditure incurred by this approach.

  3. Persons with rheumatoid arthritis challenge the relevance of the health assessment questionnaire: a qualitative study of patient perception.

    Science.gov (United States)

    Ebbevi, David; Essén, Anna; Forsberg, Helena Hvitfeldt

    2017-05-12

    The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. The study used secondary data analysis. Persons with RA participated in semi-structured interviews in previous research projects. Thirty-nine interviews were included based on data fit, and thematic analysis applied. The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.

  4. Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in Bangalore, India

    Directory of Open Access Journals (Sweden)

    Giridhara R. Babu

    2015-03-01

    Full Text Available Background. Screening and timely treatment of gestational hyperglycaemia (GH is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women. Design and Methods. We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used. Results. We reported that gestational diabetes mellitus (GDM screening was done in nearly all the health centres (96%. However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92% of the doctors had poor knowledge (68% about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time. Conclusions. Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them.

  5. Human health risk assessment with spatial analysis: study of a population chronically exposed to arsenic through drinking water from Argentina.

    Science.gov (United States)

    Navoni, J A; De Pietri, D; Olmos, V; Gimenez, C; Bovi Mitre, G; de Titto, E; Villaamil Lepori, E C

    2014-11-15

    Arsenic (As) is a ubiquitous element widely distributed in the environment. This metalloid has proven carcinogenic action in man. The aim of this work was to assess the health risk related to As exposure through drinking water in an Argentinean population, applying spatial analytical techniques in addition to conventional approaches. The study involved 650 inhabitants from Chaco and Santiago del Estero provinces. Arsenic in drinking water (Asw) and urine (UAs) was measured by hydride generation atomic absorption spectrophotometry. Average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR) were estimated, geo-referenced and integrated with demographical data by a health composite index (HI) applying geographic information system (GIS) analysis. Asw covered a wide range of concentration: from non-detectable (ND) to 2000 μg/L. More than 90% of the population was exposed to As, with UAs levels above the intervention level of 100 μg/g creatinine. GIS analysis described an expected level of exposure lower than the observed, indicating possible additional source/s of exposure to inorganic arsenic. In 68% of the locations, the population had a HQ greater than 1, and the CR ranged between 5·10(-5) and 2,1·10(-2). An environmental exposure area through ADD geo-referencing defined a baseline scenario for space-time risk assessment. The time of residence, the demographic density and the potential health considered outcomes helped characterize the health risk in the region. The geospatial analysis contributed to delimitate and analyze the change tendencies of risk in the region, broadening the scopes of the results for a decision-making process. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Environmental health studies

    International Nuclear Information System (INIS)

    Easterly, C.E.; Shank, K.E.

    1978-01-01

    The two major thrusts of the environmental health studies have been in the areas of health physics aspects of fusion power and methodology for assessing health effects related to nuclear facilities. Researchers were unable to discern a dose-response relationship or to find adverse health effects in the local population around nuclear facilities which might be related to radiation exposure. A second study analyzed the trends in incidence of cancer, congenital malformation, and fetal and infant mortality for Oak Ridge, Anderson County, and Roane County relative to Tennessee. Finally, a more in-depth study on congenital malformations and fetal mortality trends for nine East Tennessee counties surrounding Oak Ridge was completed. The objective of the Health Physics Aspects of Fusion Power Program is to provide, on a timely basis, scientific information and technical evaluations on the potential impacts of fusion power to occupational workers and to members of the public. The primary areas of study in this program during the past year have been (1) factors affecting calculations of dose resulting from a release of tritium, (2) an assessment of the potential for reducing occupational risk from exposures to tritium, and (3) experimental studies of tritium conversion from molecular hydrogen to tritiated water

  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. Assessing potential human health hazards and benefits from subtherapeutic antibiotics in the United States: tetracyclines as a case study.

    Science.gov (United States)

    Cox, Louis Anthony Tony; Popken, Douglas A

    2010-03-01

    Many scientists, activists, regulators, and politicians have expressed urgent concern that using antibiotics in food animals selects for resistant strains of bacteria that harm human health and bring nearer a "postantibiotic era" of multidrug resistant "super-bugs." Proposed political solutions, such as the Preservation of Antibiotics for Medical Treatment Act (PAMTA), would ban entire classes of subtherapeutic antibiotics (STAs) now used for disease prevention and growth promotion in food animals. The proposed bans are not driven by formal quantitative risk assessment (QRA), but by a perceived need for immediate action to prevent potential catastrophe. Similar fears led to STA phase-outs in Europe a decade ago. However, QRA and empirical data indicate that continued use of STAs in the United States has not harmed human health, and bans in Europe have not helped human health. The fears motivating PAMTA contrast with QRA estimates of vanishingly small risks. As a case study, examining specific tetracycline uses and resistance patterns suggests that there is no significant human health hazard from continued use of tetracycline in food animals. Simple hypothetical calculations suggest an unobservably small risk (between 0 and 1.75E-11 excess lifetime risk of a tetracycline-resistant infection), based on the long history of tetracycline use in the United States without resistance-related treatment failures. QRAs for other STA uses in food animals also find that human health risks are vanishingly small. Whether such QRA calculations will guide risk management policy for animal antibiotics in the United States remains to be seen.

  9. Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review.

    Science.gov (United States)

    Eysenbach, Gunther; Powell, John; Kuss, Oliver; Sa, Eun-Ryoung

    The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed. To establish a methodological framework on how quality on the Web is evaluated in practice, to determine the heterogeneity of the results and conclusions, and to compare the methodological rigor of these studies, to determine to what extent the conclusions depend on the methodology used, and to suggest future directions for research. We searched MEDLINE and PREMEDLINE (1966 through September 2001), Science Citation Index (1997 through September 2001), Social Sciences Citation Index (1997 through September 2001), Arts and Humanities Citation Index (1997 through September 2001), LISA (1969 through July 2001), CINAHL (1982 through July 2001), PsychINFO (1988 through September 2001), EMBASE (1988 through June 2001), and SIGLE (1980 through June 2001). We also conducted hand searches, general Internet searches, and a personal bibliographic database search. We included published and unpublished empirical studies in any language in which investigators searched the Web systematically for specific health information, evaluated the quality of Web sites or pages, and reported quantitative results. We screened 7830 citations and retrieved 170 potentially eligible full articles. A total of 79 distinct studies met the inclusion criteria, evaluating 5941 health Web sites and 1329 Web pages, and reporting 408 evaluation results for 86 different quality criteria. Two reviewers independently extracted study characteristics, medical domains, search strategies used, methods and criteria of quality assessment, results (percentage of sites or pages rated as inadequate pertaining to a quality criterion), and quality and rigor of study methods and reporting. Most frequently used quality criteria used include accuracy, completeness, readability, design, disclosures, and references provided

  10. Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study.

    Science.gov (United States)

    Cunningham, Frances C; Ferguson-Hill, Sue; Matthews, Veronica; Bailie, Ross

    2016-10-18

    Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs. The mixed methods approach involved a review of documents and internal reports relating to experience with use of the SAT since its development in 2002 and a survey of key informants on their experience with using the SAT. The paper drew from documents and internal reports to describe the SAT development and application in primary health care services from 2002 to 2014. Survey feedback highlighted the benefit to the whole primary health care team from participating in the SAT, bringing to light issues that might not emerge with separate individual tool completion. A majority of respondents reported changes in their health centres as a result of using the SAT. Good organisational and management support assisted with ensuring allocation of time and resources for SAT conduct. Respondents identified the importance of having a skilled, external facilitator. Originally designed as a measurement tool, the SAT rapidly evolved to become an important development tool, assisting teams in learning about primary health care system functioning, applying best practice and contributing to team strengthening. It is valued by primary health care centres as a lever in implementing improvements to strengthen centre delivery systems, and has potential for further adaptation and wider application in Australia and internationally.

  11. Marijuana use among US tobacco users: Findings from wave 1 of the population assessment of tobacco health (PATH) study.

    Science.gov (United States)

    Strong, David R; Myers, Mark G; Pulvers, Kim; Noble, Madison; Brikmanis, Kristin; Doran, Neal

    2018-05-01

    With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary. Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314). When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p users of tobacco and marijuana. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Risk assessment for job burnout with a mobile health web application using questionnaire data: a proof of concept study.

    Science.gov (United States)

    von Känel, Roland; van Nuffel, Marc; Fuchs, Walther J

    2016-01-01

    Job burnout has become a rampant epidemic in working societies, causing high productivity loss and healthcare costs. An easy accessible tool to detect clinically relevant risk may bear the potential to timely avert the dire sequelae of burnout. As a start, we performed a proof of concept study to test the utilization of a mobile health web application for a free and anonymous burnout risk assessment with established questionnaires. We designed a client-side javascript web application for users who filled out demographic and psychometric data forms over the internet. Users were recruited through social media, back links from hospital websites, and search engine optimization. Similar to population-based studies, we used the Maslach Burnout Inventory-General Survey (MBI-GS) to calculate a burnout risk index (BRIX). As additional mental health burden indices, users filled out the Perceived Stress Scale, Insomina Severity Index, and Profile of Mood States. Within six months, the MBI-GS was completed by 11,311 users (median age 33 years, 85 % women) of whom 20.0 % had no clinically relevant burnout risk, 54.7 % had mild-to-moderate risk, and 25.3 % had high risk. In the 2947 users completing all questionnaires, female sex ( B  = -0.03), cohabiting ( B  = -0.03), negative affect ( B  = 0.46), positive affect ( B  = -0.20), perceived stress ( B  = 0.18), and insomnia symptoms ( B  = 0.04) explained 56.2 % of the variance in the continuously scaled BRIX. The reliability was good to excellent for all psychometric scales. The weighting of the BRIX with mental health burden indices primarily modified the risk in users with mild-to-moderate burnout risk. A low-threshold web application can reliably assess the risk of job burnout. As the bulk of users had clinically relevant burnout scores, a web application may be useful to target employees at risk. The clinical value of the BRIX and its modification with coexistent/absent mental health burden

  13. Assessing quality of a worksite health promotion programme from participants’ views: findings from a qualitative study in Malaysia

    Science.gov (United States)

    Liau, Siow‐Yen; Hassali, Mohamed‐Azmi A.; Shafie, Asrul A.; Ibrahim, Mohamed‐Izham M.

    2014-01-01

    Abstract Background  An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. Objective  To explore the participants’ perceptions of the quality and effectiveness of the ‘Love Your Heart Programme’. Design  A qualitative study using semi‐structured interviews with a purposive sample of participants of the ‘Love Your Heart’ programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio‐recorded, transcribed verbatim and analysed using the principles of grounded theory. Results  A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the ‘Road to a Healthy Heart’ booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. Discussion and conclusions  In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme. PMID:22050457

  14. EVALUATION OF THE HTA CORE MODEL FOR NATIONAL HEALTH TECHNOLOGY ASSESSMENT REPORTS: COMPARATIVE STUDY AND EXPERIENCES FROM EUROPEAN COUNTRIES.

    Science.gov (United States)

    Kõrge, Kristina; Berndt, Nadine; Hohmann, Juergen; Romano, Florence; Hiligsmann, Mickael

    2017-01-01

    The health technology assessment (HTA) Core Model® is a tool for defining and standardizing the elements of HTA analyses within several domains for producing structured reports. This study explored the parallels between the Core Model and a national HTA report. Experiences from various European HTA agencies were also investigated to determine the Core Model's adaptability to national reports. A comparison between a national report on Genetic Counseling, produced by the Cellule d'expertise médicale Luxembourg, and the Core Model was performed to identify parallels in terms of relevant and comparable assessment elements (AEs). Semi-structured interviews with five representatives from European HTA agencies were performed to assess their user experiences with the Core Model. The comparative study revealed that 50 percent of the total number (n = 144) of AEs in the Core Model were relevant for the national report. Of these 144 AEs from the Core Model, 34 (24 percent) were covered in the national report. Some AEs were covered only partly. The interviewees emphasized flexibility in using the Core Model and stated that the most important aspects to be evaluated include characteristics of the disease and technology, clinical effectiveness, economic aspects, and safety. In the present study, the national report covered an acceptable number of AEs of the Core Model. These results need to be interpreted with caution because only one comparison was performed. The Core Model can be used in a flexible manner, applying only those elements that are relevant from the perspective of the technology assessment and specific country context.

  15. Study protocol on ecological momentary assessment of health-related quality of life using a smartphone application

    DEFF Research Database (Denmark)

    Mareva, Silvana; Thomson, David M; Marenco, Pietro

    2016-01-01

    recall and current mood state may undermine their validity and reliability. Retrospective tools can be further criticized for their lack of ecology, as individuals are usually assessed in less natural settings such as hospitals and health centers, and may be obliged to spend time and money traveling...... to receive assessment. Ecological momentary assessment (EMA) is an alternative, as mobile assessment using mobile health (mHealth) technology has the potential to minimize biases and overcome many of these limitations. Employing an EMA methodology, we will use a smartphone application to collect data on real-time...... HRQoL, with an adapted version of the widely used WHOQOL-BREF questionnaire. We aim to recruit a total of 450 healthy participants. Participants will be prompted by the application to report their real-time HRQoL over 2 weeks together with information on mood and current activities. At the end of 2...

  16. 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...

  17. 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

  18. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  19. An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study (Final Report, 2010)

    Science.gov (United States)

    EPA announced the availability of the final report, An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study. This report outlines an approach to evaluate genomic data for use in risk assessment and a case study to ...

  20. Association between Cardiovascular Health Score and Carotid Intima-Media Thickness: Cross-Sectional Analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Baseline Assessment.

    Science.gov (United States)

    Santos, Itamar S; Goulart, Alessandra C; Pereira, Alexandre C; Lotufo, Paulo A; Benseñor, Isabela M

    2016-12-01

    The American Heart Association aims to reduce the burden of cardiovascular disease in this decade by improving seven ideal cardiovascular health (CVH) characteristics in the population. The aim of this study was to quantify the association between the American Heart Association's CVH score and values for carotid intima-media thickness (CIMT) in the Brazilian Longitudinal Study of Adult Health baseline assessment. The Brazilian Longitudinal Study of Adult Health is a multicenter cohort study of civil servants aged 35 to 74 years in Brazil. In this study, the investigators analyzed 9,662 individuals with no previous cardiovascular disease. The distribution of CIMT values (categorized into age-, sex-, and race-specific quartiles) was analyzed according to CVH scores using χ 2 trend tests. Linear and multinomial regression models were built to evaluate the association between CIMT and CVH score. A significant increase was observed in the proportion of individuals within the first and second CIMT quartiles, as well as a decrease within the fourth quartile with higher CVH score strata (P for trend < .001). A 1-point increase in CVH score was associated in adjusted models with a decrease of 0.011 mm in CIMT and an odds ratio of 0.79 (95% CI, 0.77-0.81) of having CIMT in the fourth quartile. However, nearly 16% of individuals with optimal CVH scores had CIMT values in the highest quartile. In this study, significant associations were found between CIMT and CVH score in a large sample of middle-aged adults. However, a high CVH score did not warrant the absence of a significant subclinical atherosclerotic burden. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  1. Is health impact assessment useful in the context of trade negotiations? A case study of the Trans Pacific Partnership Agreement.

    Science.gov (United States)

    Hirono, Katherine; Haigh, Fiona; Gleeson, Deborah; Harris, Patrick; Thow, Anne Marie; Friel, Sharon

    2016-04-04

    The Trans Pacific Partnership Agreement (TPP) is a recently concluded free trade agreement involving Australia and 11 other Pacific-rim nations, which has the potential for far-reaching impacts on public health. A health impact assessment (HIA) was carried out during the negotiations to determine the potential future public health impact in Australia and to provide recommendations to mitigate potential harms. This paper explores the findings and outcomes of the HIA, and how this approach can be used to provide evidence for public health advocacy. A modified version of the standard HIA process was followed. The HIA was led by technical experts in HIA, trade policy, and health policy, in collaboration with advocacy organisations concerned with the TPP and health. The HIA reviewed the provisions in leaked TPP text in order to determine their potential impact on future health policy. As part of this process, researchers developed policy scenarios in order to examine how TPP provisions may affect health policies and their subsequent impact to health for both the general and vulnerable populations. The four policy areas assessed were the cost of medicines, tobacco control, alcohol control and food labelling. In all areas assessed, the HIA found that proposed TPP provisions were likely to adversely affect health. These provisions are also likely to more adversely affect the health of vulnerable populations. The HIA produced relevant evidence that was useful in advocacy efforts by stakeholders, and engaging the public through various media platforms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. 77 FR 29667 - Proposed Collection; Comment Request; Population Assessment of Tobacco and Health (PATH) Study

    Science.gov (United States)

    2012-05-18

    ... partnership with the Food and Drug Administration (FDA). Using annual interviews and the collection of bio-specimens from adults, the study is designed to establish a population-based framework for monitoring and... the Family Smoking Prevention and Tobacco Control Act (FSPTCA) to regulate tobacco-product advertising...

  3. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

    Science.gov (United States)

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

    2016-01-01

    An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for

  4. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol

    OpenAIRE

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

    2016-01-01

    Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project.Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for as...

  5. 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

  6. The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO study: the effect of dry eye

    Directory of Open Access Journals (Sweden)

    Trattler WB

    2017-08-01

    Full Text Available William B Trattler,1 Parag A Majmudar,2 Eric D Donnenfeld,3 Marguerite B McDonald,4 Karl G Stonecipher,5 Damien F Goldberg6 On behalf of the PHACO Study Group 1Center for Excellence in Eye Care, Miami, FL, USA; 2Chicago Cornea Consultants, Chicago, IL, USA; 3Ophthalmic Consultants of Long Island, Garden City, NY, USA; 4Ophthalmic Consultants of Long Island, Lynbrook, NY, USA; 5University North Carolina School of Medicine, Chapel Hill, NC, USA; 6Wolstan & Goldberg Eye Associates, Torrance, CA, USA Purpose: To determine the incidence and severity of dry eye as determined by the International Task Force (ITF scale in patients being screened for cataract surgery.Patients and methods: This was a prospective, multi-center, observational study of 136 patients, at least 55 years of age, who were scheduled to undergo cataract surgery. The primary outcome measure was the incidence of dry eye as evaluated by grade on the ITF scale and secondary outcome measures include tear break-up time (TBUT, ocular surface disease index score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye.Results: Mean patient age was 70.7 years. A total of 73.5% of patients were Caucasian and 50% were female. Almost 60% had never complained of a foreign body sensation; only 13% complained of a foreign body sensation half or most of the time. The majority of patients (62.9% had a TBUT ≤5 seconds, 77% of eyes had positive corneal staining and 50% of the eyes had positive central corneal staining. Eighteen percent had Schirmer’s score with anesthesia ≤5 mm.Conclusion: The incidence of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated. Keywords: cataract surgery screening, dry eye, International Task Force scale, observational study

  7. Taking a case study approach to assessing alternative leadership models in health care.

    Science.gov (United States)

    Harris, Jonathan; Mayo, Paula

    2018-06-14

    Good leadership is essential to patient-centred care and staff satisfaction in the healthcare environment. All members of the healthcare team can be leaders and evidence-based theory should inform their leadership practice. This article uses a case study approach to critically evaluate leadership as exercised by a charge nurse and a student nurse in a clinical scenario. Ineffective leadership styles are identified and alternatives proposed; considerable attention is given to critiquing both 'heroic' and 'post-heroic' transformational leadership theories. The concept of power will also be discussed, as power and leadership are closely related, and the importance of empowering members of the healthcare team through altering organisational structure is emphasised. This article advocates leadership that encourages innovation, enhances patient-centred care, encourages excellence and has ethical integrity. Recommendations of appropriate models of leadership are provided, while existing gaps in the healthcare leadership literature are highlighted.

  8. Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study.

    Science.gov (United States)

    Seo, Songwon; Lim, Wan Young; Lee, Dal Nim; Kim, Jung Un; Cha, Eun Shil; Bang, Ye Jin; Lee, Won Jin; Park, Sunhoo; Jin, Young Woo

    2018-03-30

    The cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure. Approximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose-response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status. This study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings

  9. Public preferences for engagement in Health Technology Assessment decision-making: protocol of a mixed methods study.

    Science.gov (United States)

    Wortley, Sally; Tong, Allison; Lancsar, Emily; Salkeld, Glenn; Howard, Kirsten

    2015-07-14

    Much attention in recent years has been given to the topic of public engagement in health technology assessment (HTA) decision-making. HTA organizations spend substantial resources and time on undertaking public engagement, and numerous studies have examined challenges and barriers to engagement in the decision-making process however uncertainty remains as to optimal methods to incorporate the views of the public in HTA decision-making. Little research has been done to ascertain whether current engagement processes align with public preferences and to what extent their desire for engagement is dependent on the question being asked by decision-makers or the characteristics of the decision. This study will examine public preferences for engagement in Australian HTA decision-making using an exploratory mixed methods design. The aims of this study are to: 1) identify characteristics about HTA decisions that are important to the public in determining whether public engagement should be undertaken on a particular topic, 2) determine which decision characteristics influence public preferences for the extent, or type of public engagement, and 3) describe reasons underpinning these preferences. Focus group participants from the general community, aged 18-70 years, will be purposively sampled from the Australian population to ensure a wide range of demographic groups. Each focus group will include a general discussion on public engagement as well as a ranking exercise using a modified nominal group technique (NGT). The NGT will inform the design of a discrete choice study to quantitatively assess public preferences for engagement in HTA decision-making. The proposed research seeks to investigate under what circumstances and how the public would like their views and preferences to be considered in health technology assessments. HTA organizations regularly make decisions about when and how public engagement should occur but without consideration of the public's preferences on

  10. Health assessment of Arsenic and Zinc in rice cultivated in Fars province (Case Study: Firoozabad fields

    Directory of Open Access Journals (Sweden)

    M Cheraghi

    2013-11-01

    Full Text Available Food security along with the protection of environment has become a global issue.Accumulation of Arsenic and Zinc in rice is considered as a major problem for South-East Asia, where rice is a staple food. Given that, rice is considered as the highly consumed food in the diet of Iranian people, this study was conducted to estimate the concentrations of Zinc and Arsenic in rice cultivated in Firoozabad fields. For this purpose, 38 rice samples were collected from 22 nearby villages. Samples were digested by Digesdahl device and the concentrations of Arsenic and Zinc were determined by ICP. The results showed that the concentration (mean ± SD of Zinc was 20.87 ± 1.9 mg/kg of dry matter (ranged from 25.26 to 32.97; meanwhile mean value of Arsenic concentration was estimated at 22.89 ± 2.2 mg/kg of dry matter (ranged from 17.61 to 26.77.Comparing the concentrations of Arsenic and Zinc in rice samples with the standard limit set by WHO/FAO it was revealed that Arsenic concentrations in 100% of the samples were higher than standard level, whereas Zinc concentrations in 97.36% of the samples were below the limit.

  11. 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.

  12. An E-Learning Module to Improve Nongenetic Health Professionals' Assessment of Colorectal Cancer Genetic Risk: Feasibility Study.

    Science.gov (United States)

    Douma, Kirsten Freya Lea; Aalfs, Cora M; Dekker, Evelien; Tanis, Pieter J; Smets, Ellen M

    2017-12-18

    Nongenetic health providers may lack the relevant knowledge, experience, and communication skills to adequately detect familial colorectal cancer (CRC), despite a positive attitude toward the assessment of history of cancer in a family. Specific training may enable them to more optimally refer patients to genetic counseling. The aim of this study was to develop an e-learning module for gastroenterologists and surgeons (in training) aimed at improving attitudes, knowledge, and comprehension of communication skills, and to assess the feasibility of the e-learning module for continued medical education of these specialists. A focus group helped to inform the development of a training framework. The e-learning module was then developed, followed by a feasibility test among a group of surgeons-in-training (3rd- and 4th-year residents) and then among gastroenterologists, using pre- and posttest questionnaires. A total of 124 surgeons-in-training and 14 gastroenterologists participated. The e-learning was positively received (7.5 on a scale of 1 to 10). Between pre- and posttest, attitude increased significantly on 6 out of the 10 items. Mean test score showed that knowledge and comprehension of communication skills improved significantly from 49% to 72% correct at pretest to 67% to 87% correct at posttest. This study shows the feasibility of a problem-based e-learning module to help surgeons-in-training and gastroenterologists in recognizing a hereditary predisposition in patients with CRC. The e-learning led to improvements in attitude toward the assessment of cancer family history, knowledge on criteria for referral to genetic counseling for CRC, and comprehension of communication skills. ©Kirsten Freya Lea Douma, Cora M Aalfs, Evelien Dekker, Pieter J Tanis, Ellen M Smets. Originally published in JMIR Medical Education (http://mededu.jmir.org), 18.12.2017.

  13. An E-Learning Module to Improve Nongenetic Health Professionals’ Assessment of Colorectal Cancer Genetic Risk: Feasibility Study

    Science.gov (United States)

    Aalfs, Cora M; Dekker, Evelien; Tanis, Pieter J; Smets, Ellen M

    2017-01-01

    Background Nongenetic health providers may lack the relevant knowledge, experience, and communication skills to adequately detect familial colorectal cancer (CRC), despite a positive attitude toward the assessment of history of cancer in a family. Specific training may enable them to more optimally refer patients to genetic counseling. Objective The aim of this study was to develop an e-learning module for gastroenterologists and surgeons (in training) aimed at improving attitudes, knowledge, and comprehension of communication skills, and to assess the feasibility of the e-learning module for continued medical education of these specialists. Methods A focus group helped to inform the development of a training framework. The e-learning module was then developed, followed by a feasibility test among a group of surgeons-in-training (3rd- and 4th-year residents) and then among gastroenterologists, using pre- and posttest questionnaires. Results A total of 124 surgeons-in-training and 14 gastroenterologists participated. The e-learning was positively received (7.5 on a scale of 1 to 10). Between pre- and posttest, attitude increased significantly on 6 out of the 10 items. Mean test score showed that knowledge and comprehension of communication skills improved significantly from 49% to 72% correct at pretest to 67% to 87% correct at posttest. Conclusions This study shows the feasibility of a problem-based e-learning module to help surgeons-in-training and gastroenterologists in recognizing a hereditary predisposition in patients with CRC. The e-learning led to improvements in attitude toward the assessment of cancer family history, knowledge on criteria for referral to genetic counseling for CRC, and comprehension of communication skills. PMID:29254907

  14. Comparative assessment of three different indices of multimorbidity for studies on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Dubois Marie-France

    2005-11-01

    Full Text Available Abstract Background Measures of multimorbidity are often applied to source data, populations or outcomes outside the scope of their original developmental work. As the development of a multimorbidity measure is influenced by the population and outcome used, these influences should be taken into account when selecting a multimorbidity index. The aim of this study was to compare the strength of the association of health-related quality of life (HRQOL with three multimorbidity indices: the Cumulative Illness Rating Scale (CIRS, the Charlson index (Charlson and the Functional Comorbidity Index (FCI. The first two indices were not developed in light of HRQOL. Methods We used data on chronic diseases and on the SF-36 questionnaire assessing HRQOL of 238 adult primary care patients who participated in a previous study. We extracted all the diagnoses for every patient from chart review to score the CIRS, the FCI and the Charlson. Data for potential confounders (age, sex, self-perceived economic status and self-perceived social support were also collected. We calculated the Pearson correlation coefficients (r of the SF-36 scores with the three measures of multimorbidity, as well as the coefficient of determination, R2, while controlling for confounders. Results The r values for the CIRS (range: -0.55 to -0.18 were always higher than those for the FCI (-0.47 to -0.10 and Charlson (-0.31 to -0.04 indices. The CIRS explained the highest percent of variation in all scores of the SF-36, except for the Mental Component Summary Score where the variation was not significant. Variations explained by the FCI were significant in all scores of SF-36 measuring physical health and in two scales evaluating mental health. Variations explained by the Charlson were significant in only three scores measuring physical health. Conclusion The CIRS is a better choice as a measure of multimorbidity than the FCI and the Charlson when HRQOL is the outcome of interest. However

  15. Integrating toxicogenomics into human health risk assessment: lessons learned from the benzo[a]pyrene case study.

    Science.gov (United States)

    Chepelev, Nikolai L; Moffat, Ivy D; Labib, Sarah; Bourdon-Lacombe, Julie; Kuo, Byron; Buick, Julie K; Lemieux, France; Malik, Amal I; Halappanavar, Sabina; Williams, Andrew; Yauk, Carole L

    2015-01-01

    The use of short-term toxicogenomic tests to predict cancer (or other health effects) offers considerable advantages relative to traditional toxicity testing methods. The advantages include increased throughput, increased mechanistic data, and significantly reduced costs. However, precisely how toxicogenomics data can be used to support human health risk assessment (RA) is unclear. In a companion paper ( Moffat et al. 2014 ), we present a case study evaluating the utility of toxicogenomics in the RA of benzo[a]pyrene (BaP), a known human carcinogen. The case study is meant as a proof-of-principle exercise using a well-established mode of action (MOA) that impacts multiple tissues, which should provide a best case example. We found that toxicogenomics provided rich mechanistic data applicable to hazard identification, dose-response analysis, and quantitative RA of BaP. Based on this work, here we share some useful lessons for both research and RA, and outline our perspective on how toxicogenomics can benefit RA in the short- and long-term. Specifically, we focus on (1) obtaining biologically relevant data that are readily suitable for establishing an MOA for toxicants, (2) examining the human relevance of an MOA from animal testing, and (3) proposing appropriate quantitative values for RA. We describe our envisioned strategy on how toxicogenomics can become a tool in RA, especially when anchored to other short-term toxicity tests (apical endpoints) to increase confidence in the proposed MOA, and emphasize the need for additional studies on other MOAs to define the best practices in the application of toxicogenomics in RA.

  16. Assessment of validation of health-economics decision models in intervention studies of seasonal influenza and breast cancer

    NARCIS (Netherlands)

    De Boer, P.T.; Frederix, G.W.; Al, M.J.; Feenstra, T.F.; Vemer, P.

    2015-01-01

    Objectives: We aimed to review recently published health-economic (HE) decision models to assess the reporting of validation efforts. An infectious disease (seasonal influenza, SI) and a chronic disease (breast cancer, BC) were used as examples, giving a preliminary insight in the reporting of

  17. An E-Learning Module to Improve Nongenetic Health Professionals' Assessment of Colorectal Cancer Genetic Risk: Feasibility Study

    NARCIS (Netherlands)

    Douma, Kirsten Freya Lea; Aalfs, Cora M.; Dekker, Evelien; Tanis, Pieter J.; Smets, Ellen M.

    2017-01-01

    Nongenetic health providers may lack the relevant knowledge, experience, and communication skills to adequately detect familial colorectal cancer (CRC), despite a positive attitude toward the assessment of history of cancer in a family. Specific training may enable them to more optimally refer

  18. 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)

  19. 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.

  20. Assessment of Urban Ecosystem Health Based on Matter Element Analysis: A Case Study of 13 Cities in Jiangsu Province, China.

    Science.gov (United States)

    Xie, Xuefeng; Pu, Lijie

    2017-08-21

    Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000-2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city's UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel's coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province.

  1. Is HIA the most effective tool to assess the impact on health of climate change mitigation policies at the local level? A case study in Geneva, Switzerland.

    Science.gov (United States)

    Diallo, Thierno; Cantoreggi, Nicola; Simos, Jean; Christie, Derek P T H

    2017-06-01

    This study aims to understand how the health dimension is integrated into four impact assessment tools used in Geneva, Switzerland: environmental impact assessment (EIA), strategic environmental assessment (SEA), sustainability assessment (SA) and health impact assessment (HIA). We have chosen as a case study greenhouse gas (GHG) emissions reduction policies chosen by the city of Geneva. The methodological approach consists in analysing EIA, SEA, SA and HIA conducted on three projects in three topic areas: urban planning, heating and transportation. These projects are: a complex urbanisation plan in an urban neighbourhood in Geneva (the Gare des Eaux-Vives project), a sustainable transportation plan for a central district in Geneva (the St-Gervais transportation project) and a strategy to encourage the City's employees to use sustainable transport for local business travel. The results show some shortcomings in the consideration of health in SEA, EIA and SA. This work highlights a narrow vision of health in SEA and EIA, limiting itself to a review of the effects of projects on the determinants of the physical environment as required by the legislation relating to these tools. EIA does not require the integration of the health dimension. As for SA, our research found that health is treated much more superficially than in HIA and primarily through the analysis of 'health and safety' criteria. It appears from this work that HIA is the tool which provides the most elaborate assessment, compared to SA, SEA or EIA, of the consequences for health of the GHG reduction policies chosen by the local decision-makers of a city. However, our study suggests that the HIA community should identify the situations in which HIA should be carried out and in which cases it is better to include health issues within an integrated analysis.

  2. Mental health self-assessment in patients with moderate to severe psoriasis: an observational, multicenter study of 1164 patients in Spain (the VACAP Study).

    Science.gov (United States)

    Pujol, R M; Puig, L; Daudén, E; Sánchez-Carazo, J L; Toribio, J; Vanaclocha, F; Yébenes, M; Sabater, E; Casado, M A; Caloto, M T; Aragón, B

    2013-12-01

    Poor self-assessed mental health appears to be related to the severity of psoriasis. To evaluate the impact of psoriasis severity on mood and anxiety disorders. A prospective, observational, multicenter study was conducted by 123 dermatologists in Spain. Patients (n=164; mean [SD] age, 45.11 [13.92] years; 60.8% males) with moderate to severe psoriasis were evaluated at baseline and 4 months later. Psoriasis severity was measured using the Psoriasis Area and Severity Index (PASI), with a score range of 0 (mild) to 72 (severe); body surface area involvement (BSA); and physician global assessment (PGA) scores, with a range of 1 (mild) to 7 (severe). Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0-42 (higher scores representing worse mental health). Mean first and second visit scores were compared. Mean (SD) scores improved between the first and second visit as follows: 13.24 (9.50) to 5.07 (6.03) for PASI, 12.52 (7.92) to 10.78 (7.32) for overall HADS, 7.83 (4.55) to 6.85 (4.21) for the HADS anxiety subscale, and 4.72 (4.12) to 3.95 (3.76) for the HADS depression subscale (P<.001 in all cases). Multivariate analyses showed that the main factors related to anxiety were psoriasis severity, sex, and completion of graduate studies. The independent variables included in the model for depression were psoriasis severity, sex, and psoriasis located on the head. Reductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  3. How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards

    Science.gov (United States)

    Rooney, Andrew A.; Cooper, Glinda S.; Jahnke, Gloria D.; Lam, Juleen; Morgan, Rebecca L.; Boyles, Abee L.; Ratcliffe, Jennifer M.; Kraft, Andrew D.; Schünemann, Holger J.; Schwingl, Pamela; Walker, Teneille D.; Thayer, Kristina A.; Lunn, Ruth M.

    2016-01-01

    Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or “risk of bias” — the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program’s (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or “domains” for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. PMID:26857180

  4. Is it worth it? Patient and public views on the impact of their involvement in health research and its assessment: a UK-based qualitative interview study.

    Science.gov (United States)

    Crocker, Joanna C; Boylan, Anne-Marie; Bostock, Jennifer; Locock, Louise

    2017-06-01

    There are mounting calls for robust, critical evaluation of the impact of patient and public involvement (PPI) in health research. However, questions remain about how to assess its impact, and whether it should be assessed at all. The debate has thus far been dominated by professionals. To explore the views of PPI contributors involved in health research regarding the impact of PPI on research, whether and how it should be assessed. Qualitative interview study. Thirty-eight PPI contributors involved in health research across the UK. Participants felt that PPI has a beneficial impact on health research. They described various impactful roles, which we conceptualize as the 'expert in lived experience', the 'creative outsider', the 'free challenger', the 'bridger', the 'motivator' and the 'passive presence'. Participants generally supported assessing the impact of PPI, while acknowledging the challenges and concerns about the appropriateness and feasibility of measurement. They expressed a range of views about what impacts should be assessed, by whom and how. Individual feedback on impact was seen as an important driver of improved impact and motivation to stay involved. While there appears to be widespread support for PPI impact assessment among PPI contributors, their views on what to assess and how are diverse. PPI contributors should be involved as equal partners in debates and decisions about these issues. Individual feedback on impact may increase PPI contributors' potential impact and their motivation to stay involved. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  5. Assessing the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud iTu, to reduce health disparities in unintended pregnancies among Hispanic adolescents: study protocol for a cluster randomised control trial.

    Science.gov (United States)

    Tebb, Kathleen P; Rodriguez, Felicia; Pollack, Lance M; Trieu, Sang Leng; Hwang, Loris; Puffer, Maryjane; Adams, Sally; Ozer, Elizabeth M; Brindis, Claire D

    2018-01-10

    Teen pregnancy rates in the USA remain higher than any other industrialised nation, and pregnancies among Hispanic adolescents are disproportionately high. Computer-based interventions represent a promising approach to address sexual health and contraceptive use disparities. Preliminary findings have demonstrated that the Health-E You/Salud iTu, computer application (app) is feasible to implement, acceptable to Latina adolescents and improves sexual health knowledge and interest in selecting an effective contraceptive method when used in conjunction with a healthcare visit. The app is now ready for efficacy testing. The purpose of this manuscript is to describe patient-centred approaches used both in developing and testing the Health-E You app and to present the research methods used to evaluate its effectiveness in improving intentions to use an effective method of contraception as well as actual contraceptive use. This study is designed to assess the effectiveness of a patient-centred computer-based clinic intervention, Health-E You/Salud  iTu, on its ability to reduce health disparities in unintended pregnancies among Latina adolescent girls. This study uses a cluster randomised control trial design in which 18 school-based health centers from the Los Angeles Unified School District were randomly assigned, at equal chance, to either the intervention ( Health-E You app) or control group. Analyses will examine differences between the control and intervention group's knowledge of and attitudes towards contraceptive use, receipt of contraception at the clinic visit and self-reported use of contraception at 3-month and 6-month follow-ups. The study began enrolling participants in August 2016, and a total of 1400 participants (700 per treatment group) are expected to be enrolled by March 2018. Ethics approval was obtained through the University of California, San Francisco Institutional Review Board. Results of this trial will be submitted for publication in peer

  6. Health risk assessment and source study of PAHs from roadside soil dust of a heavy mining area in India.

    Science.gov (United States)

    Tarafdar, Abhrajyoti; Sinha, Alok

    2018-02-26

    The total concentrations of 13 detected polycyclic aromatic hydrocarbons (PAHs) in different traffic soil samples of Dhanbad heavy mining area, India, were between 8.256 and 12.562 µg/g and were dominated by four ring PAHs (44%). Diagnostic ratio study revealed that fossil fuel burning and vehicular pollution are the most prominent sources of the PAHs in roadside soil even at a heavy coal mining area. The 90th percentiles cancer risks determined by probabilistic health risk assessment (Monte Carlo simulations) for both the age groups (children and adults) were above tolerable limit (>1.00E-06) according to USEPA. The simulated mean cancer risk was 1.854E-05 for children and 1.823E-05 for adults. For different exposure pathways, dermal contact was observed to be the major pathway with an exposure load of 74% for children and 85% for adults. Sensitivity analysis demonstrated relative skin adherence factor for soil (AF) is the most influential parameter of the simulation, followed by exposure duration (ED).

  7. Health and ecological risk assessment of heavy metals pollution in an antimony mining region: a case study from South China.

    Science.gov (United States)

    Fei, Jiang-Chi; Min, Xiao-Bo; Wang, Zhen-Xing; Pang, Zhi-Hua; Liang, Yan-Jie; Ke, Yong

    2017-12-01

    In recent years, international research on the toxicity of the heavy metal, antimony, has gradually changed focus from early medical and pharmacological toxicology to environmental toxicology and ecotoxicology. However, little research has been conducted for sources identification and risk management of heavy metals pollution by long-term antimony mining activities. In this study, a large number of investigations were conducted on the temporal and spatial distribution of antimony and related heavy metal contaminants (lead, zinc, and arsenic), as well as on the exposure risks for the population for the Yuxi river basin in the Hunan province, China. The scope of the investigations included mine water, waste rock, tailings, agricultural soil, surface water, river sediments, and groundwater sources of drinking water. Health and ecological risks from exposure to heavy metal pollution were evaluated. The main pollution sources of heavy metals in the Yuxi River basin were analyzed. Remediation programs and risk management strategies for heavy metal pollution were consequently proposed. This article provides a scientific basis for the risk assessment and management of heavy metal pollution caused by antimony basin ore mining.

  8. 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...

  9. 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.

  10. 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.

  11. A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis.

    Science.gov (United States)

    Joharatnam, Nalinie; McWilliams, Daniel F; Wilson, Deborah; Wheeler, Maggie; Pande, Ira; Walsh, David A

    2015-01-20

    Pain remains the most important problem for people with rheumatoid arthritis (RA). Active inflammatory disease contributes to pain, but pain due to non-inflammatory mechanisms can confound the assessment of disease activity. We hypothesize that augmented pain processing, fibromyalgic features, poorer mental health, and patient-reported 28-joint disease activity score (DAS28) components are associated in RA. In total, 50 people with stable, long-standing RA recruited from a rheumatology outpatient clinic were assessed for pain-pressure thresholds (PPTs) at three separate sites (knee, tibia, and sternum), DAS28, fibromyalgia, and mental health status. Multivariable analysis was performed to assess the association between PPT and DAS28 components, DAS28-P (the proportion of DAS28 derived from the patient-reported components of visual analogue score and tender joint count), or fibromyalgia status. More-sensitive PPTs at sites over or distant from joints were each associated with greater reported pain, higher patient-reported DAS28 components, and poorer mental health. A high proportion of participants (48%) satisfied classification criteria for fibromyalgia, and fibromyalgia classification or characteristics were each associated with more sensitive PPTs, higher patient-reported DAS28 components, and poorer mental health. Widespread sensitivity to pressure-induced pain, a high prevalence of fibromyalgic features, higher patient-reported DAS28 components, and poorer mental health are all linked in established RA. The increased sensitivity at nonjoint sites (sternum and anterior tibia), as well as over joints, indicates that central mechanisms may contribute to pain sensitivity in RA. The contribution of patient-reported components to high DAS28 should inform decisions on disease-modifying or pain-management approaches in the treatment of RA when inflammation may be well controlled.

  12. 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

  13. An assessment of maternal, newborn and child health implementation studies in Nigeria: implications for evidence informed policymaking and practice

    Directory of Open Access Journals (Sweden)

    Chigozie Jesse Uneke

    2016-08-01

    Full Text Available Background: The introduction of implementation science into maternal, newborn and child health (MNCH research has facilitated better methods to improve uptake of research findings into practices. With increase in implementation research related to MNCH world-wide, stronger scientific evidence are now available and have improved MNCH policies in many countries including Nigeria. The purpose of this study was to review MNCH implementation studies undertaken in Nigeria in order to understand the extent the evidence generated informed better policy. Methods: This study was a systematic review. A MEDLINE Entrez PubMed search was performed in August 2015 and implementation studies that investigated MNCH in Nigeria from 1966 to 2015 in relation to health policy were sought. Search key words included Nigeria, health policy,maternal, newborn, and child health. Only policy relevant studies that were implementation or intervention research which generated evidence to improve MNCH in Nigeria were eligible and were selected. Results: A total of 18 relevant studies that fulfilled the study inclusion criteria were identified out of 471 studies found. These studies generated high quality policy relevance evidence relating to task shifting, breastfeeding practices, maternal nutrition, childhood immunization, kangaroo mother care (KMC, prevention of maternal to child transmission of HIV, etc. These indicated significant improvements in maternal health outcomes in localities and health facilities where the studies were undertaken. Conclusion: There is a dire need for more implementation research related to MNCH in low income settings because the priority for improved MNCH outcome is not so much the development of new technologies but solving implementation issues, such as how to scale up and evaluate interventions within complex health systems.

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

    International Nuclear Information System (INIS)

    Matanoski, G.M.

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

  15. 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.

  16. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2016-05-01

    Full Text Available Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011 will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre–post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. Conclusions: The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child

  17. Research on Value Assessment and Compensation for Health Hazards of Urban Air Pollution-A Case Study of Urumqi

    Directory of Open Access Journals (Sweden)

    Chen Yu

    Full Text Available ABSTRACT With the acceleration of urbanization and industrialization, urban air pollution has become a serious threat to the health of urban residents. In this study, to investigate health hazards caused by air pollution for urban residents, concentrations of main air pollutants and annual coal consumption amounts during the period from 2000 to 2013 were analyzed. Our results showed that economic losses of Urumqi caused by air pollution amounted to 63.155 million yuan in 2013, accounting for 0.2 ‰ of its GDP and 5.7% of public utility expenditures for that year. The compensation mechanism analysis suggested that it is necessary to further improve the health care system and increase corporate environmental taxes. More environmental health protection taxes should be levied on key monitoredenterprises in Urumqi to achieve effective compensations for urban residents affected by air pollution-related health hazards.

  18. Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research.

    Science.gov (United States)

    Wallis, Selina; Cole, Donald C; Gaye, Oumar; Mmbaga, Blandina T; Mwapasa, Victor; Tagbor, Harry; Bates, Imelda

    2017-09-05

    Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. Four African universities. 83 university staff and students from 11 cadres. A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be

  19. Government Crisis Assessment and Reputation Management. A Case Study of the Vietnam Health Minister's Crises in 2013-2014

    Directory of Open Access Journals (Sweden)

    Tuong-Minh Ly-Le

    2015-06-01

    Full Text Available In Vietnam, many government announcements have gathered negative receptions from the public. Among them, Ms. Nguyen Thi Kim Tien, Vietnam Minister of Health, has received more of it. Through the case study of Ms. Kim Tien’s many scandals during the 2013-2014 period, this study is interested to see if the health scandals eventually elevated into a government crisis, how they affected the minister’s reputation, and what she could have done to better respond to the public. This study examined news articles on such health scandals to confirm whether the health scandals indeed escalated to be a government crisis. It also identified the advantages and disadvantages of Ms. Kim Tien’s responses in restoring her reputation to the public to understand what factors contributed to public dissatisfaction toward the minister. This study concluded that poorly-managed health scandals eventually elevated into a government crisis and greatly affected the minister’s reputation. It is suggested that PR is what the government needs to deal with such situations. The research also leaves room for a quantitative approach to the case to increase the result’s validity and representativeness. Until now, as the health issues and the resignation appeals are still needed, the crisis management effort should get more attention from the government, and such study is needed to better understand the situation.

  20. 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).

  1. 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.

  2. 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 ...

  3. Indian Psychiatric Society multicentric study on assessment of health-care needs of patients with severe mental illnesses as perceived by their family caregivers and health-care providers

    OpenAIRE

    Grover, Sandeep; Avasthi, Ajit; Shah, Sandip; Lakdawala, Bhavesh; Chakraborty, Kaustav; Nebhinani, Naresh; Kallivayalil, Roy A; Dalal, Pranob K.; Sinha, Vishal; Khairkar, Praveen; Mukerjee, Divya G.; Thara, R.; Behere, Prakash; Chauhan, Nidhi; Thirunavukarasu, M.

    2015-01-01

    Aim: To study the health-care needs of the patients with severe mental disorders as perceived by their family caregivers and the treating psychiatrists. Materials and Methods: Caregivers of patients with severe mental disorders and their treating psychiatrists were assessed using Camberwell Assessment of Need-Research Version (CAN-R) scale and indigenously designed Supplementary Assessment of Needs Scale (SNAS). Results: The study included 1494 patients recruited from 15 centers. The mean nee...

  4. Assessing patterns of spatial behavior in health studies: their socio-demographic determinants and associations with transportation modes (the RECORD Cohort Study).

    Science.gov (United States)

    Perchoux, Camille; Kestens, Yan; Thomas, Frédérique; Van Hulst, Andraea; Thierry, Benoit; Chaix, Basile

    2014-10-01

    Prior epidemiological studies have mainly focused on local residential neighborhoods to assess environmental exposures. However, individual spatial behavior may modify residential neighborhood influences, with weaker health effects expected for mobile populations. By examining individual patterns of daily mobility and associated socio-demographic profiles and transportation modes, this article seeks to develop innovative methods to account for daily mobility in health studies. We used data from the RECORD Cohort Study collected in 2011-2012 in the Paris metropolitan area, France. A sample of 2062 individuals was investigated. Participants' perceived residential neighborhood boundaries and regular activity locations were geocoded using the VERITAS application. Twenty-four indicators were created to qualify individual space-time patterns, using spatial analysis methods and a geographic information system. Three domains of indicators were considered: lifestyle indicators, indicators related to the geometry of the activity space, and indicators related to the importance of the residential neighborhood in the overall activity space. Principal component analysis was used to identify main dimensions of spatial behavior. Multilevel linear regression was used to determine which individual characteristics were associated with each spatial behavior dimension. The factor analysis generated five dimensions of spatial behavior: importance of the residential neighborhood in the activity space, volume of activities, and size, eccentricity, and specialization of the activity space. Age, socioeconomic status, and location of the household in the region were the main predictors of daily mobility patterns. Activity spaces of small sizes centered on the residential neighborhood and implying a large volume of activities were associated with walking and/or biking as a transportation mode. Examination of patterns of spatial behavior by individual socio-demographic characteristics and in

  5. Research on Value Assessment and Compensation for Health Hazards of Urban Air Pollution-A Case Study of Urumqi

    OpenAIRE

    Yu, Chen; Hui, Sun

    2016-01-01

    ABSTRACT With the acceleration of urbanization and industrialization, urban air pollution has become a serious threat to the health of urban residents. In this study, to investigate health hazards caused by air pollution for urban residents, concentrations of main air pollutants and annual coal consumption amounts during the period from 2000 to 2013 were analyzed. Our results showed that economic losses of Urumqi caused by air pollution amounted to 63.155 million yuan in 2013, accounting for ...

  6. Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study.

    Science.gov (United States)

    Raghu, Arvind; Praveen, Devarsetty; Peiris, David; Tarassenko, Lionel; Clifford, Gari

    2015-04-29

    The incidence of chronic diseases in low- and middle-income countries is rapidly increasing both in urban and rural regions. A major challenge for health systems globally is to develop innovative solutions for the prevention and control of these diseases. This paper discusses the development and pilot testing of SMARTHealth, a mobile-based, point-of-care Clinical Decision Support (CDS) tool to assess and manage cardiovascular disease (CVD) risk in resource-constrained settings. Through pilot testing, the preliminary acceptability, utility, and efficiency of the CDS tool was obtained. The CDS tool was part of an mHealth system comprising a mobile application that consisted of an evidence-based risk prediction and management algorithm, and a server-side electronic medical record system. Through an agile development process and user-centred design approach, key features of the mobile application that fitted the requirements of the end users and environment were obtained. A comprehensive analytics framework facilitated a data-driven approach to investigate four areas, namely, system efficiency, end-user variability, manual data entry errors, and usefulness of point-of-care management recommendations to the healthcare worker. A four-point Likert scale was used at the end of every risk assessment to gauge ease-of-use of the system. The system was field-tested with eleven village healthcare workers and three Primary Health Centre doctors, who screened a total of 292 adults aged 40 years and above. 34% of participants screened by health workers were identified by the CDS tool to be high CVD risk and referred to a doctor. In-depth analysis of user interactions found the CDS tool feasible for use and easily integrable into the workflow of healthcare workers. Following completion of the pilot, further technical enhancements were implemented to improve uptake of the mHealth platform. It will then be evaluated for effectiveness and cost-effectiveness in a cluster randomized

  7. An exploratory study assessing psychological distress of indigents in Burkina Faso: a step forward in understanding mental health needs in West Africa

    OpenAIRE

    Pigeon-Gagn?, ?milie; Hassan, Ghayga; Yaogo, Maurice; Ridde, Val?ry

    2017-01-01

    Background Poverty is known as an important determinant of health, but empirical data are still missing on the relationships between poverty, other adverse living conditions, and psychological distress, particularly in low-income countries. This study aimed to assess mental health needs and psychological distress among the poorest in rural settings in Burkina Faso where food security and access to water, electricity, schooling, and healthcare are limited. Methods We randomly selected 2000 ind...

  8. Health Risk Assessment for Uranium in Groundwater - An Integrated Case Study Based on Hydrogeological Characterization and Dose Calculation

    Science.gov (United States)

    Franklin, M. R.; Veiga, L. H.; Py, D. A., Jr.; Fernandes, H. M.

    2010-12-01

    The uranium mining and milling facilities of Caetité (URA) is the only active uranium production center in Brazil. Operations take place at a very sensitive semi-arid region in the country where water resources are very scarce. Therefore, any contamination of the existing water bodies may trigger critical consequences to local communities because their sustainability is closely related to the availability of the groundwater resources. Due to the existence of several uranium anomalies in the region, groundwater can present radionuclide concentrations above the world average. The radiological risk associated to the ingestion of these waters have been questioned by members of the local communities, NGO’s and even regulatory bodies that suspected that the observed levels of radionuclide concentrations (specially Unat) could be related to the uranium mining and milling operations. Regardless the origin of these concentrations the fear that undesired health effects were taking place (e.g. increase in cancer incidence) remain despite the fact that no evidence - based on epidemiological studies - is available. This paper intends to present the connections between the local hydrogeology and the radiological characterization of groundwater in the neighboring areas of the uranium production center to understand the implications to the human health risk due to the ingestion of groundwater. The risk assessment was performed, taking into account the radiological and the toxicological risks. Samples from 12 wells have been collected and determinations of Unat, Thnat, 226Ra, 228Ra and 210Pb were performed. The radiation-related risks were estimated for adults and children by the calculation of the annual effective doses. The potential non-carcinogenic effects due to the ingestion of uranium were evaluated by the estimation of the hazard index (HI). Monte Carlo simulations were used to calculate the uncertainty associated with these estimates, i.e. the 95% confidence interval

  9. Public Knowledge and Assessment of Child Mental Health Problems: Findings from the National Stigma Study-Children

    Science.gov (United States)

    Pescosolido, Bernice A.; Jensen, Peter S.; Martin, Jack K.; Perry, Brea L.; Olafsdottir, Sigrun; Fettes, Danielle

    2008-01-01

    The study examines the general public's perceptions of, and response to, mental disorders in children by using the National Stigma Study-Children. Results concluded that lack of knowledge, skepticism, and misinformed beliefs are the reasons for low utilization rates for children's mental health problems.

  10. A global study on lone mothers: exploring the associations of self-assessed general health with motherhood types and gender inequality in 32 countries.

    Science.gov (United States)

    Witvliet, Margot I; Arah, Onyebuchi A; Stronks, Karien; Kunst, Anton E

    2014-01-01

    In a study of 32 mostly non-affluent countries, we aimed to i) compare lone mother's general health to the health of other women and ii) assess whether the association of health with gender inequality was stronger among lone mothers than among other women. World Health Survey data were analyzed on 57,182 women aged 18 to 50 in 32 countries. The main outcome was self-assessed general poor health. The Global Gender Gap Index (GGGI) was used to measure the magnitude of gender inequality within countries. Logistic multilevel regression was used to compare the health of different groups of women, and to study the possible influence of gender inequality. Compared with all other women, lone mothers had the highest odds of poor health odds ratio (OR, 1.15; 95% confidence interval [CI], 1.09-1.22), also at 35 years or older with an OR of 1.18 (95% CI, 1.10-1.27). Lone mothers in Ethiopia and Tunisia had the highest odds of reporting poor health (OR, 1.65 [95% CI, 1.21-2.26] and OR, 1.57 [95% CI, 0.92-2.68], respectively). The degree of gender inequality was weakly related to cross-national variations in health of women. These associations were about similar for all women. For example, the OR for the GGGI was 1.03 for all women except coupled mothers. As within North America, lone mothers in non-affluent countries tend to have higher rates of poor health. The degree of gender inequality is not related to the relative health of lone mothers, suggesting that other characteristics of nations might be more influential. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. Comparison of a Medication Inventory and a Dietary Supplement Interview in Assessing Dietary Supplement Use in the Hispanic Community Health Study/Study of Latinos

    Directory of Open Access Journals (Sweden)

    Keturah R. Faurot

    2016-01-01

    Full Text Available Although dietary supplement use is common, its assessment is challenging, especially among ethnic minority populations such as Hispanics/Latinos. Using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL (n = 16,415, this report compares two strategies for capturing dietary supplement use over a 30-day period: a medication-based inventory and a nutrition-based dietary supplement interview. Age-standardized prevalence was calculated across multiple dietary supplement definitions, adjusted with survey/nonresponse weights. The prevalence of dietary supplement use was substantially higher as measured in the dietary supplement interview, compared to the medication inventory: for total dietary supplements (39% vs 26%, respectively, for nonvitamin, nonmineral supplements (24% vs 12%, and for botanicals (9.2% vs 4.5%. Concordance between the two assessments was fair to moderate (Cohen's kappa: 0.31–0.52. Among women, inclusion of botanical teas increased the prevalence of botanical supplement use from 7% to 15%. Supplement assessment that includes queries about botanical teas yields more information about patient supplement use.

  12. The development and assessment of Web-based health information for a corporate Intranet--a pilot study.

    OpenAIRE

    Matarrese, P.; Helwig, A.

    2000-01-01

    Consumers readily use the Internet for medical information, advice and support. Studies of general clinic populations show that moderated internet patient education systems can improve patient satisfaction and affect self help behaviors. Many Americans have Internet access through their employers and large corporations have often developed Intranets for employee information. There is little study of health information available online to employees through company Intranets. This study relates...

  13. A cross-sectional study to assess the long-term health status of patients with lower respiratory tract infections, including Q-fever.

    NARCIS (Netherlands)

    Dam, A.S.G. van; Loenhout, J.A.F. van; Peters, J.B.; Rietveld, A.; Paget, W.J.; Akkermans, R.P.; Olde Loohuis, A.; Hautvast, J.L.A.; Velden, J. van der

    2015-01-01

    Patients with a lower respiratory tract infection (LRTI) might be at risk for long-term impaired health status. We assessed whether LRTI patients without Q fever are equally at risk for developing long-term symptoms compared to LRTI patients with Q fever. The study was a cross-sectional cohort

  14. The Life-course Approach in Assessment of Dental Health: A Cross Sectional Study among Finnish and Turkish Pre-adolescents

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak; Murtomaa, Heikki; Tseveenjav, Battsetseg

    2008-01-01

    Interest is growing on conceptualizing dental disease aetiology under the life-course approach. The aim of this study was to assess the association of dental caries experience with the major components of life-course approach, health- and behavioral capital, among Turkish and Finnish pre-adolesce...

  15. Predictors for assessing electronic messaging between nurses and general practitioners as a useful tool for communication in home health care services: a cross-sectional study.

    Science.gov (United States)

    Lyngstad, Merete; Hofoss, Dag; Grimsmo, Anders; Hellesø, Ragnhild

    2015-02-17

    Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care. The aim of this study was to explore home health care nurses' assessments of the utility of the e-messaging system for communicating with GPs and identify elements that influence the assessment of e-messaging as a useful communication tool. The data were collected using a self-developed questionnaire based on variables identified by focus group interviews with home health care nurses (n=425) who used e-messaging and existing research. Data were analyzed using logistic regression analyses. Over two-thirds (425/632, 67.2%) of the home health care nurses returned the questionnaire. A high proportion (388/399, 97.2%) of the home health care nurses who returned the questionnaire found the e-messaging system to be a useful tool for communication with GPs. The odds of reporting that e-messaging was a useful tool were over five times higher (OR 5.1, CI 2.489-10.631, Pcommunicate with GPs. By identifying these elements, it is easier to determine which interventions are the most important for the development and implementation of ICT systems in home health care services.

  16. 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.

  17. 77 FR 48994 - Submission for OMB Review; Comment Request; Population Assessment of Tobacco and Health (PATH) Study

    Science.gov (United States)

    2012-08-15

    ... Institutes of Health (NIH) National Institute on Drug Abuse (NIDA) and in partnership with the Food and Drug... adults, the PATH study is designed to establish a population-based framework for monitoring and... the Family Smoking Prevention and Tobacco Control Act (FSPTCA) to regulate tobacco-product advertising...

  18. Community based interventional study to assess the impact of health education on alcohol use among adult males in Bareilly, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Himalaya Singh

    2017-12-01

    Full Text Available Background: Alcoholic beverages have been a part of social life for millennia, yet societies have always found it difficult to understand or restrain their use. Apart from the health concerns, chronic alcoholism is one of the greatest causes for poverty in the country. Objective: To assess the impact of health education on alcohol use among adult males in Bareilly District, Uttar Pradesh. Material & Methods: A community based interventional study conducted in the Bareilly district among males aged >15 years during November 2015 to April 2017 taking a sample of 699 by 30 cluster sampling with PPS. Data was collected by home visit using WHO-AUDIT (Alcohol Use Disorder Identification Test questionnaire. After data collection, health education was given to study population in form of speech, posters, short films and focus group discussion. One year after providing health education, AUDIT questionnaire was re-filled by current alcohol drinkers to know the impact of health education. Results: Prevalence of drinking alcohol is 30.47% i.e. 213 current drinkers. AUDIT Scores before and after Health education were positively correlated (r=.768, p=0.0001. There was a significant average difference between AUDIT Scores before and after Health education (t178=2.973, p=0.003. Conclusion: Health education has a positive impact on alcohol use therefore research focus should be on primary prevention by health education/behaviour change communication in primary and secondary care settings.

  19. Replacing car trips by increasing bike and public transport in the greater Barcelona metropolitan area: a health impact assessment study.

    Science.gov (United States)

    Rojas-Rueda, D; de Nazelle, A; Teixidó, O; Nieuwenhuijsen, M J

    2012-11-15

    Estimate the health risks and benefits of mode shifts from car to cycling and public transport in the metropolitan area of Barcelona, Spain. We conducted a health impact assessment (HIA), creating 8 different scenarios on the replacement of short and long car trips, by public transport or/and bike. The primary outcome measure was all-cause mortality and change in life expectancy related to two different assessments: A) the exposure of travellers to physical activity, air pollution to particulate matter car trips, starting and ending in Barcelona City, to cycling (n=141,690) would be for the travellers who shift modes 1.15 additional deaths from air pollution, 0.17 additional deaths from road traffic fatality and 67.46 deaths avoided from physical activity resulting in a total of 66.12 deaths avoided. Fewer deaths would be avoided annually if half of the replaced trips were shifted to public transport (43.76 deaths). The annual health impact in the Barcelona City general population (n=1,630,494) of the 40% reduction in car trips would be 10.03 deaths avoided due to the reduction of 0.64% in exposure to PM2.5. The deaths (including travellers and general population) avoided in Barcelona City therefore would be 76.15 annually. Further health benefits would be obtained with a shift of 40% of the car trips from the Greater Barcelona Metropolitan which either start or end in Barcelona City to public transport (40.15 deaths avoided) or public transport and cycling (98.50 deaths avoided).The carbon dioxide reduction for shifting from car to other modes of transport (bike and public transport) in Barcelona metropolitan area was estimated to be 203,251t/CO₂ emissions per year. Interventions to reduce car use and increase cycling and the use of public transport in metropolitan areas, like Barcelona, can produce health benefits for travellers and for the general population of the city. Also these interventions help to reduce green house gas emissions. Copyright © 2012

  20. Assessing Unmet Information Needs of Breast Cancer Survivors: Exploratory Study of Online Health Forums Using Text Classification and Retrieval.

    Science.gov (United States)

    McRoy, Susan; Rastegar-Mojarad, Majid; Wang, Yanshan; Ruddy, Kathryn J; Haddad, Tufia C; Liu, Hongfang

    2018-05-15

    Patient education materials given to breast cancer survivors may not be a good fit for their information needs. Needs may change over time, be forgotten, or be misreported, for a variety of reasons. An automated content analysis of survivors' postings to online health forums can identify expressed information needs over a span of time and be repeated regularly at low cost. Identifying these unmet needs can guide improvements to existing education materials and the creation of new resources. The primary goals of this project are to assess the unmet information needs of breast cancer survivors from their own perspectives and to identify gaps between information needs and current education materials. This approach employs computational methods for content modeling and supervised text classification to data from online health forums to identify explicit and implicit requests for health-related information. Potential gaps between needs and education materials are identified using techniques from information retrieval. We provide a new taxonomy for the classification of sentences in online health forum data. 260 postings from two online health forums were selected, yielding 4179 sentences for coding. After annotation of data and training alternative one-versus-others classifiers, a random forest-based approach achieved F1 scores from 66% (Other, dataset2) to 90% (Medical, dataset1) on the primary information types. 136 expressions of need were used to generate queries to indexed education materials. Upon examination of the best two pages retrieved for each query, 12% (17/136) of queries were found to have relevant content by all coders, and 33% (45/136) were judged to have relevant content by at least one. Text from online health forums can be analyzed effectively using automated methods. Our analysis confirms that breast cancer survivors have many information needs that are not covered by the written documents they typically receive, as our results suggest that at most

  1. Assessment of differences in psychosocial resources and state of health of rural and urban residents – based on studies carried out on students during examination stress

    Directory of Open Access Journals (Sweden)

    Danuta Zarzycka

    2014-11-01

    Full Text Available [b]introduction[/b]. Civilization changes of the environment shaping the psychosocial resources from rural to urban influence human health. [b]aim.[/b] The study aimed to identify the differences due to the place of residence (rural, urban as far as health resources are concerned (social support, sense of coherence, dehydroepiandrosterone sulfate concentration in plasma and health in examination stress situations. The study also determined the concentration of dehydroepiandrosterone sulfate (health resource and cortisol (stress indicator. [b]material and methods.[/b] The psychosocial variables were assessed using the scales: ISEL-48v. Coll., SOC-29, SF-36v.2™ o and analogue scale (perception of examination stress. The study included, based on a stratified sampling (year of study and purposive sampling (written examination, major, 731 students representing the six universities in Lublin, south-east Poland. Among the respondents, 130 students were rural residents. [b]results.[/b] Health resources of students living in rural and urban areas generally differ statistically significantly in social support and the subscales of availability of tangible support, availability of appreciative support, the availability of cognitive-evaluative support and a sense of resourcefulness. The study recorded a sstatistically significantly larger network of family ties among students living in rural areas. The demonstrated diversity of resources did not substantially affect the perceived health, with the exception of pain sensation. Examination stress assessed by subjective opinion of the respondents and plasma cortisol levels vary relative to the place of residence. Students residing in rural areas showed significantly lower cortisol levels values, but subjectively perceived the situation of examation as more stressful. [b]conclusions[/b]. Differences in health resources and their mechanism of impact on health, to a limited extent, were conditioned by the place

  2. 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

  3. 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…

  4. 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…

  5. Three-dimensional framework of vigor, organization, and resilience (VOR) for assessing rangeland health: a case study from the alpine meadow of the Qinghai-Tibetan Plateau, China.

    Science.gov (United States)

    Li, Yuan-yuan; Dong, Shi-kui; Wen, Lu; Wang, Xue-xia; Wu, Yu

    2013-12-01

    Rangeland health assessments play an important role in providing qualitative and quantitative data about ecosystem attributes and rangeland management. The objective of this study is to test the feasible of a modified model and visualize the health in a three-dimensional model. A modified Costanza model was employed, and eight indicators, including the biomass, biodiversity, and carrying capacity [associated with the vigor, organization, and resilience (VOR)] were applied. An entropy method was also developed to calculate the weight of each indicator, and a three-dimensional framework was applied to visualize the indicators and health index. The conceptual model was demonstrated using data from a case study on the alpine rangeland of the Qinghai-Tibetan Plateau, one of the globally important grassland biomes being severely degraded by natural and human factors. The health indices of four grassland plots at different levels of degradation were calculated using a modified approach to measuring their VOR. The results indicated that the least disturbed plot was relatively healthy compared to the other plots. In addition, the health indices presented in the three-dimensional VOR framework decreased in a consistent manner across the four plots along the disturbance gradients. Such rangeland health assessments should be integrated with management efforts to insure their long-term sustainable use.

  6. [Requirements for and expectations of health technology assessment in Galicia (Spain). A qualitative study from the perspective of decision-makers and clinicians].

    Science.gov (United States)

    Varela-Lema, Leonor; Merino, Gerardo Atienza; García, Marisa López; Martínez, María Vidal; Triana, Elena Gervas; Mota, Teresa Cerdá

    2011-01-01

    To explore perceptions of the use of health technology assessment (HTA) in the Galician public health system, identify opinions on the usefulness of the products and services developed by the Galician Health Technology Assessment Agency (avalia-t), and determine the barriers and facilitators to the transfer of results to clinical practice. We performed a qualitative study based on in-depth semi-structured interviews of 20 intentionally selected experts (10 health care professionals and 10 hospital decision makers). The interviews were tape recorded and transcribed for inductive thematic analysis. Interest in HTA activities was high, but most informants considered these activities to be underused as a tool to aid decision making in clinical practice. A series of key factors was identified to guarantee HTA use: greater dissemination of HTA activities and availability of the results, increased involvement and communication among health care professionals in the selection and prioritization of relevant research, contextualization and adaptation of results to the local context, increased organizational support and greater financial resources. The present study allows end-userś opinions on the utility of the various products/services offered by HTA agencies to be contrasted in order to adapt HTA activity to their needs and requirements. The involvement of health care professionals in all HTA fields is perceived as one of the main lines of action for HTA agencies. Such involvement could be achieved by reinforcing personal contact and increasing feedback to collaborators. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. 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...

  8. Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

    Science.gov (United States)

    Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

    2018-02-01

    The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

  9. 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

  10. Assessing the readiness of precision medicine interoperabilty: An exploratory study of the National Institutes of Health genetic testing registry.

    Science.gov (United States)

    Ronquillo, Jay G; Weng, Chunhua; Lester, William T

    2017-11-17

      Precision medicine involves three major innovations currently taking place in healthcare:  electronic health records, genomics, and big data.  A major challenge for healthcare providers, however, is understanding the readiness for practical application of initiatives like precision medicine.   To better understand the current state and challenges of precision medicine interoperability using a national genetic testing registry as a starting point, placed in the context of established interoperability formats.   We performed an exploratory analysis of the National Institutes of Health Genetic Testing Registry.  Relevant standards included Health Level Seven International Version 3 Implementation Guide for Family History, the Human Genome Organization Gene Nomenclature Committee (HGNC) database, and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT).  We analyzed the distribution of genetic testing laboratories, genetic test characteristics, and standardized genome/clinical code mappings, stratified by laboratory setting. There were a total of 25472 genetic tests from 240 laboratories testing for approximately 3632 distinct genes.  Most tests focused on diagnosis, mutation confirmation, and/or risk assessment of germline mutations that could be passed to offspring.  Genes were successfully mapped to all HGNC identifiers, but less than half of tests mapped to SNOMED CT codes, highlighting significant gaps when linking genetic tests to standardized clinical codes that explain the medical motivations behind test ordering.  Conclusion:  While precision medicine could potentially transform healthcare, successful practical and clinical application will first require the comprehensive and responsible adoption of interoperable standards, terminologies, and formats across all aspects of the precision medicine pipeline.

  11. Assessing the readiness of precision medicine interoperabilty: An exploratory study of the National Institutes of Health genetic testing registry

    Directory of Open Access Journals (Sweden)

    Jay G Ronquillo

    2017-11-01

    Full Text Available Background:  Precision medicine involves three major innovations currently taking place in healthcare:  electronic health records, genomics, and big data.  A major challenge for healthcare providers, however, is understanding the readiness for practical application of initiatives like precision medicine. Objective:  To better understand the current state and challenges of precision medicine interoperability using a national genetic testing registry as a starting point, placed in the context of established interoperability formats. Methods:  We performed an exploratory analysis of the National Institutes of Health Genetic Testing Registry.  Relevant standards included Health Level Seven International Version 3 Implementation Guide for Family History, the Human Genome Organization Gene Nomenclature Committee (HGNC database, and Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT.  We analyzed the distribution of genetic testing laboratories, genetic test characteristics, and standardized genome/clinical code mappings, stratified by laboratory setting. Results: There were a total of 25472 genetic tests from 240 laboratories testing for approximately 3632 distinct genes.  Most tests focused on diagnosis, mutation confirmation, and/or risk assessment of germline mutations that could be passed to offspring.  Genes were successfully mapped to all HGNC identifiers, but less than half of tests mapped to SNOMED CT codes, highlighting significant gaps when linking genetic tests to standardized clinical codes that explain the medical motivations behind test ordering.   Conclusion:  While precision medicine could potentially transform healthcare, successful practical and clinical application will first require the comprehensive and responsible adoption of interoperable standards, terminologies, and formats across all aspects of the precision medicine pipeline.

  12. Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

    Science.gov (United States)

    Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

    2016-12-01

    Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study.

    Science.gov (United States)

    Mokkink, Lidwine B; Terwee, Caroline B; Patrick, Donald L; Alonso, Jordi; Stratford, Paul W; Knol, Dirk L; Bouter, Lex M; de Vet, Henrica C W

    2010-05-01

    Aim of the COSMIN study (COnsensus-based Standards for the selection of health status Measurement INstruments) was to develop a consensus-based checklist to evaluate the methodological quality of studies on measurement properties. We present the COSMIN checklist and the agreement of the panel on the items of the checklist. A four-round Delphi study was performed with international experts (psychologists, epidemiologists, statisticians and clinicians). Of the 91 invited experts, 57 agreed to participate (63%). Panel members were asked to rate their (dis)agreement with each proposal on a five-point scale. Consensus was considered to be reached when at least 67% of the panel members indicated 'agree' or 'strongly agree'. Consensus was reached on the inclusion of the following measurement properties: internal consistency, reliability, measurement error, content validity (including face validity), construct validity (including structural validity, hypotheses testing and cross-cultural validity), criterion validity, responsiveness, and interpretability. The latter was not considered a measurement property. The panel also reached consensus on how these properties should be assessed. The resulting COSMIN checklist could be useful when selecting a measurement instrument, peer-reviewing a manuscript, designing or reporting a study on measurement properties, or for educational purposes.

  14. 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

  15. Health risk assessment from contaminated foodstuffs: a field study in chromite mining-affected areas northern Pakistan.

    Science.gov (United States)

    Nawab, Javed; Li, Gang; Khan, Sardar; Sher, Hassan; Aamir, Muhammad; Shamshad, Isha; Khan, Anwarzeb; Khan, Muhammad Amjad

    2016-06-01

    This study aimed to investigate the potential health risk associated with toxic metals in contaminated foodstuffs (fruits, vegetables, and cereals) collected from various agriculture fields present in chromite mining-affected areas of mafic and ultramafic terrains (northern Pakistan). The concentrations of Cr, Ni, Zn, Cd, and Pb were quantified in both soil and food samples. The soil samples were highly contaminated with Cr (320 mg/kg), Ni (108 mg/kg), and Cd (2.55 mg/kg), which exceeded their respective safe limits set by FAO/WHO. Heavy metal concentrations in soil were found in the order of Cr>Ni>Pb>Zn>Cd and showed significantly (p pollution load index (PLI) value was observed greater than three indicating high level of contamination in the study area. The concentrations of Cr (1.80-6.99 mg/kg) and Cd (0.21-0.90 mg/kg) in foodstuffs exceeded their safe limits, while Zn, Pb, and Ni concentrations were observed within their safe limits. In all foodstuffs, the selected heavy metal concentrations were accumulated significantly (p 1 for children and can pose potential health threats for local inhabitants. Graphical Abstract Heavy metals released from chromite mining lead to soil and foodstuff contamination and human health risk.

  16. The Parkin'Play study: protocol of a phase II randomized controlled trial to assess the effects of a health game on cognition in Parkinson's disease.

    Science.gov (United States)

    van de Weijer, Sjors C F; Duits, Annelien A; Bloem, Bastiaan R; Kessels, Roy P; Jansen, Jacobus F A; Köhler, Sebastian; Tissingh, Gerrit; Kuijf, Mark L

    2016-11-03

    In Parkinson's disease (PD), cognitive impairment is an important non-motor symptom heralding the development of dementia. Effective treatments to slow down the rate of cognitive decline in PD patients with mild cognitive impairment are lacking. Here, we describe the design of the Parkin'Play study, which assesses the effects of a cognitive health game intervention on cognition in PD. This study is a multicentre, phase-II, open-randomized clinical trial that aims to recruit 222 PD patients with mild cognitive impairment. Eligible patients have PD, Hoehn & Yahr stages I-III, are aged between 40 and 75 years, and have cognitive impairment but no dementia. The intervention group (n = 111) will be trained using a web-based health game targeting multiple cognitive domains. The control group (n = 111) will be placed on a waiting list. In order to increase compliance the health game adapts to the subjects' performance, is enjoyable, and can be played at home. From each group, 20 patients will undergo fMRI to test for potential functional brain changes underlying treatment. The primary outcome after 12 weeks of training is cognitive function, as assessed by a standard neuropsychological assessment battery and an online cognitive assessment. The neuropsychological assessment battery covers the following domains: executive function, memory, visual perception, visuoconstruction and language. A compound score for overall cognitive function will be calculated as the mean score of all test Z-scores based on the distribution of scores for both groups taken together. Secondary outcomes at follow-up visits up to 24 weeks include various motor and non-motor symptoms, compliance, and biological endpoints (fMRI). This study aims at evaluating whether a cognitive intervention among PD patients leads to an increased cognitive performance on targeted domains. Strengths of this study are a unique web-based health game intervention, the large sample size, a control group without

  17. 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...

  18. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (pmobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  19. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  20. What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study

    Directory of Open Access Journals (Sweden)

    Ahmad Farah

    2012-12-01

    Full Text Available Abstract Background Emerging eHealth tools could facilitate the delivery of comprehensive care in time-constrained clinical settings. One such tool is interactive computer-assisted health-risk assessments (HRA, which may improve provider-patient communication at the point of care, particularly for psychosocial health concerns, which remain under-detected in clinical encounters. The research team explored the perspectives of healthcare providers representing a variety of disciplines (physicians, nurses, social workers, allied staff regarding the factors required for implementation of an interactive HRA on psychosocial health. Methods The research team employed a semi-qualitative participatory method known as Concept Mapping, which involved three distinct phases. First, in face-to-face and online brainstorming sessions, participants responded to an open-ended central question: “What factors should be in place within your clinical setting to support an effective computer-assisted screening tool for psychosocial risks?” The brainstormed items were consolidated by the research team. Then, in face-to-face and online sorting sessions, participants grouped the items thematically as ‘it made sense to them’. Participants also rated each item on a 5-point scale for its ‘importance’ and ‘action feasibility’ over the ensuing six month period. The sorted and rated data was analyzed using multidimensional scaling and hierarchical cluster analyses which produced visual maps. In the third and final phase, the face-to-face Interpretation sessions, the concept maps were discussed and illuminated by participants collectively. Results Overall, 54 providers participated (emergency care 48%; primary care 52%. Participants brainstormed 196 items thought to be necessary for the implementation of an interactive HRA emphasizing psychosocial health. These were consolidated by the research team into 85 items. After sorting and rating, cluster analysis

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

    International Nuclear Information System (INIS)

    Scott, B.R.; Hahn, F.F.; Guilmette, R.A.; Muggenburg, B.A.; Snipes, M.B.; Boecker, B.B.; McClellan, R.O.

    1986-01-01

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

  2. Assessing the Short-Term Global Health Experience: A Cross-Sectional Study of Demographics, Socioeconomic Factors, and Disease Prevalence.

    Science.gov (United States)

    Geen, Olivia; Pumputis, Allison; Kochi, Cristina; Costa, Andrew; Stobbe, Karl

    2017-08-01

    Interest in short-term global health experiences to underserviced populations has grown rapidly in the last few decades. However, there remains very little research on what participants can expect to encounter. At the same time, it has been suggested that in order for physicians and workers to provide safe and effective care, volunteers should have a basic understanding of local culture, health systems, epidemiology, and socioeconomic needs of the community before arriving. Our objective was to add to the limited literature on what short-term global health trips can expect to encounter through a cross-sectional study of patient demographics, socioeconomic markers, and the prevalence of diseases encountered on a short-term medical service trip to Lima, Peru. Descriptive analysis was conducted on clinic data collected from patients living in Pamplona Alta and Pamplona Baja, Lima, Peru, in July 2015. We found that volunteers encountered mainly female patients (70.8%), and that there were significant socioeconomic barriers to care including poverty, poor housing, environmental exposures, and lack of continuity of health care. Analysis of the disease prevalence found a high proportion of acute and chronic musculoskeletal pain in the adult populations (18.8% and 11.4%, respectively), and a high presentation of upper respiratory tract infections (25.4%) and parasites (22.0%) in the pediatric group. These findings can be used by future short-term medical service trips to address potential gaps in care including the organization of weekend clinics to allow access to working men, and the use of patient education and nonpharmacological management of acute and chronic disease.

  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. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

    Science.gov (United States)

    Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France

    2015-08-01

    We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.

  5. Commentary on "The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)": Army STARRS: a Framingham-like study of psychological health risk factors in soldiers.

    Science.gov (United States)

    Ressler, Kerry J; Schoomaker, Eric B

    2014-01-01

    Although historically the Army suicide rate has been significantly lower than the civilian rate, in 2004, the suicide and accidental death rates began trending upward. By 2008, the Army suicide rate had risen above the national average (20.2 per 100,000). In 2009, 160 active duty Soldiers took their lives, making suicide the third leading cause of death among the Army population. If accidental death, frequently the result of high-risk behavior, is included, then more Soldiers died by their own actions than in combat in 2009. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was thus created in 2009 to begin to address these problems. The Army STARRS project is a large consortium of seven different studies to develop data-driven methods for mitigating or preventing suicide behaviors and improving the overall mental health and behavioral functioning of Army Soldiers during and after their Army service. The first research articles from the Army STARRS project were published in late 2013 and early 2014. This work has already begun to outline important facets of risk in the military, and it is helping to drive an empirically derived approach to improvements in understanding mental disorders and risk behavior and to improve prevention and support of mental health and resilience. The Framingham Heart Study, started in the 1940s, marked a watershed event in utilizing large cross-sectional and prospective longitudinal collaborative research to identify and understand risk factors for cardiovascular disease. The Army STARRS project, through its collaborative, prospective, and robust innovative design and implementation, may provide the beginning of a similar scientific cohort in mental disorders. The work of this project will help understand biological and psychological aspects of military service, including those leading to suicide. When coupled with timely feedback to Army leadership, it permits near real-time steps to diagnose, mitigate, and

  6. A Qualitative Study to Assess Barber Perceptions of the Feasibility of the Employer as a Health Advisor for Obesity Prevention.

    Science.gov (United States)

    Roy, Siddhartha; Hansen, Andrew R; Ross, Levi; Larson, Rebecca

    2018-04-01

    Obesity has become a serious issue affecting millions of Americans, especially in the southern United States. One avenue for addressing obesity is the workplace setting. This formative research study examined the feasibility of an obesity prevention worksite intervention in the barbershop for African American barbershop owners (employers) and barbers (employees). The study proposes an intervention where the owner of the barbershop would be trained to educate his barbers about obesity prevention. Twenty in-depth interviews were conducted with the owners ( n = 5) and barbers ( n = 15) of five barbershops in Statesboro, Georgia, to determine the feasibility of the intervention. The results of this study indicated that the owners and barbers all felt that the intervention was feasible and could be implemented in the barbershop. The owners and barbers felt that obesity was an important issue in their community. Additional themes identified include program benefits, empowerment of owners and barbers, and motivational components to help produce healthy habits. The owners felt comfortable educating their barbers about obesity prevention, and the barbers were receptive toward the idea of being educated by their employer. In order for this intervention to be implemented and effective, it must be tailored to fit within the barbershop environment. This intervention addresses known health disparities that exist in the African American community and underscores the need for additional worksite health promotion programs in medically underserved communities.

  7. Assessing the knowledge and attitudes of group of mothers living in Saudi Arabia with regards to their children’s oral health: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    AlBandary AlJameel

    2017-11-01

    Full Text Available Background The knowledge of mothers with respect to health can affect their children’s health either directly by promoting health practices or indirectly by influencing the health-related attitudes and behaviours of children. Aims The aim of this study was to assess the knowledge and attitude of a group of mothers living in Saudi Arabia with regard to their children’s oral health. Methods This cross-sectional study involved 614 mothers living across Saudi Arabia. An electronic web-based questionnaire was developed and distributed among the participants using different social media outlets. Results Almost 80 per cent of study participants were knowledgeable regarding their child’s primary and permanent teeth’s eruption time and agreed that their child’s primary teeth were as important as the permanent teeth. The results also indicated that 79 per cent of the participants were aware that bottle feeding during sleep causes tooth decay and 73.7 per cent knew that the frequency of sugar consumption has a greater impact on oral health than the quantity of sugar consumed. Almost all participants (97 per cent reported that they watch and help their children to brush their teeth. More than half (55.8 per cent of them reported that they take their children for their first dental check-up when the children are one-year old, and almost three-quarters (73 per cent reported they take their children to regular dental check-ups. Conclusion Most mothers had a positive attitude toward their children’s oral health and were reasonably knowledgeable about it; however, further health education is required among some groups and in some aspects particularly those concerning oral and systemic health.

  8. Predictors for Assessing Electronic Messaging Between Nurses and General Practitioners as a Useful Tool for Communication in Home Health Care Services: A Cross-Sectional Study

    Science.gov (United States)

    Hofoss, Dag; Grimsmo, Anders; Hellesø, Ragnhild

    2015-01-01

    Background Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care. Objective The aim of this study was to explore home health care nurses’ assessments of the utility of the e-messaging system for communicating with GPs and identify elements that influence the assessment of e-messaging as a useful communication tool. Methods The data were collected using a self-developed questionnaire based on variables identified by focus group interviews with home health care nurses (n=425) who used e-messaging and existing research. Data were analyzed using logistic regression analyses. Results Over two-thirds (425/632, 67.2%) of the home health care nurses returned the questionnaire. A high proportion (388/399, 97.2%) of the home health care nurses who returned the questionnaire found the e-messaging system to be a useful tool for communication with GPs. The odds of reporting that e-messaging was a useful tool were over five times higher (OR 5.1, CI 2.489-10.631, Pmessaging was easy to use. The odds of finding e-messaging easy to use were nearly seven times higher (OR 6.9, CI 1.713-27.899, P=.007) if the nurses did not consider the system functionality poor. If the nurses had received training in the use of e-messaging, the odds were over six times higher (OR 6.6, CI 2.515-17.437, Pmessaging easy to use. The odds that a home health care nurse would experience e-messaging as easy to use increased as the full-time equivalent percentage of the nurses increased (OR 1.032, CI 1.001-1.064, P=.045). Conclusions This study has shown that technical (ease of use and system functionality), organizational (training), and individual (full

  9. Integrated health and environmental risk assessment and risk management in large industrial areas. Case study Zagreb (CSZ). Final report for 1992

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1992-07-01

    This report is the result of the Phase 1 of the research within the Case Study Zagreb co-financed by the IAEA according to the project YUG/9/029. The basic long term aim of the project is the reduction in hazards to human health and to the environment in the area of Zagreb. This project is about risk assessment and risk management to achieve the environment protection goals.

  10. Integrated health and environmental risk assessment and risk management in large industrial areas. Case study Zagreb (CSZ). Final report for 1992

    International Nuclear Information System (INIS)

    1992-01-01

    This report is the result of the Phase 1 of the research within the Case Study Zagreb co-financed by the IAEA according to the project YUG/9/029. The basic long term aim of the project is the reduction in hazards to human health and to the environment in the area of Zagreb. This project is about risk assessment and risk management to achieve the environment protection goals

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

    Science.gov (United States)

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

    2015-12-01

    Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills. © The Author(s) 2013.

  12. Assessment of Industry-Induced Urban Human Health Risks Related to Benzo[a]pyrene based on a Multimedia Fugacity Model: Case Study of Nanjing, China

    Directory of Open Access Journals (Sweden)

    Linyu Xu

    2015-05-01

    Full Text Available Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP from industrial effluent and gaseous emissions, and established a multi-pathway exposure model based on a Level IV multimedia fugacity model to analyze the human health risks in a city that has undergone rapid industrialization. In this study, GIS tools combined with land-use data was introduced to analyze smaller spatial scales so as to enhance the spatial resolution of the results. An uncertainty analysis using a Monte Carlo simulation was also conducted to illustrate the rationale of the probabilistic assessment mode rather than deterministic assessment. Finally, the results of the case study in Nanjing, China indicated the annual average human cancer risk induced by local industrial emissions during 2002–2008 (lowest at 1.99´10–6 in 2008 and highest at 3.34´10–6 in 2004, which was lower than the USEPA prescriptive level (1´10–6–1´10–4 but cannot be neglected in the long term. The study results could not only instruct the BaP health risk management but also help future health risk prediction and control.

  13. Community based interventional study to assess the impact of health education on alcohol use among adult males in Bareilly, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Himalaya Singh

    2017-12-01

    Full Text Available Background: Alcoholic beverages have been a part of social life for millennia, yet societies have always found it difficult to understand or restrain their use. Apart from the health concerns, chronic alcoholism is one of the greatest causes for poverty in the country. Objective: To assess the impact of health education on alcohol use among adult males in Bareilly District, Uttar Pradesh. Material & Methods: A community based interventional study conducted in the Bareilly district among males aged >15 years during November 2015 to April 2017 taking a sample of 699 by 30 cluster sampling with PPS. Data was collected by home visit using WHO-AUDIT (Alcohol Use Disorder Identification Test questionnaire. After data collection, health education was given to study population in form of speech, posters, short films and focus group discussion. One year after providing health education, AUDIT questionnaire was re-filled by current alcohol drinkers to know the impact of health education. Results: Prevalence of drinking alcohol is 30.47% i.e. 213 current drinkers. AUDIT Scores before and after Health education were positively correlated (r=.768, p=0.0001. There was a significant average difference between AUDIT Scores before and after Health education (t178=2.973, p=0.003. Conclusion: Health education has a positive impact on alcohol use therefore research focus should be on primary prevention by health education/behaviour change communication in primary and secondary care settings.

  14. Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait--a cohort study.

    Science.gov (United States)

    Farran, Bassam; Channanath, Arshad Mohamed; Behbehani, Kazem; Thanaraj, Thangavel Alphonse

    2013-05-14

    We build classification models and risk assessment tools for diabetes, hypertension and comorbidity using machine-learning algorithms on data from Kuwait. We model the increased proneness in diabetic patients to develop hypertension and vice versa. We ascertain the importance of ethnicity (and natives vs expatriate migrants) and of using regional data in risk assessment. Retrospective cohort study. Four machine-learning techniques were used: logistic regression, k-nearest neighbours (k-NN), multifactor dimensionality reduction and support vector machines. The study uses fivefold cross validation to obtain generalisation accuracies and errors. Kuwait Health Network (KHN) that integrates data from primary health centres and hospitals in Kuwait. 270 172 hospital visitors (of which, 89 858 are diabetic, 58 745 hypertensive and 30 522 comorbid) comprising Kuwaiti natives, Asian and Arab expatriates. Incident type 2 diabetes, hypertension and comorbidity. Classification accuracies of >85% (for diabetes) and >90% (for hypertension) are achieved using only simple non-laboratory-based parameters. Risk assessment tools based on k-NN classification models are able to assign 'high' risk to 75% of diabetic patients and to 94% of hypertensive patients. Only 5% of diabetic patients are seen assigned 'low' risk. Asian-specific models and assessments perform even better. Pathological conditions of diabetes in the general population or in hypertensive population and those of hypertension are modelled. Two-stage aggregate classification models and risk assessment tools, built combining both the component models on diabetes (or on hypertension), perform better than individual models. Data on diabetes, hypertension and comorbidity from the cosmopolitan State of Kuwait are available for the first time. This enabled us to apply four different case-control models to assess risks. These tools aid in the preliminary non-intrusive assessment of the population. Ethnicity is seen significant

  15. 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...

  16. Technology assessment and resource allocation for predictive genetic testing: A study of the perspectives of Canadian genetic health care providers

    Directory of Open Access Journals (Sweden)

    Einsiedel Edna

    2009-06-01

    Full Text Available Abstract Background With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. Methods The authors conducted semi-structured interviews with 16 senior lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Results Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Conclusion Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate.

  17. Assessment of psychiatric morbidity among health-care students in a teaching hospital, Telangana state: A cross-sectional questionnaire-based study

    Directory of Open Access Journals (Sweden)

    Udai Kiran

    2017-01-01

    Full Text Available Introduction: Professional education can be a stressful experience for health-care students and may impact negatively on emotional well-being and academic performance which leads to psychiatric morbidity. The aim of this study is to assess the prevalence of psychiatric morbidity among the professional health-care students. Materials and Methods: A cross-sectional study was conducted among professional health-care students in a tertiary care teaching hospital of Telangana state. The information regarding demographic data, academic achievements, and positive and negative events in the recent past was collected using semi-structured pro forma, and the General Health Questionnaire (GHQ-28 is used to assess the psychiatric morbidity. Descriptive analysis and Pearson's correlation analysis were done to analyze the data. Results: A total of 836 students participated in the study, and the overall mean GHQ total score in the study population was 26.8, which is above the cutoff (24 score. The prevalence of psychiatric morbidity among study population is about 58.7%. Academic achievement and negative events in the recent past had effect on psychological morbidity and showed high GHQ scores among study population which was found to be statistically significant. Conclusion: The poor academic performance and negative events had a strong impact on psychological morbidity of students. The higher level of psychological morbidity warrants need for intervention such as social and psychological support to improve the quality of life for the health-care students. Further, a creation of positive academic environment as a teamwork of faculty, administration, educational experts, and students helps to develop psychological healthy dental and medical professionals who can perform better in a coming future.

  18. 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

  19. The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study

    Science.gov (United States)

    Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O’Brien, Katherine L.; Feikin, Daniel R.

    2012-01-01

    To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing. PMID:22403224

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. A Study to Assess Knowledge and Attitude Regarding Hand Hygiene amongst Residents and Nursing Staff in a Tertiary Health Care Setting of Bhopal City.

    Science.gov (United States)

    Maheshwari, Veena; Kaore, Navin Chandra M; Ramnani, Vijay Kumar; Gupta, Sanjay Kumar; Borle, Amod; Kaushal, Rituja

    2014-08-01

    Infection due to hospital-acquired microbes is an evolving problem worldwide, and horizontal transmission of bacterial organism continues to cause a high nosocomial infection rate in health care settings. Most nosocomial infections are thought to be transmitted by the hands of health care workers.The application of hand hygiene is effective in reducing infection rates. To assess the level of knowledge and attitude regarding hand hygiene practices amongst the health care professionals and to identify areas of gaps in their knowledge and attitude. A cross-sectional study. A total 160 respondents were studied about their knowledge and attitude towards hand hygiene practices and significant difference with a p-value of 0.0025 was observed regarding most frequent source of germs responsible for health care associated infections among resident and nurses. A significant difference with p-value of 0.0001 & 0.04 was observed in colonization due to jewellery and artificial nail among the study groups. The attitude regarding correct hand hygiene practices to be followed at all times was found to be better among nurses (62.5%) as compared to residents (21.3%) which was found to be highly significant with p-value hand hygiene practices among the health care workers to provide the current knowledge in the area with a behavioral change in attitudes and practices leading to reduction of nosocomial infections.

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

    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.

  7. [Prevalence of hypertension and assessment of its impact on self-rated health in rural populations: a cross-sectional study in northern Senegal].

    Science.gov (United States)

    Seck, S M; Diop-Dia, A; Dia, D Gueye; Gueye, L

    2015-01-01

    High blood pressure (hypertension) is a growing public health problem, and its impact on the overall health of patients in Africa is not well known. The objective of this study was to determine its prevalence and its influence on self-rated health among people living in rural areas of Senegal. This cross-sectional study was conducted over a two-week period in the rural communities of Labgar and Lougré Thiolly, located in the central northern region of Senegal, in an agricultural area. Randomly recruited volunteers were questioned during direct individual interviews about socio-demographic (age, sex, marital status, education, occupation) and lifestyle data (smoking or alcohol, physical activity). Clinical data (medical history, weight, height, blood pressure, course of treatment) were also collected. Self-rated health (SRH) was assessed by asking if they felt their health was bad or good. We included 627 patients with a mean age of 40.93 ± 17.2 years (range: 15-100 years), 59.9% of them women. Illiteracy and overweight were more common among women than among men, and smoking and alcohol consumption more frequent in men. The overall prevalence of hypertension was 23.4% and did not differ significantly between men (24.9%) and women (22.4%)(P = 0.50). Self-rated health was similar in men and women (with respectively 66.9% and 72.9% reporting good health, P = 0.10). On univariate analysis, the factors associated with perceived health status were age (OR = 1.34, P = 0.04), smoking (OR = 2.16, P = 0.03), educational level (OR = 1.21, P = 0.04), and the presence of hypertension (OR = 0.63, P = 0.05). The multivariate regression analysis showed that among women, advanced age (≥50 years) and hypertension (≥140/90 mmHg) were associated with poorer perceived health, whereas for men, only smoking was significantly correlated with poor health status (OR = 0.41, P = 0.01). This study shows that hypertension is common in this rural area of Senegal and is significantly

  8. An integrated approach to the assessment of the eastern Gulf of Finland health: A case study of coastal habitats

    Science.gov (United States)

    Berezina, Nadezhda A.; Gubelit, Yulia I.; Polyak, Yulia M.; Sharov, Andrey N.; Kudryavtseva, Valentina A.; Lubimtsev, Vasily A.; Petukhov, Vasily A.; Shigaeva, Tatyana D.

    2017-07-01

    Eutrophication and chemical pollution are typical threats to the ecosystem of the Gulf of Finland. This paper aims to make a comprehensive assessment of the environmental status of coastal habitats in the easternmost Gulf of Finland (Neva River estuary) by using different physical, chemical and biotic variables to find cost-effective indicators for further monitoring. During summers of 2014 and 2015 we measured water salinity, phosphorus (eutrophication marker), biomass of harmful filamentous macroalgae (coastline hypoxia inductor), sediment hazardous substances (trace metals, polycyclic aromatic hydrocarbons) and other concomitant characters at 12 sites in the gulf. Also, we analyzed responses of the phytoplankton and benthic organisms, including metal-tolerant and hydrocarbon-oxidizing bacteria, meio- and macrofauna, to these factors. We compared the indicative sensitivity and efficiency of several well-known biotic indices and methods, including a Saprobity system (basing on phytoplankton), Raffaelli and Mason index (meiobenthos), and two macrobenthic derived indices (Goodnight-Whitley Index and Benthic Quality Index). Also, we applied a new index - the embryo malformation frequency in benthic amphipods. To estimate the level of bottom hypoxia induced by the macroalgae blooms, we measured the algal cover and thickness of the algal mats. To verify our assessment, we tested correlations between all used variables. Biotic communities of these areas are subjected to high phosphorus and macroalgae blooms, toxic pollution, water salinity and other factors. We concluded that environmental state of coastal habitats at several southern sites (in Koporskaya Bay and near the developing port Bronka) and near port Primorsk in the north was bad, while the state of the rest of sites was moderate or good. The integrated approach for the assessment may be recommended for monitoring programs as an important tool for studying human-mediated and other effects on brackishwater

  9. A class of non-linear exposure-response models suitable for health impact assessment applicable to large cohort studies of ambient air pollution.

    Science.gov (United States)

    Nasari, Masoud M; Szyszkowicz, Mieczysław; Chen, Hong; Crouse, Daniel; Turner, Michelle C; Jerrett, Michael; Pope, C Arden; Hubbell, Bryan; Fann, Neal; Cohen, Aaron; Gapstur, Susan M; Diver, W Ryan; Stieb, David; Forouzanfar, Mohammad H; Kim, Sun-Young; Olives, Casey; Krewski, Daniel; Burnett, Richard T

    2016-01-01

    The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models.

  10. Health Risk Assessment of Xylene through Microenvironment Monitoring Data: A Case Study of the Petro-Chemical Industries, Thailand

    Directory of Open Access Journals (Sweden)

    Pensri Watchalayann

    2009-01-01

    Full Text Available In the absence of environmental health epidemiology, risk managers, policy makers and health-care authorities usually rely on estimates of human exposure level of proximity to hazardous waste site or regional ambient air quality data. Based on ambient concentrations without considering time-activity patterns, the estimation of personal exposure may be overor underestimated. Twelve villages surrounding the petro-chemical industries located in the eastern region of Thailand were randomly selected to be a representative study area. In each village, air samples were collected at thirty-one microenvironments including indoor and outdoor of a household and workplace. The time-activity patterns of the commuters were also recorded. The ambient xylene concentrations were determined by thermal desorption gas chromatograhy/mass spectrometry. The indoor samples were determined by gas chromatography flame ionization detector. Commuters living in the vicinity of the industrial areas spent most of the time indoor (93.2%, especially at home (66.8%. Individuals spent a significant fraction of the day indoors. The concentrations of xylene ranged from less than 1 μg/m3 to 291.3 μg/m3. The highest level was found at the auto repair shop (291.3 μg/m3. Given micro-environmental concentrations and activity times, the average concentrations of xylene to which commuters may be exposed daily ranged from 90.62 to 134.75 μg/m3. The long term exposure level via inhalation was found to be very low. Collectively, no hazard was indicated by the hazard quotient and the results were found to be similar in all villages.

  11. Quality of life in chemical warfare survivors with ophthalmologic injuries: the first results form Iran Chemical Warfare Victims Health Assessment Study

    Directory of Open Access Journals (Sweden)

    Soroush Mohammad

    2009-01-01

    Full Text Available Abstract Background Iraq used chemical weapons extensively against the Iranians during the Iran-Iraq war (1980–1988. The aim of this study was to assess the health related quality of life (HRQOL in people who had ophthalmologic complications due to the sulfur mustard gas exposure during the war. Methods The Veterans and Martyrs Affair Foundation (VMAF database indicated that there were 196 patients with severe ophthalmologic complications due to chemical weapons exposure. Of these, those who gave consent (n = 147 entered into the study. Quality of life was measured using the 36-item Short Form Health Survey (SF-36 and scores were compared to those of the general public. In addition logistic regression analysis was performed to indicate variables that contribute to physical and mental health related quality of life. Results The mean age of the patients was 44.8 (SD = 8.7 ranging from 21 to 75 years. About one-third of the cases (n= 50 reported exposure to chemical weapons more than once. The mean exposure duration to sulfur mustard gas was 21.6 years (SD = 1.2. The lowest scores on the SF-36 subscales were found to be: the role physical and the general health. Quality of life in chemical warfare victims who had ophthalmologic problems was significantly lower than the general public (P Conclusion The study findings suggest that chemical warfare victims with ophthalmologic complications suffer from poor health related quality of life. It seems that the need for provision of health and support for this population is urgent. In addition, further research is necessary to measure health related quality of life in victims with different types of disabilities in order to support and enhance quality of life among this population.

  12. Exploring Learning Goals and Assessment Approaches for Indigenous Health Education: A Qualitative Study in Australia and New Zealand

    Science.gov (United States)

    Delany, Clare; Doughney, Lachlan; Bandler, Lilon; Harms, Louise; Andrews, Shawana; Nicholson, Patricia; Remedios, Louisa; Edmondson, Wendy; Kosta, Lauren; Ewen, Shaun

    2018-01-01

    In higher education, assessment is key to student learning. Assessments which promote critical thinking necessary for sustained learning beyond university are highly valued. However, the design of assessment tasks to achieve these types of thinking skills and dispositions to act in professional practice has received little attention. This research…

  13. Effects of artificial light at night on human health: A literature review of observational and experimental studies applied to exposure assessment.

    Science.gov (United States)

    Cho, YongMin; Ryu, Seung-Hun; Lee, Byeo Ri; Kim, Kyung Hee; Lee, Eunil; Choi, Jaewook

    2015-01-01

    It has frequently been reported that exposure to artificial light at night (ALAN) may cause negative health effects, such as breast cancer, circadian phase disruption and sleep disorders. Here, we reviewed the literature assessing the effects of human exposure to ALAN in order to list the health effects of various aspects of ALAN. Several electronic databases were searched for articles, published through August 2014, related to assessing the effects of exposure to ALAN on human health; these also included the details of experiments on such exposure. A total of 85 articles were included in the review. Several observational studies showed that outdoor ALAN levels are a risk factor for breast cancer and reported that indoor light intensity and individual lighting habits were relevant to this risk. Exposure to artificial bright light during the nighttime suppresses melatonin secretion, increases sleep onset latency (SOL) and increases alertness. Circadian misalignment caused by chronic ALAN exposure may have negative effects on the psychological, cardiovascular and/or metabolic functions. ALAN also causes circadian phase disruption, which increases with longer duration of exposure and with exposure later in the evening. It has also been reported that shorter wavelengths of light preferentially disturb melatonin secretion and cause circadian phase shifts, even if the light is not bright. This literature review may be helpful to understand the health effects of ALAN exposure and suggests that it is necessary to consider various characteristics of artificial light, beyond mere intensity.

  14. Personal exposure and health risk assessment of carbonyls in family cars and public transports-a comparative study in Nanjing, China.

    Science.gov (United States)

    Xu, Huaizhou; Zhang, Qin; Song, Ninghui; Guo, Min; Zhang, Shenghu; Ji, Guixiang; Shi, Lili

    2017-11-01

    To evaluate passenger health risks associated with inhalation exposure to carbonyl compounds mainly emitted from decoration materials of vehicles, we tested the carbonyl concentrations in interior air of 20 family cars, 6 metro lines, and 5 buses in the city of Nanjing. To assess non-carcinogenic health risks, we compared the data to the health guidelines of China, US Environmental Protection Agency (EPA), and Office of Environmental Health Hazard Assessment (OEHHA), respectively. To assess carcinogenic risks, we followed a standard approach proposed by the OEHHA to calculate lifetime cancer risks (LCR) of formaldehyde and acetaldehyde for various age groups. The results showed that there are formaldehyde, acetaldehyde, and acrolein concentrations in 40, 35, and 50% of family car samples exceeded the reference concentrations (RfCs) provided by Chinese guidelines (GB/T 27630-2011 and GB/T 18883-2002). Whereas, in the tested public transports, concentrations of the three carbonyls were all below the Chinese RfCs. Fifty and 90% of family cars had formaldehyde and acrolein concentrations exceeding the guidelines of OEHHA. Only one public transport sample (one bus) possesses formaldehyde and acetaldehyde concentrations above the chronic inhalation reference exposure limits (RELs). Furthermore, the assessments of carcinogenic risk of formaldehyde and acetaldehyde showed that lifetime cancer risks were higher than the limits of EPA for some family cars and public transports. In the study, buses and metros appear to be relatively clean environments, with total carbonyl concentrations that do not exceed 126 μg/m 3 . In family cars, carbonyl levels showed significant variations from 6.1 to 811 μg/m 3 that was greatly influenced by direct emissions from materials inside the vehicles. Public transports seemed to be the first choice for resident trips as compared to family cars. Graphical abstract ᅟ.

  15. Indicators for early assessment of palliative care in lung cancer patients: a population study using linked health data.

    Science.gov (United States)

    Kelly, Maria; O'Brien, Katie M; Lucey, Michael; Clough-Gorr, Kerri; Hannigan, Ailish

    2018-02-26

    Analysing linked, routinely collected data may be useful to identify characteristics of patients with suspected lung cancer who could benefit from early assessment for palliative care. The aim of this study was to compare characteristics of newly diagnosed lung cancer patients dying within 30 days of diagnosis (short term survivors) with those surviving more than 30 days. To identify indicators for early palliative care assessment we distinguished between characteristics available at diagnosis (age, gender, smoking status, marital status, comorbid disease, admission type, tumour stage and histology) from those available post diagnosis. A second aim was to examine the association between receiving any tumour-directed treatment, place of death and survival time. A retrospective observational population based study comparing lung cancer patients who died within 30 days of diagnosis (short term survivors) with those who survived longer using Chi-squared tests and logistic regression. Incident lung cancer (ICD-03:C34) patients diagnosed 2005-2012 inclusive who died before 01-01-2014 (n = 14,228) were identified from the National Cancer Registry of Ireland linked to death certificate data and acute hospital episode data. One in five newly diagnosed lung cancer patients died within 30 days of diagnosis. After adjusting for stage and histology, death within 30 days was higher in patients who were aged 80 years or older (adjusted OR 2.46; 95%CI 2.05-3.96; p < 0.001), patients with emergency admissions at diagnosis (adjusted OR 2.96; 95%CI 2.61-3.37; p < 0.001) and patients with any comorbidities at diagnosis (adjusted OR 1.32 95%CI 1.15-1.52; p < 0.001). Overall, 75% of those who died within 30 days died in hospital compared to 43% of longer term survivors. We have shown a high proportion of lung cancer patients who die within 30 days of diagnosis are older, have comorbidities and are admitted through the emergency department. These characteristics

  16. Countdown to 2015 country case studies: systematic tools to address the “black box” of health systems and policy assessment

    Directory of Open Access Journals (Sweden)

    Neha S. Singh

    2016-09-01

    Full Text Available Abstract Background Evaluating health systems and policy (HSP change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. Methods International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990–2015 and include: (i Policy and Programme Timeline Tool (depicting change according to level of policy; (ii Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time; (iii Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time; and (iv Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. Results The Policy and Programme Timeline tool shows that Tanzania’s RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas

  17. Studying health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Mulvad, Gert; Olsen, Jørn

    2003-01-01

    Health research in Greenland has contributed with several findings of interest for the global scientific community and has documented health problems and risk factors of importance for planning the local health care system. The study of how health develops in small, scattered communities during...... rapid epidemiological transition carries prospects of global significance. The Inuit are a genetically distinct people living under extreme physical conditions. Their traditional living conditions and diet are currently undergoing a transformation, which may approach their disease pattern...... to that of the industrialized world, while still including local outbreaks of tuberculosis. Health research in Greenland is logistically difficult and costly, but offers opportunities not found elsewhere in the world. A long tradition of registration enhances the possibilities for research. A number of research institutions...

  18. The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study

    NARCIS (Netherlands)

    Scott, J. Anthony G.; Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O'Brien, Katherine L.; Feikin, Daniel R.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.

    2012-01-01

    To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very

  19. Quality of life in chemical warfare survivors with ophthalmologic injuries: the first results form Iran Chemical Warfare Victims Health Assessment Study.

    Science.gov (United States)

    Mousavi, Batool; Soroush, Mohammad Reza; Montazeri, Ali

    2009-01-19

    Iraq used chemical weapons extensively against the Iranians during the Iran-Iraq war (1980-1988). The aim of this study was to assess the health related quality of life (HRQOL) in people who had ophthalmologic complications due to the sulfur mustard gas exposure during the war. The Veterans and Martyrs Affair Foundation (VMAF) database indicated that there were 196 patients with severe ophthalmologic complications due to chemical weapons exposure. Of these, those who gave consent (n = 147) entered into the study. Quality of life was measured using the 36-item Short Form Health Survey (SF-36) and scores were compared to those of the general public. In addition logistic regression analysis was performed to indicate variables that contribute to physical and mental health related quality of life. The mean age of the patients was 44.8 (SD = 8.7) ranging from 21 to 75 years. About one-third of the cases (n= 50) reported exposure to chemical weapons more than once. The mean exposure duration to sulfur mustard gas was 21.6 years (SD = 1.2). The lowest scores on the SF-36 subscales were found to be: the role physical and the general health. Quality of life in chemical warfare victims who had ophthalmologic problems was significantly lower than the general public (P chemical warfare victims with ophthalmologic complications suffer from poor health related quality of life. It seems that the need for provision of health and support for this population is urgent. In addition, further research is necessary to measure health related quality of life in victims with different types of disabilities in order to support and enhance quality of life among this population.

  20. Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

    Science.gov (United States)

    Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

    2017-05-11

    -based algorithms, (3) empirical measurement of indicators using linked administrative health data, (4) validation of indicators, (5) analyses of geographic and temporal variations for reliable and valid indicators, and (6) data visualization. Study populations will consist of 166,670 Swiss and 5,902,037 French residents aged 65 years and older admitted to an acute care hospital at least once during the 2012-2014 period and insured for at least 1 year before admission and 1 year after discharge. We will extract Swiss data from the Helsana Group data warehouse and French data from the national health insurance information system (SNIIR-AM). The study has been approved by Swiss and French ethics committees and regulatory organizations for data protection. Validated GPSIs and GQIs should help support and drive quality and safety improvement in older inpatients, inform health care stakeholders, and enable international comparisons. We discuss several limitations relating to the representativeness of study populations, accuracy of administrative health data, methods used for GPSI criterion validity assessment, and potential confounding bias in comparisons based on GQIs, and we address these limitations to strengthen study feasibility and validity. ©Marie-Annick Le Pogam, Catherine Quantin, Oliver Reich, Philippe Tuppin, Anne Fagot-Campagna, Fred Paccaud, Isabelle Peytremann-Bridevaux, Bernard Burnand. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 11.05.2017.

  1. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study.

    Science.gov (United States)

    van Gelder, Marleen M H J; Schouten, Naomi P E; Merkus, Peter J F M; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

    2015-06-16

    Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman's general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0.61, P=.04), inhalation allergies (0

  2. Airborne particulate metals in the New York City subway: a pilot study to assess the potential for health impacts.

    Science.gov (United States)

    Grass, David S; Ross, James M; Family, Farnosh; Barbour, Jonathan; James Simpson, H; Coulibaly, Drissa; Hernandez, Jennifer; Chen, Yingdi; Slavkovich, Vesna; Li, Yongliang; Graziano, Joseph; Santella, Regina M; Brandt-Rauf, Paul; Chillrud, Steven N

    2010-01-01

    A prior study in New York City observed that airborne concentrations of three metals found in steel - iron, manganese, and chromium - are more than 100 times higher in the subway system than in aboveground air. To investigate the potential for health effects of exposure at these levels, we conducted a pilot study of subway workers comparing personal exposures to steel dust with biomarkers of metal exposure, oxidative stress, and DNA damage in blood and urine samples. Workers wore a personal air sampler operating at 4L/m for one to three work shifts with blood and urine samples collected at the end of the final shift. We found that PM(2.5) exposures varied among subway workers on the basis of job title and job activity. The subway workers' mean time-weighted PM(2.5) exposure was 52 microg/m3, with a median of 27 microg/m3, and a range of 6-469 microg/m3. The observed concentrations of PM(2.5), iron, manganese, and chromium fell well below occupational standards. Biomarker concentrations among the 39 subway workers were compared with a group of 11 bus drivers, and a group of 25 suburban office workers. Concentrations of DNA-protein crosslinks and chromium in plasma were significantly higher in subway workers than in bus drivers, but no significant difference was observed for these biomarkers between subway workers and office workers. Urinary isoprostane concentrations were significantly correlated with the number of years working in the subway system, and were detected at higher, though not significantly higher, concentrations in subway workers than in bus drivers or office workers. At the group level, there was no consistent pattern of biomarker concentrations among subway workers significantly exceeding those of the bus drivers and office workers. At the individual level, steel dust exposure was not correlated with any of the biomarkers measured.

  3. 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.

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

    International Nuclear Information System (INIS)

    Oudinet, Jean-Paul; Meline, Julie; Chelmicki, Wojciech; Sanak, Marek; Magdalena, Dutsch-Wicherek; Besancenot, Jean-Pierre; Wicherek, Stanislas; Julien-Laferriere, Bertrand; Gilg, Jean-Paul; Geroyannis, Helene; Szczeklik, Andrew; Krzemien, Kazimierz

    2006-01-01

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

  5. 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...

  6. 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.

  7. A community-based cluster randomized controlled trial (cRCT) to evaluate the impact and operational assessment of "safe motherhood and newborn health promotion package": study protocol.

    Science.gov (United States)

    Hoque, Dewan Md Emdadul; Chowdhury, Mohiuddin Ahsanul Kabir; Rahman, Ahmed Ehsanur; Billah, Sk Masum; Bari, Sanwarul; Tahsina, Tazeen; Hasan, Mohammad Mehedi; Islam, Sajia; Islam, Tajul; Mori, Rintaro; Arifeen, Shams El

    2018-05-03

    Despite considerable progress in reduction of both under-five and maternal mortality in recent decades, Bangladesh is still one of the low and middle income countries with high burden of maternal and neonatal mortality. The primary objective of the current study is to measure the impact of a comprehensive package of interventions on maternal and neonatal mortality. In addition, changes in coverage, quality and utilization of maternal and newborn health (MNH) services, social capital, and cost effectiveness of the interventions will be measured. A community-based, cluster randomized controlled trial design will be adopted and implemented in 30 unions of three sub-districts of Chandpur district of Bangladesh. Every union, the lowest administrative unit of the local government with population of around 20,000-30,000, will be considered a cluster. Based on the baseline estimates, 15 clusters will be paired for random assignment as intervention and comparison clusters. The primary outcome measure is neonatal mortality, and secondary outcomes are coverage of key interventions like ANC, PNC, facility and skilled provider delivery. Baseline, midterm and endline household survey will be conducted to assess the key coverage of interventions. Health facility assessment surveys will be conducted periodically to assess facility readiness and utilization of MNH services in the participating health facilities. The current study is expected to provide essential strong evidences on the impact of a comprehensive package of interventions to the Bangladesh government, and other developmental partners. The study results may help in prioritizing, planning, and scaling-up of Safe Motherhood Promotional interventions in other geographical areas of Bangladesh as well as to inform other developing countries of similar settings. NCT03032276 .

  8. 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

  9. 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.

  10. A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting.

    Science.gov (United States)

    Addissie, Adamu; Davey, Gail; Newport, Melanie J; Addissie, Thomas; MacGregor, Hayley; Feleke, Yeweyenhareg; Farsides, Bobbie

    2014-05-02

    Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders

  11. Oro-facial pain perception and barriers to assess oral health care among the children with intellectual disability: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    G Radha

    2015-01-01

    Full Text Available Introduction: Dental caries is one of the most prevalent diseases affecting children invariably across the world; a toothache is one of the common outcomes found to be associated with dental caries as pain perception is a subjective phenomenon reporting of pain may vary among different individuals. The aim of this study was to assess the difference in oral health status and pain perception related to oral health status among the children with intellectual disability (ID and their normal counterparts. Materials and Methods: A cross-sectional study was conducted among 100 school children of 9-14 years with or without ID in Bangalore City, ethical clearance and informed consent were obtained. The study involved 50 children with ID and 50 children with non-ID (NID, of age group 9-14 years. A self-administered questionnaire was used to assess participant′s demographic profile, self-assessed medical and dental conditions. Clinical assessment was done for recording dental caries and gingival status. Dental pain was measured using the "Dental Discomfort Questionnaire +" given by Versloot et al. Results: It was found that children with ID had a higher score for D(T, and M(T compared to NID control. This difference was statistically significant. Children with ID showed higher discomfort due to pain. Except for chewing on one side all other questions showed a significant difference between the groups. Conclusion: It was found that children with ID had a higher caries experience compared to NID control and showed significantly higher pain experience than children with NID.

  12. Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

    Science.gov (United States)

    Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

    2013-10-24

    Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was

  13. Collaborative Health Impact Assessment and Policy Development to Improve Air Quality in West Yorkshire—A Case Study and Critical Reflection

    Directory of Open Access Journals (Sweden)

    Yannish Naik

    2017-08-01

    Full Text Available Air pollution is increasingly recognised as a significant problem for cities, with wide ranging impacts on health and quality of life. Combined knowledge of the legal context and health impacts led to air pollution becoming a priority in West Yorkshire. A health impact assessment methodology was used to explore the impacts of low emissions zones, demonstrating significant gains from the implementation of such a measure. This fed in to the collaborative development of the West Yorkshire Low Emissions Strategy (WYLES, resulting in policy changes and an incorporation of health and wellbeing concerns into transport and infrastructure planning, amongst other successes. This case study describes the collaborative approach taken to tackle air pollution locally and summarises key outputs and outcomes of work to date, before providing a critical reflection on what can be learnt from the West Yorkshire experience. This paper will thus interest advocates and stakeholders who are facing similar challenges. Key lessons revolve around broad stakeholder engagement and developing shared ambition. We finally discuss air pollution as a wicked problem, applying the lens of transitions management, a multidisciplinary systems change theory and discuss the local experience in relation to the literature on collaborative public management.

  14. Can health workers reliably assess their own work? A test-retest study of bias among data collectors conducting a Lot Quality Assurance Sampling survey in Uganda.

    Science.gov (United States)

    Beckworth, Colin A; Davis, Rosemary H; Faragher, Brian; Valadez, Joseph J

    2015-03-01

    Lot Quality Assurance Sampling (LQAS) is a classification method that enables local health staff to assess health programmes for which they are responsible. While LQAS has been favourably reviewed by the World Bank and World Health Organization (WHO), questions remain about whether using local health staff as data collectors can lead to biased data. In this test-retest research, Pallisa Health District in Uganda is subdivided into four administrative units called supervision areas (SA). Data collectors from each SA conducted an LQAS survey. A week later, the data collectors were swapped to a different SA, outside their area of responsibility, to repeat the LQAS survey with the same respondents. The two data sets were analysed for agreement using Cohens' kappa coefficient and disagreements were analysed. Kappa values ranged from 0.19 to 0.97. On average, there was a moderate degree of agreement for knowledge indicators and a substantial level for practice indicators. Respondents were found to be systematically more knowledgeable on retest indicating bias favouring the retest, although no evidence of bias was found for practices indicators. In this initial study, using local health care providers to collect data did not bias data collection. The bias observed in the knowledge indicators is most likely due to the 'practice effect', whereby respondents increased their knowledge as a result of completing the first survey, as no corresponding effect was seen in the practices indicators. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  15. 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.

  16. 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

  17. 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

  18. EVALUATION AND INTERPRETATION OF NEURODEVELOPMENTAL ENDPOINTS FOR HUMAN HEALTH RISK ASSESSMENT -- POSITIVE CONTROL STUDIES, NORMAL VARIABILITY AND STATISTICAL ISSUES.

    Science.gov (United States)

    ILSI Research Foundation/Risk Science Institute convened an expert working group to assess the lessons learned from the implementation of the EPA Developmental Neurotoxicity (DNT) Guideline and provide guidance for future use. The group prepared manuscripts in five areas: public ...

  19. 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...

  20. Assessing the Value of High-Quality Care for Work-Associated Carpal Tunnel Syndrome in a Large Integrated Health Care System: Study Design.

    Science.gov (United States)

    Conlon, Craig; Asch, Steven; Hanson, Mark; Avins, Andrew; Levitan, Barbara; Roth, Carol; Robbins, Michael; Dworsky, Michael; Seabury, Seth; Nuckols, Teryl

    2016-01-01

    Little is known about quality of care for occupational health disorders, although it may affect worker health and workers' compensation costs. Carpal tunnel syndrome (CTS) is a common work-associated condition that causes substantial disability. To describe the design of a study that is assessing quality of care for work-associated CTS and associations with clinical outcomes and costs. Prospective observational study of 477 individuals with new workers' compensation claims for CTS without acute trauma who were treated at 30 occupational health clinics from 2011 to 2013 and followed for 18 months. Timing of key clinical events, adherence to 45 quality measures, changes in scores on the Boston Carpal Tunnel Questionnaire and 12-item Short Form Health Survey Version 2 (SF-12v2), and costs associated with medical care and disability. Two hundred sixty-seven subjects (56%) received a diagnosis of CTS and had claims filed around the first visit to occupational health, 104 (22%) received a diagnosis before that visit and claim, and 98 (21%) received a diagnosis or had claims filed after that visit. One hundred seventy-eight (37%) subjects had time off work, which started around the time of surgery in 147 (83%) cases and lasted a median of 41 days (interquartile range = 42 days). The timing of diagnosis varied, but time off work was generally short and related to surgery. If associations of quality of care with key medical, economic, and quality-of-life outcomes are identified for work-associated CTS, systematic efforts to evaluate and improve quality of medical care for this condition are warranted.

  1. 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.

  2. 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.

  3. Potential Health Risk Assessment of Cr, Cu, Fe and Zn for Human Population via Consumption of Commercial Spices; a Case Study of Hamedan City, Iran

    Directory of Open Access Journals (Sweden)

    Sobhanardakani S.* PhD

    2016-09-01

    Full Text Available Abstract Aims: Spices are sources of many bioactive compounds that can improve the taste of food as well as affecting the digestion and metabolism. Along with that, they may also contain some substances as heavy metals, which have harmful effects on the body. The aim of present study was to assess the potential health risk of Cr, Cu, Fe and Zn contents of cardamom, curry powder and turmeric in Hamedan City, Iran. Instrument & Methods: 18 industrially packaged and weighted spice samples (cardamom, curry powder and turmeric belonging to 6 famous brands were bought from different supermarkets of Hamedan City, Iran, in 2015. The human health risks posed by chronic exposure to the heavy metals were assessed by computing the average daily intake of metal. The health risk index (HRI for the local population through the consumption of spice was assessed using DIM/RfD formula. Data were analyzed using ANOVA, DMS post-hoc, Tukey HSD and Pearson's correlation coefficient tests. Findings: Cr was detected in spice samples in 0.08-1.67mg/kg, Cu 0.05-1.28mg/kg, Fe 1.04-6.89mg/kg and Zn 0.40-2.25mg/kg. The mean concentration of Cu, Fe and Zn were lower than MPL. The DIM values for the examined spice samples were below the recommended values. Conclusion: The levels of Cr, Cu, Fe and Zn are less than the MPL in cardamom, curry powder and turmeric in Hamedan City, Iran.

  4. 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

  5. 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...

  6. 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

  7. Contamination source apportionment and health risk assessment of heavy metals in soil around municipal solid waste incinerator: A case study in North China.

    Science.gov (United States)

    Ma, Wenchao; Tai, Lingyu; Qiao, Zhi; Zhong, Lei; Wang, Zhen; Fu, Kaixuan; Chen, Guanyi

    2018-08-01

    Few studies have comprehensively taken into account the source apportionment and human health risk of soil heavy metals in the vicinity of municipal solid waste incinerator (MSWI) in high population density area. In this study, 8 elements (Cr, Pb, Cu, Ni, Zn, Cd, Hg, and As) in fly ash, soil samples from different functional areas and vegetables collected surrounding the MSWI in North China were determined. The single pollution index, integrated Nemerow pollution index, principal component analysis (PCA), absolute principle component score-multiple linear regression (APCS-MLR) model and dose-response model were used in this study. The results showed that the soils around the MSWI were moderately polluted by Cu, Pb, Zn, and Hg, and heavily polluted by As and Cd. MSWI had a significant influence on the distribution of soil heavy metals in different distances from MSWI. The source apportionment results showed that MSWI, natural source, industrial discharges and coal combustion were the four major potential sources for heavy metals in the soils, with the contributions of 36.08%, 29.57%, 10.07%, and 4.55%, respectively. MSWI had a major impact on Zn, Cu, Pb, Cd, and Hg contamination in soil. The non-carcinogenic risk and carcinogenic risk posed by soil heavy metals surrounding the MSWI were unacceptable. The soil heavy metals concentrations and health risks in different functional areas were distinct. MSWI was the predominate source of non-carcinogenic risk with the average contribution rate of 36.99% and carcinogenic risk to adult male, adult female and children with 4.23×10 -4 , 4.57×10 -4 , and 1.41×10 -4 respectively, implying that the impact of MSWI on human health was apparent. This study provided a new insight for the source apportionment and health risk assessment of soil heavy metals in the vicinity of MSWI. Copyright © 2018. Published by Elsevier B.V.

  8. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Likelihood and predictors of detention in patients with personality disorder compared with other mental disorders: A retrospective, quantitative study of Mental Health Act assessments.

    Science.gov (United States)

    Olajide, Kike; Tyrer, Peter; Singh, Swaran P; Burns, Tom; Rugkåsa, Jorun; Thana, Lavanya; Paul, Moli; Islam, Zoebia; Crawford, Mike J

    2016-08-01

    The UK guidelines on the treatment of personality disorder recommend avoiding compulsory treatment except in extreme situations. Little is known about how often patients with personality disorder are detained or how this compares with the treatment of other mental disorders. Our aim is to test the hypothesis that people with personality disorder are infrequently detained under the Mental Health Act (MHA) and that risk factors associated with detention are the same as those for people with other mental disorders. We used a retrospective, quantitative study of MHA assessments. Of the 2 087 assessments undertaken, 204 (9.8%) patients had a diagnosis of personality disorder; 40.7% of assessments in the personality disorder group resulted in detention, as did 69.7% of patients with other mental disorders. A higher proportion of people with personality disorder received no intervention following assessment compared with those with other mental disorders (20.6% vs. 4.7%, p mental disorders. Detention rates in patients with personality disorder are lower than those for other disorders but are still substantial. Risk factors for detention in patients with personality disorder differ from those with other mental disorders. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. [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.

  12. Concurrent and face validity of the MacArthur scale for assessing subjective social status: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Ferreira, Wasney de Almeida; Giatti, Luana; Figueiredo, Roberta Carvalho de; Mello, Heliana Ribeiro de; Barreto, Sandhi Maria

    2018-04-01

    This work assessed the concurrent and face validity of the MacArthur scale, which attempts to capture subjective social status in society, neighborhood and work contexts. The study population comprised a convenience sample made up of 159 adult participants of the ELSA-Brasil cohort study conducted in Minas Gerais between 2012 and 2014. The analysis was conducted drawing on Conceptual Metaphor Theory and using corpus linguistic methods. Concurrent validity was shown to be moderate for the society ladder (Kappaw = 0.55) and good for the neighborhood (Kappaw = 0.60) and work (Kappaw = 0,67) ladders. Face validity indicated that the MacArthur scale really captures subjective social status across indicators of socioeconomic position, thus confirming that it is a valuable tool for the study of social inequalities in health Brazil.

  13. The SF-8 Spanish Version for Health-Related Quality of Life Assessment: Psychometric Study with IRT and CFA Models.

    Science.gov (United States)

    Tomás, José M; Galiana, Laura; Fernández, Irene

    2018-03-22

    The aim of current research is to analyze the psychometric properties of the Spanish version of the SF-8, overcoming previous shortcomings. A double line of analyses was used: competitive structural equations models to establish factorial validity, and Item Response theory to analyze item psychometric characteristics and information. 593 people aged 60 years or older, attending long life learning programs at the University were surveyed. Their age ranged from 60 to 92 years old. 67.6% were women. The survey included scales on personality dimensions, attitudes, perceptions, and behaviors related to aging. Competitive confirmatory models pointed out two-factors (physical and mental health) as the best representation of the data: χ2(13) = 72.37 (p < .01); CFI = .99; TLI = .98; RMSEA = .08 (.06, .10). Item 5 was removed because of unreliability and cross-loading. Graded response models showed appropriate fit for two-parameter logistic model both the physical and the mental dimensions. Item Information Curves and Test Information Functions pointed out that the SF-8 was more informative for low levels of health. The Spanish SF-8 has adequate psychometric properties, being better represented by two dimensions, once Item 5 is removed. Gathering evidence on patient-reported outcome measures is of crucial importance, as this type of measurement instruments are increasingly used in clinical arena.

  14. Ecological assessment of the direct and indirect effects of routine rotavirus vaccination in Merseyside, UK using data from multiple health systems: a study protocol.

    Science.gov (United States)

    Hungerford, Daniel; Vivancos, Roberto; French, Neil; Iturriza-Gomara, Miren; Cunliffe, Nigel

    2014-11-25

    Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. Currently 67 countries include rotavirus vaccine in childhood immunisation programmes, but uptake in Western Europe has been slow. In July 2013, rotavirus vaccine was introduced into the UK's routine childhood immunisation programme. Prior to vaccine introduction in the UK, rotavirus was estimated to result in 750,000 diarrhoea episodes and 80,000 general practice (GP) consultations each year, together with 45% and 20% of hospital admissions and emergency department attendances for acute gastroenteritis, in children under 5 years of age. This paper describes a protocol for an ecological study that will assess rotavirus vaccine impact in the UK, to inform rotavirus immunisation policy in the UK and in other Western European countries. In Merseyside, UK, we will conduct an ecological study using a 'before and after' approach to examine changes in gastroenteritis and rotavirus incidence following the introduction of rotavirus vaccination. Data will be collected on mortality, hospital admissions, nosocomial infection, emergency department attendances, GP consultations and community health consultations to capture all healthcare providers in the region. We will assess both the direct and indirect effects of the vaccine on the study population. Comparisons of outcome indicator rates will be made in relation to vaccine uptake and socioeconomic status. The study has been approved by NHS Research Ethics Committee, South Central-Berkshire REC Reference: 14/SC/1140. Study outputs will be disseminated through scientific conferences and peer-reviewed publications. The study will demonstrate the impact of rotavirus vaccination on the burden of disease from a complete health system perspective. It will identify key areas that require improved data collection tools to maximise the usefulness of this surveillance approach and will provide a template for vaccine evaluations using

  15. Which functionalities are available in the electronic health record systems used by French general practitioners? An assessment study of 15 systems.

    Science.gov (United States)

    Darmon, David; Sauvant, Rémy; Staccini, Pascal; Letrilliart, Laurent

    2014-01-01

    Whereas an unprecedented effort is currently under way worldwide for the implementation of electronic health record (EHR) systems, their capabilities are poorly understood, especially in primary care. The objective of this study was to assess the main functionalities of the EHR systems used in French general practices. Among the 20 EHR systems marketed in France, we assessed the 15 systems used by more than 1500 general practitioners in the Provence-Alpes-Côte d'Azur region in the southeast part of France. Each EHR system was assessed in a general practice office, using two clinical vignettes describing virtual patient consultations. The evaluation criteria were derived from the EuroRec requirements for EHR system quality. The assessment scale included 37 criteria grouped into three sets: background data, consultation data, and exchange functionalities. The scoring system used, totalling 64 points, was based on the validation of the criteria and was adjusted based on the possibility of standardising the data. A high score indicated a good EHR system quality. The median global score was 32 points out of a possible 64 (range: 20-39). The median score was 12 points out of 22 (range: 6-15) for the background data set, 16 points out of 32 (range: 9-22) for the consultation data set, and four points out of 10 (range: 0-6) for the exchange functionalities. No association was found between the number of users and the assessment score of the EHR systems (p=0.79). One third of the EHR systems lacked a problem list and only one of them supported the episode of care. Functionalities noticeably vary among the EHR systems currently used in French primary care. Whereas these systems are globally very focused on drug prescriptions, several core functionalities are frequently lacking. They are also poorly interoperable for healthcare professionals and patients. Further research is necessary to assess their actual use. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Assessment of periodontal health status in postmenopausal women visiting dental hospital from in and around Meerut city: Cross-sectional observational study

    Directory of Open Access Journals (Sweden)

    D Deepa

    2016-01-01

    Full Text Available Background: Puberty, menses, pregnancy, and menopause are the different phases of a woman′s life which have a varied influence on oral health. During the menopause, women go through biological and endocrine changes, particularly in their sex steroid hormone production which affects their health. Because the oral mucosa contains estrogen receptors, variations in hormone levels can be seen directly in the oral cavity leading to a few oral conditions and diseases seen more frequently during postmenopausal years. Objective: The objective of this study is to assess periodontal health status in postmenopausal women in and around Meerut city. Materials and Methods: The study sample comprised ninety postmenopausal women. History of menopause was recorded, and the dental examinations were done by measuring the following parameters of periodontal health: plaque index (PI, gingival index (GI, bleeding on probing (BOP, pocket probing depth, and Russell′s periodontal index. The collected data were subjected to statistical analyses. Results and Conclusion: In the study group, mean age was 55 years, mean missing teeth were 10.3, mean duration of menopause was 9.23. Eleven percent females were completely edentulous, and 5 females had never brushed. Mean PI-s was 1.99, mean GI-s was 1.74, mean BOP was 52.85, and mean Russell′s periodontal index was 4.34. Eleven patients were at the initial stages of destructive periodontal disease, 34 had established destructive periodontal disease while thirty patients had the terminal periodontal disease. These findings suggest that females after menopause are at a risk of developing destructive periodontal disease if proper oral hygiene practices are not followed.

  17. Community Engagement to Optimize the Use of Web-Based and Wearable Technology in a Cardiovascular Health and Needs Assessment Study: A Mixed Methods Approach.

    Science.gov (United States)

    Yingling, Leah R; Brooks, Alyssa T; Wallen, Gwenyth R; Peters-Lawrence, Marlene; McClurkin, Michael; Cooper-McCann, Rebecca; Wiley, Kenneth L; Mitchell, Valerie; Saygbe, Johnetta N; Johnson, Twanda D; Curry, Rev Kendrick E; Johnson, Allan A; Graham, Avis P; Graham, Lennox A; Powell-Wiley, Tiffany M

    2016-04-25

    Resource-limited communities in Washington, D.C. have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited Internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions. The objective of the study was to use qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and Web-based technology by predominantly African American, church-based populations in resource-limited Washington, D.C. neighborhoods. To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). As their first initiative, the Washington, D.C. Cardiovascular Health and Needs Assessment intends to evaluate cardiovascular health, social determinants of health, and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure Internet account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by Internet account usage, wristband utilization, and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts. Study participants (5 males, 3 females) were African American and age 28-70 years. Participant wristbands recorded data on

  18. Assessing relationships between chemical exposure, parasite infection, fish health, and fish ecological status: a case study using chub (Leuciscus cephalus) in the Bílina River, Czech Republic.

    Science.gov (United States)

    Wenger, Michael; Ondracková, Markéta; Machala, Miroslav; Neca, Jirí; Hyrsl, Pavel; Simková, Andrea; Jurajda, Pavel; von der Ohe, Peter; Segner, Helmut

    2010-02-01

    Multiple stressor scenarios, as they are relevant in many watersheds, call for approaches extending beyond conventional chemical-focused approaches. The present study, investigated the fish population, represented by chub (Leuciscus cephalus), in the Bílina River (Czech Republic), which is impacted by various pollution sources and might pose a risk on the fish population. To confirm or reject this hypothesis it was examined whether there exists an association between abundance of chub and exposure to toxic chemicals as well as natural stressors, represented by parasites, and whether health-related suborganismal traits, namely, organ indices, tissue histopathology, and immune parameters, would help in revealing relationships between stressor impact and population status. Toxic pressure was assessed by the toxic unit approach, which gives an integrative estimate of toxic effect concentrations and by measuring the biomarkers cytochrome P4501A and vitellogenin, which indicate exposure to bioavailable arylhydrocarbon- or estrogen receptor ligands. Parasite pressure was estimated by determining abundance and species composition of ecto- and endoparasites of chub. Chub abundance was high upstream in the Bílina, low to zero in the middle stretches, and increased again downstream. Toxic pressure increased in the downstream direction, while parasite intensity decreased in this direction. Health status of chub did not differ clearly between up-, middle-, and downstream sites. Thus, it appears that neither toxic pressure nor parasite pressure nor their combination translates into a change of chub health status. By using varied assessment tools, this study provides evidence against a presumed causative role of toxicants impairing the fish ecological status of the Bílina River. Copyright 2009 SETAC.

  19. mHealth App for Risk Assessment of Pigmented and Nonpigmented Skin Lesions-A Study on Sensitivity and Specificity in Detecting Malignancy.

    Science.gov (United States)

    Thissen, Monique; Udrea, Andreea; Hacking, Michelle; von Braunmuehl, Tanja; Ruzicka, Thomas

    2017-12-01

    With the advent of smartphone devices, an increasing number of mHealth applications that target melanoma identification have been developed, but none addresses the general context of melanoma and nonmelanoma skin cancer identification. In this study a smartphone application using fractal and classical image analysis for the risk assessment of skin lesions is systematically evaluated to determine its sensitivity and specificity in the diagnosis of melanoma and nonmelanoma skin cancer along with actinic keratosis and Bowen's disease. In the Department of Dermatology, Catharina Hospital Eindhoven, The Netherlands, 341 melanocytic and nonmelanocytic lesions were imaged using SkinVision app; 239 underwent histopathological examination, while the rest of 102 lesions were clinically diagnosed as clearly benign and not removed. The algorithm has been calibrated using the images of the first 233 lesions. The calibrated version of the algorithm was used in a subset of 108 lesions, and the obtained results were compared with the medical findings. On the 108 cases used for evaluation the algorithm scored 80% sensitivity and 78% specificity in detecting (pre)malignant conditions. Although less accurate than the dermatologist's clinical eye, the app may offer support to other professionals who are less familiar with differentiating between benign and malignant lesions. An mHealth application for the risk assessment of skin lesions was evaluated. It adds value to diagnosis tools of its type by taking into consideration pigmented and nonpigmented lesions all together and detecting signs of malignancy with high sensitivity.

  20. 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.

  1. 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

  2. Health impact assessments in hospital community benefit: A multiple case study of the use of HIAs at Children’s Hospital Colorado

    Directory of Open Access Journals (Sweden)

    Gregory Jackson Tung

    2017-09-01

    Full Text Available Objective:  To explore the use of Health Impact Assessments (HIAs within non-profit hospital community benefit activities. Methods:  We constructed case studies of three HIAs that were conducted in collaboration with Children’s Hospital Colorado as part of the hospital’s community benefit portfolio. These HIAs were part of a pilot that was funded by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. Results:  HIAs provided Children’s Hospital Colorado with a transparent and systematic process for generating evidence-based recommendations with community and stakeholder feedback within the hospital’s community benefit activities. HIAs were used to generate recommendations to inform community benefit planning activities and to generate public policy recommendations to enhance child health. The case studies highlighted several issues that need to be addressed in order to further advance the use of HIA within hospital community benefit activities including: use of HIA on explicit health issues, hospital capacity for HIA, potentially broadening the scope of HIA recommendations, and the use of HIA to generate recommendations from broad priority areas. Conclusion: HIAs can help meet the need for established, evidence-based, and stakeholder responsive tools and processes to be used within non-profit hospital community benefit activities. In meeting this need, the non-profit hospital community benefit area can potentially serve as a major institutional home for the practice of HIA. There is a need for additional research and practice innovation to further explore and refine the use of HIA within non-profit hospital community benefit activities.

  3. Feasibility of assessing the public health impacts of air pollution reduction programs on a local scale: New Haven accountability case study

    Science.gov (United States)

    Background: New approaches on how to link health surveillance data with environmental and population exposure information are needed in order to examine the health benefits of risk management decisions. Objective: This study's objective was to examine the feasibility of conductin...

  4. Assessing the Potential for Bias From Nonresponse to a Study Follow-up Interview: An Example From the Agricultural Health Study.

    Science.gov (United States)

    Rinsky, Jessica L; Richardson, David B; Wing, Steve; Beard, John D; Alavanja, Michael; Beane Freeman, Laura E; Chen, Honglei; Henneberger, Paul K; Kamel, Freya; Sandler, Dale P; Hoppin, Jane A

    2017-08-15

    Prospective cohort studies are important tools for identifying causes of disease. However, these studies are susceptible to attrition. When information collected after enrollment is through interview or exam, attrition leads to missing information for nonrespondents. The Agricultural Health Study enrolled 52,394 farmers in 1993-1997 and collected additional information during subsequent interviews. Forty-six percent of enrolled farmers responded to the 2005-2010 interview; 7% of farmers died prior to the interview. We examined whether response was related to attributes measured at enrollment. To characterize potential bias from attrition, we evaluated differences in associations between smoking and incidence of 3 cancer types between the enrolled cohort and the subcohort of 2005-2010 respondents, using cancer registry information. In the subcohort we evaluated the ability of inverse probability weighting (IPW) to reduce bias. Response was related to age, state, race/ethnicity, education, marital status, smoking, and alcohol consumption. When exposure and outcome were associated and case response was differential by exposure, some bias was observed; IPW conditional on exposure and covariates failed to correct estimates. When response was nondifferential, subcohort and full-cohort estimates were similar, making IPW unnecessary. This example provides a demonstration of investigating the influence of attrition in cohort studies using information that has been self-reported after enrollment. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Using community participation to assess acceptability of "Contra Caries", a theory-based, promotora-led oral health education program for rural Latino parents: a mixed methods study.

    Science.gov (United States)

    Hoeft, Kristin S; Rios, Sarah M; Pantoja Guzman, Estela; Barker, Judith C

    2015-09-03

    Latino children experience more prevalent and severe tooth decay than non-Hispanic white and non-Hispanic black children. Few theory-based, evaluated and culturally appropriate interventions target parents of this vulnerable population. To fill this gap, the Contra Caries Oral Health Education Program, a theory-based, promotora-led education program for low-income, Spanish-speaking parents of children aged 1-5 years, was developed. This article describes qualitative findings of the acceptability of curriculum content and activities, presents the process of refinement of the curriculum through engaging the target population and promotoras, and presents results from the evaluation assessing the acceptability of the curriculum once implemented. Focus groups were conducted with low-income Spanish-speaking parents of children 1-5 years living in a city in an agricultural area of California. Interviews were digitally recorded, translated and transcribed, checked for accuracy and the resulting data was thematically coded and analyzed using a social constructionist approach. The Contra Caries Oral Health Education Program was then implemented with a separate but similar sample, and after completing the program, participants were administered surveys asking about acceptability and favorite activities of the education program. Data were entered into a database, checked for accuracy, open-ended questions were categorized, and responses to close-ended questions counted. Twelve focus groups were conducted (N = 51), 105 parents attended the Contra Caries Oral Health Education Program, and 83 parents filled out surveys. Complete attendance and retention was high (89% and 90%, respectively). This study found that their children's oral health is a high priority. Parents were not only interested in, but actually attended classes focused on increasing their knowledge and skills with respect to early childhood oral health. The Contra Caries content and format was perceived as

  6. Content of Heavy Metal in the Dust of Leisure Squares and Its Health Risk Assessment-A Case Study of Yanta District in Xi'an.

    Science.gov (United States)

    Shao, Tianjie; Pan, Lihuan; Chen, Zhiqing; Wang, Ruiyuan; Li, Wenjing; Qin, Qing; He, Yuran

    2018-02-25

    Taking Yanta District in Xi'an as the research object, the present study measures the contents of Cadmium (Cd), Lead (Pb), Copper (Cu), Nickel (Ni), and Chromium (Cr) in dust samples and further assesses the health risk of heavy metals intake through dust based on the assessment method of human exposure risk proposed by U.S. EPA, with an aim to investigate the content of heavy metal in the dust of leisure squares and its exposure risk. As the results indicate, the average contents of five heavy metals are obviously higher than the soil background value in Shaanxi Province. Therefore, Cd, Ni, Cu, Pb, and Cr are obviously enriched in urban surface dust in Shaanxi Province, due to the influence of human activities. In addition, it can also be found that the non-carcinogen exposure risk in children is significantly higher than that in adults with the risk values of these five heavy metals all one order of magnitude higher than those of adults. Irrespective of whether addressing the results for children or adults, the non-carcinogen exposure doses of five heavy metals are sorted as Cr > Pb > Cu > Ni > Cd. According to the present situation, for a child, the total non-carcinogenic risk values of five heavy metals have exceeded the safety limit in 11 of the 20 leisure squares in Yanta District of Xi'an. That means the leisure squares are no longer suitable for physical and recreational activities. For the five heavy metals, the average non-carcinogenic risk value of Cr is largest, and causes the largest threat to health in Yanta District, Xi'an. The carcinogenic exposure doses of the heavy metals Cr, Cd, and Ni are very low in respiratory pathways and there is no carcinogenic health risk. In general, the Cr content in dust in domestic cities is higher than that of foreign cities; however, the Pb content is much lower.

  7. Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia

    Directory of Open Access Journals (Sweden)

    Emily Saurman

    2014-07-01

    Full Text Available The Mental Health Emergency Care-Rural Access Program (MHEC-RAP is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

  8. 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 ...

  9. 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 ...

  10. Age-related changes relevant to health in women: design, recruitment, and retention strategies for the Longitudinal Assessment of Women (LAW) study.

    Science.gov (United States)

    Khoo, Soo Keat; O'Neill, Sheila; Travers, Catherine; Oldenburg, Brian

    2008-01-01

    The primary aim was to assess the age-related changes that occur in older women. This paper describes the study rationale and methods, recruitment, and retention strategies. The Longitudinal Assessment of Women (LAW) Study was a longitudinal, observational, and multidisciplinary evaluation of a population-based cohort of urban-living women, aged between 40 and 80 years at recruitment and randomly invited from a district in Brisbane (a city in Australia) via the electoral roll. Five hundred eleven women were recruited and stratified into four age groups (40-49, 50-59, 60-69, 70-79 years) and were assessed on three or four occasions each year, using interviews and diagnostic instruments (echocardiography, applination tonometry, dual-energy x-ray absorptiometry [DEXA]) Retention strategies included flexibility, accessibility, personalized attention, and feedback. From a sample frame of 1598 names, there were 1082 respondents, of whom 511 (47%) were successfully recruited from those eligible to participate. Recruitment was quickest for the oldest age group, 70-79 years, and slowest for the age group 40-49 years; all age groups achieved their required quota. A scheduling program was developed to minimize the number of visits and maximize the use of allocated time. The largest dropout was seen in year 1 of the study, with very few thereafter. Of the 9 deaths, cancer was the cause in 7. The retention rate after 5 years was 95.5%. The design of the present study, with careful attention to coordination and a personal approach, facilitated the completion of a 5-year study, enabling a collection of a set of wide-ranging data from almost all the women recruited. The information thus collected will form the basis of cross-linking analysis of the risk factors associated with health problems in aging women.

  11. A study of the psychometric properties of 12-item World Health Organization Disability Assessment Schedule 2.0 in a large population of people with chronic musculoskeletal pain.

    Science.gov (United States)

    Saltychev, Mikhail; Bärlund, Esa; Mattie, Ryan; McCormick, Zachary; Paltamaa, Jaana; Laimi, Katri

    2017-02-01

    To assess the validity of the Finnish translation of the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Cross-sectional cohort survey study. Physical and Rehabilitation Medicine outpatient university clinic. The 501 consecutive patients with chronic musculoskeletal pain. Exploratory factor analysis and a graded response model using item response theory analysis were used to assess the constructs and discrimination ability of WHODAS 2.0. The exploratory factor analysis revealed two retained factors with eigenvalues 5.15 and 1.04. Discrimination ability of all items was high or perfect, varying from 1.2 to 2.5. The difficulty levels of seven out of 12 items were shifted towards the elevated disability level. As a result, the entire test characteristic curve showed a shift towards higher levels of disability, placing it at the point of disability level of +1 (where 0 indicates the average level of disability within the sample). The present data indicate that the Finnish translation of the 12-item WHODAS 2.0 is a valid instrument for measuring restrictions of activity and participation among patients with chronic musculoskeletal pain.

  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. Statistical health-effects study

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  14. Transform: assessing the potential of e-health to transform patient recruitment and follow-up in primary care studies.

    NARCIS (Netherlands)

    Mastellos, N.; Andreasson, A.; Curcin, V.; Verheij, R.; Hek, K.; Car, J.; Delaney, B.

    2014-01-01

    Background: Opportunistic recruitment to clinical studies is a particularly demanding process for GPs, patients and researchers. To date, this is performed manually using paper-based administration methods. The EU FP7-funded TRANSFoRm project team is currently finalising the tools to enable

  15. 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

  16. Defect assessment benchmark studies

    International Nuclear Information System (INIS)

    Hooton, D.G.; Sharples, J.K.

    1995-01-01

    Assessments of the resistance to fast fracture of the beltline region of a PWR vessel subjected to a pressurized thermal shock (PTS) transient have been carried out using the procedures of French (RCC-M) and German (KTA) design codes, and comparisons made with results obtained using the R6 procedure as applied for Sizewell B. The example chosen for these comparisons is of a generic nature, and is taken as the PTS identified by the Hirsch addendum to the Second Marshall report (1987) as the most severe transient with regard to vessel integrity. All assessment methods show the beltline region of the vessel to be safe from the risk of fast fracture, but by varying factors of safety. These factors are discussed in terms of margins between limiting and reference defect sizes, fracture toughness and stress intensity factor, and material temperature and temperature at the onset of upper-shelf materials behaviour. Based on these studies, consideration is given to issues involved in the harmonization of those sections of the design codes which are concerned with methods for the demonstration of the avoidance of the risk of failure by fast fracture. (author)

  17. 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

  18. Groundwater nitrogen pollution and assessment of its health risks: a case study of a typical village in rural-urban continuum, China.

    Directory of Open Access Journals (Sweden)

    Yang Gao

    Full Text Available Protecting groundwater from nitrogen contamination is an important public-health concern and a major national environmental issue in China. In this study, we monitored water quality in 29 wells from 2009 to 2010 in a village in Shanghai city, whick belong to typical rural-urban continuum in China. The total N and NO(3-N exhibited seasonal changes, and there were large fluctuations in NH(4-N in residential areas, but without significant seasonal patterns. NO(2-N in the water was not stable, but was present at high levels. Total N and NO(3-N were significantly lower in residential areas than in agricultural areas. The groundwater quality in most wells belonged to Class III and IV in the Chinese water standard, which defines water that is unsuitable for human consumption. Our health risk assessments showed that NO(3-N posed the greatest carcinogenic risk, with risk values ranging from 19×10(-6 to 80×10(-6, which accounted for more than 90% of the total risk in the study area.

  19. Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team.

    Science.gov (United States)

    Nanton, Veronica; Appleton, Rebecca; Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

    2017-07-28

    The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by

  20. Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team

    Science.gov (United States)

    Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

    2017-01-01

    Background The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Objective Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. Methods A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Results Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to

  1. [Risk assessment work-related stress. pilot study on perceived stress, quality of health and work problems in a sample of workers of judicial offices in rome.

    Science.gov (United States)

    Berivi, Sandra; Grassi, Antonio; Russello, Carla; Palummieri, Antonio

    2017-11-01

    In 2008, it was introduced by the Legislature legislation which provided the inclusion of Article 28, paragraph 1 of Legislative Decree. N. 81/2008, which stipulates for businesses and public authorities a duty to assess, among a variety of risks that could threaten the safety and health of workers (chemical, biological risk, etc) and also the work-related stress. The implementation of this decree is, therefore, specified as "work-related stress" as one of the subjects of mandatory assessment risks. The decree, then entrusted to the Permanent Consultative Commission for health and safety at work the task to "prepare the necessary information for the risk assessment of work-related stress", subsequently issued on 17/11/2010 in the form of a "methodological path which represents the minimum level of implementation of the obligation". In light of this regulatory framework, we established our pilot study, with the objective of analyzing a growing occupational discomfort. This objective has been diffused and palpable, but very difficult to define, in a sample of employees of the Judiciary Lazio Offices. The study was commissioned by Law Committee of Guarantee of Equal Opportunity Enhancement of Welfare Work and those against Discrimination (CUG) of the Judicial Offices Romans of the Court of Appeal of Rome also contributed to its realization. The data collected from the administration of two standardized questionnaires was analyzed (Questionnaire-gauge instrument INAIL and the SF-12 v1). More evidently in this pilot study, there was a serious problem in the organizational dimension, in specific, in Managerial Support. Just as it appears, the study sample is perceived "less healthy", both physically and mentally, than the Italian normative sample. Although the sample is only a part of the study population, 26% of workers of the Judicial Offices Romans, the data obtained shows however, from both a quantitative and qualitative view point, a significant occupational stress

  2. 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,…

  3. 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

  4. 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.

  5. Evaluation of health risks related to the operation of the AREVA sites of the Tricastin platform: Georges Besse plants I and II, SOCATRI, COGEMA Pierrelatte and COMURHEX (first level approach) Assessment of health studies. Final report

    International Nuclear Information System (INIS)

    Mandin, C.

    2006-03-01

    This document reports the study of health risks related to the chemical toxicity of species related to the operation of several AREVA installations in Tricastin. A qualitative and quantitative inventory of the species released in the atmosphere and in waters is based on data supplied by the operator. A selection of health tracers has lead to a global investigation of nitrogen oxides, sulphur dioxide, fluorine, uranium, arsenic, hexavalent chromium, mercury and nickel. The hazard associated with each of these species has been characterized. Different exposure ways have been considered: inhalation, soil ingestion, by vegetable, fruit and crop ingestion, ingestion of meat, milk and eggs produced by local breeding, fish ingestion, and ingestion of water sampled from the Tricastin aquifer. Atmospheric concentrations, soil deposits, surface soil layer concentrations, and other concentrations (in meat, milk, eggs, crops, vegetables, fruits, and drinking water) have been either modelled or measured. Different exposure scenarios have been defined, and the different risks (carcinogen or not) have been assessed

  6. 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.

  7. Multiple assessment methods of prenatal exposure to radio frequency radiation from telecommunication in the Mothers and Children’s Environmental Health (MOCEH study

    Directory of Open Access Journals (Sweden)

    Kyung-Hwa Choi

    2016-12-01

    Full Text Available Objectives: To evaluate prenatal exposure to radiofrequency radiation (RFR from telecommunication using a mobile phone questionnaire, operator data logs of mobile phone use and a personal exposure meter (PEM. Material and Methods: The study included 1228 mother–infants pairs from the Mothers and Children’s Environmental Health (MOCEH study – a multicenter prospective cohort study ongoing since 2006, in which participants were enrolled at ≤ 20 weeks of pregnancy, with a follow-up of a child birth and growth to assess the association between prenatal environmental exposure and children’s health. The questionnaire included the average calling frequency per day and the average calling time per day. An EME Spy 100 PEM was used to measure RFR among 269 pregnant women from November 2007 to August 2010. The operators’ log data were obtained from 21 participants. The Spearman’s correlation test was performed to evaluate correlation coefficient and 95% confidence intervals between the mobile phone use information from the questionnaire, operators’ log data, and data recorded by the PEM. Results: The operators’ log data and information from the self-reported questionnaire showed significantly high correlations in the average calling frequency per day (ρ = 0.6, p = 0.004 and average calling time per day (ρ = 0.5, p = 0.02. The correlation between information on the mobile phone use in the self-reported questionnaire and exposure index recorded by the PEM was poor. But correlation between the information of the operators’ log data and exposure index for transmission of mobile communication was significantly high: correlation coefficient (p-value was 0.44 (0.07 for calling frequency per day, and it was 0.49 (0.04 for calling time per day. Conclusions: The questionnaire information on the mobile phone use showed moderate to high quality. Using multiple methods for exposure assessment might be better than using only one method. Int J Occup

  8. Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe

    Directory of Open Access Journals (Sweden)

    Marta Aymerich

    2009-10-01

    Full Text Available Marta Aymerich1, Imma Guillamón2, Albert J Jovell3,41Medical Sciences Department, University of Girona, Catalonia, Spain; 2Catalan Agency for Health Technology Assessment and Research, Barcelona, Catalonia, Spain; 3Fundació Biblioteca Josep Laporte, Barcelona, Catalonia, Spain; 4Autonomous University of Barcelona, Catalonia, SpainObjectives: To measure the health-related quality of life (HRQoL of multiple sclerosis (MS patients and their caregivers, and to assess which factors can best describe HRQoL.Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL.Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS and 551 caregivers (mean age 45.4 years participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3. Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3. Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL.Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context.Keywords: health-related quality of life, multiple sclerosis

  9. Co-occurrence of tobacco product use, substance use, and mental health problems among adults: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study.

    Science.gov (United States)

    Conway, Kevin P; Green, Victoria R; Kasza, Karin A; Silveira, Marushka L; Borek, Nicolette; Kimmel, Heather L; Sargent, James D; Stanton, Cassandra; Lambert, Elizabeth; Hilmi, Nahla; Reissig, Chad J; Jackson, Kia J; Tanski, Susanne E; Maklan, David; Hyland, Andrew J; Compton, Wilson M

    2017-08-01

    Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems. Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females. This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Study protocol for the Integra Initiative to assess the benefits and costs of integrating sexual and reproductive health and HIV services in Kenya and Swaziland

    Directory of Open Access Journals (Sweden)

    Warren Charlotte E

    2012-11-01

    Full Text Available Abstract Background In sub-Saharan Africa (SSA there are strong arguments for the provision of integrated sexual and reproductive health (SRH and HIV services. Most HIV transmissions are sexually transmitted or associated with pregnancy, childbirth, and breastfeeding. Many of the behaviours that prevent HIV transmission also prevent sexually transmitted infections and unintended pregnancies. There is potential for integration to increase the coverage of HIV services, as individuals who use SRH services can benefit from HIV services and vice-versa, as well as increase cost-savings. However, there is a dearth of empirical evidence on effective models for integrating HIV/SRH services. The need for robust evidence led a consortium of three organizations – International Planned Parenthood Federation, Population Council and the London School of Hygiene & Tropical Medicine – to design/implement the Integra Initiative. Integra seeks to generate rigorous evidence on the feasibility, effectiveness, cost and impact of different models for delivering integrated HIV/SRH services in high and medium HIV prevalence settings in SSA. Methods/design A quasi-experimental study will be conducted in government clinics in Kenya and Swaziland – assigned into intervention/comparison groups. Two models of service delivery are investigated: integrating HIV care/treatment into 1 family planning and 2 postnatal care. A full economic-costing will be used to assess the costs of different components of service provision, and the determinants of variations in unit costs across facilities/service models. Health facility assessments will be conducted at four time-periods to track changes in quality of care and utilization over time. A two-year cohort study of family planning/postnatal clients will assess the effect of integration on individual outcomes, including use of SRH services, HIV status (known/unknown and pregnancy (planned/unintended. Household surveys within some

  11. Impact of wastewater on fish health: a case study at the Neckar River (Southern Germany) using biomarkers in caged brown trout as assessment tools.

    Science.gov (United States)

    Vincze, Krisztina; Scheil, Volker; Kuch, Bertram; Köhler, Heinz R; Triebskorn, Rita

    2015-08-01

    The present work describes a field survey aiming at assessing the impact of a sewage treatment plant (STP) effluent on fish health by means of biomarkers. Indigenous fish were absent downstream of the STP. To elucidate the reason behind this, brown trout (Salmo trutta f. fario) were exposed in floating steel cages up- and downstream of a STP located at the Neckar River near Tübingen (Southern Germany), for 10 and 30 days. A combination of biomarker methods (histopathological investigations, analysis of the stress protein Hsp70, micronucleus test, B-esterase assays) offered the possibility to investigate endocrine, geno-, proteo- and neurotoxic effects in fish organs. Biological results were complemented with chemical analyses on 20 accumulative substances in fish tissue. Even after short-term exposure, biomarkers revealed clear evidence of water contamination at both Neckar River sites; however, physiological responses of caged brown trout were more severe downstream of the STP. According to this, similar bioaccumulation levels (low μg/kg range) of DDE and 12 polycyclic aromatic hydrocarbons (PAHs) were detected at both sampling sites, while up to fourfold higher concentrations of four PAHs, methyl-triclosan and two synthetic musks occurred in the tissues of downstream-exposed fish. The results obtained in this study suggest a constitutive background pollution at both sites investigated at the Neckar River and provided evidence for the additional negative impact of the STP Tübingen on water quality and the health condition of fish.

  12. Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality.

    Science.gov (United States)

    Necyk, Candace; Tsuyuki, Ross T; Boon, Heather; Foster, Brian C; Legatt, Don; Cembrowski, George; Murty, Mano; Barnes, Joanne; Charrois, Theresa L; Arnason, John T; Ware, Mark A; Rosychuk, Rhonda J; Vohra, Sunita

    2014-03-28

    To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. Cross-sectional study of screened patients. 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30 July 2011. The participating pharmacy staff screened consecutive patients, or agents of patients, who were dropping or picking up prescription medications. Patients were screened to determine the proportions of them using prescription drugs and/or NHPs, as well as their respective AE rates. All AEs reported by the screened patients who took a NHP, consented to, and were available for, a detailed telephone interview (14%) were adjudicated fully to assess for causality. Over a total of 105 pharmacy weeks and 1118 patients screened, 410 patients reported taking prescription drugs only (36.7%; 95% CI 33.9% to 39.5%), 37 reported taking NHPs only (3.3%; 95% CI 2.4% to 4.5%) and 657 reported taking prescription drugs and NHPs concurrently (58.8%; 95% CI 55.9% to 61.6%). In total, 54 patients reported an AE, representing 1.2% (95% CI 0.51% to 2.9%), 2.7% (95% CI 0.4% to 16.9%) and 7.3% (95% CI 5.6% to 9.6%) of each population, respectively. Compared with patients who reported using prescription drugs, the patients who reported using prescription drugs and NHPs concurrently were 6.4 times more likely to experience an AE (OR; 95% CI 2.52 to 16.17; ppharmacies take NHPs and prescription drugs concurrently, and of those, 7.4% (95% CI 6.3% to 8.8%) report an AE. A substantial proportion of community pharmacy patients use prescription drugs and NHPs concurrently; these patients are at a greater risk of experiencing an AE. Active surveillance provides a means of detecting such AEs and collecting high-quality data on which causality assessment can be based.

  13. Quality of Life among Turkish Immigrants in Sweden: a Study for Assessing the Measurement Properties of the World Health Organization’s Quality of Life 100 Instrument

    Directory of Open Access Journals (Sweden)

    Nazan Bilgel

    2011-04-01

    Full Text Available Many instruments have been developed to measure the multidimensional construct of quality of life. One of them has been developed by the World Health Organization (WHOQOL-100 and adapted into different languages and cultures around the world. The authors of this study wanted to assess the measurement properties of the Turkish version of WHOQOL-100, to find out the latent factors underlying quality of life, and to determine the direction and magnitude of the interdependent effects among these factors by using structural equation modeling (SEM. The measurement properties of the Turkish version of WHOQOL-100 scale were assessed on 520 voluntary participants who were immigrants in Stockholm/Sweden. SEM gave us one second-order factor QOL and the five correlated first-order factors labelled: physical, social relations, psychological, environment and independence. In the model for total participants, all the factor loadings were high (ranging from 0.60 to 0.92 except for “sexuality” which was 0.47, indicating a strong association between each of the latent factors and their respective items. In the models which were separately constructed regarding birthplace, the authors found a strong association between each of the latent factors and their respective items. The most substantial possible effect on QOL was psychological domain (0.93, which was larger than physical health (0.84, social relations (0.82, level of independence (0.91 and environment (0.73. The effect of psychological domain on the overall quality of life is greater than those of other domains.

  14. Assessing the quality of media reporting of suicide news in India against World Health Organization guidelines: A content analysis study of nine major newspapers in Tamil Nadu.

    Science.gov (United States)

    Armstrong, Gregory; Vijayakumar, Lakshmi; Niederkrotenthaler, Thomas; Jayaseelan, Mala; Kannan, Ramya; Pirkis, Jane; Jorm, Anthony F

    2018-05-01

    Suicide rates in India are among the highest in the world, resulting in an estimated 250,000 suicide deaths annually. How the media communicates with the Indian public on the topic of suicide has thus far gone without sufficient scrutiny. The objective of our study was to assess the quality of newspaper reporting of suicide-related news in India against World Health Organization suicide reporting guidelines. We used content analysis to assess the quality of suicide reporting against World Health Organization guidelines in nine of the most highly read daily newspapers in the southern state of Tamil Nadu between June and December 2016. Five of the nine newspapers under review were in the top 20 most circulated daily newspapers in the country. A total of 1681 suicide articles were retrieved. The mean number of suicide articles per day per newspaper was 0.9%, and 54.5% of articles were 10 sentences or less. The vast majority (95.9%) of articles primarily focused on reporting specific suicide incidents. Harmful reporting practices were very common (e.g. a detailed suicide method was reported in 43.3% of articles), while helpful reporting practices were rare (e.g. just 2.5% gave contact details for a suicide support service). We observed that a daily diet of short and explicit suicide-related news was served up to readers of newspapers. Attempts should be made to understand the perspectives of media professionals in relation to suicide reporting, and to devise strategies to boost the positive contribution that media can make to suicide prevention.

  15. 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.

  16. Assessment and Evaluation of Quality of Life (OHRQoL) of Patients with Dental Implants Using the Oral Health Impact Profile (OHIP-14) - A Clinical Study.

    Science.gov (United States)

    Alzarea, Bader K

    2016-04-01

    Peri-implant tissue health is a requisite for success of dental implant therapy. Plaque accumulation leads to initiation of gingivitis around natural teeth and peri-implantitis around dental implants. Peri-implantitis around dental implants may result in implant placement failure. For obtaining long-term success, timely assessment of dental implant site is mandatory. To assess and evaluate Quality of Life (OHRQoL) of individuals with dental implants using the Oral Health Impact Profile (OHIP-14). Total 92 patients were evaluated for assessment of the health of peri-implant tissues by recording, Plaque Index (PI), Probing Pocket Depth (PD), Bleeding On Probing (BOP) and Probing Attachment Level (PAL) as compared to contra-lateral natural teeth (control). In the same patients Quality of Life Assessment was done by utilizing Oral Health Impact Profile Index (OHIP-14). The mean plaque index around natural teeth was more compared to implants and it was statistically significant. Other three dimensions mean bleeding on probing; mean probing attachment level and mean pocket depth around both natural teeth and implant surfaces was found to be not statistically significant. OHIP-14 revealed that patients with dental implants were satisfied with their Oral Health-Related Quality of Life (OHRQoL). Similar inflammatory conditions are present around both natural teeth and implant prostheses as suggested by results of mean plaque index, mean bleeding on probing, mean pocket depth and mean probing attachment level, hence reinforcing the periodontal health maintenance both prior to and after incorporation of dental implants. Influence of implant prostheses on patient's oral health related quality of life (as depicted by OHIP-14) and patients' perceptions and expectations may guide the clinician in providing the best implant services.

  17. 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.

  18. 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

  19. 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.

  20. Mental health assessment in health checks of participants aged 30-49 years: A large-scale cohort study

    DEFF Research Database (Denmark)

    Geyti, Christine; Maindal, Helle Terkildsen; Dalsgaard, Else-Marie

    2018-01-01

    Helbredsundersøgelser af den brede befolkning er et omdebatteret emne. Dette studie viser, at screening for psykiske problemer som en del af et helbredstjek kan identificere sårbare personer, der ellers ikke ville få hjælp fra læger eller psykologer til at håndtere deres psykiske problemer. Studiet...... alle med dårlig mental sundhed, der har behov for læge- eller psykologhjælp, men at så stor en del ikke har modtaget nogen hjælp til deres psykiske problemer, tyder på, helbredstjekket kan opspore en del personer, der ikke får den hjælp, de har brug for. Studiet er et vigtigt indspark i debatten om...

  1. 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.

  2. 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.

  3. Misperceptions of harm among Natural American Spirit smokers: results from wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014).

    Science.gov (United States)

    Pearson, Jennifer L; Johnson, Amanda; Villanti, Andrea; Glasser, Allison M; Collins, Lauren; Cohn, Amy; Rose, Shyanika W; Niaura, Raymond; Stanton, Cassandra A

    2017-03-01

    This study estimated differences in cigarette harm perceptions among smokers of the Natural American Spirit (NAS) brand-marketed as 'natural', 'organic' and 'additive-free'-compared to other smokers, and examined correlates of NAS use. Data were drawn from wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of US adults (2013-2014). Weighted analyses using a subset of current adult smokers (n=10 565) estimated the prevalence of NAS use (vs all other brands) and examined associations between NAS use and sociodemographics, tobacco/substance use, tobacco harm perceptions, quit intentions, quit attempts and mental/behavioural health. Overall, 2.3% of adult smokers (920 000 people in the USA) reported NAS as their usual brand. Nearly 64% of NAS smokers inaccurately believed that their brand is less harmful than other brands compared to 8.3% of smokers of other brands, after controlling for potential confounders (aOR 22.82). Younger age (18-34 vs 35+; aOR 1.54), frequent thinking about tobacco harms (aOR 1.84), past 30-day alcohol use (aOR 1.57), past 30-day marijuana use (aOR 1.87) and sexual orientation (lesbian, gay, bisexual, 'other' or 'questioning' vs heterosexual; aOR 2.07) were also associated with increased odds of smoking NAS. The majority of NAS smokers inaccurately believes that their cigarettes are less harmful than other brands. Given the brand's rapid growth and its more common use in vulnerable groups (eg, young adults, lesbian, gay, bisexual, 'other' or 'questioning' adults), corrective messaging and enforcement action are necessary to correct harm misperceptions of NAS cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Complexity assessed by the intermed in patients with somatic symptom disorder visiting a specialized outpatient mental health care setting: : A cross sectional study complexity of patients with ssd

    NARCIS (Netherlands)

    van Eck van der Sluijs, J.F.; de Vroege, L.; van Manen, A.S.; Rijnders, C.A.Th.; van der Feltz-Cornelis, C.F.

    2017-01-01

    Background Somatic symptom disorders (SSD), a new classification in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition is associated with problematic diagnostic procedures and treatment that lead to complex care. In somatic health care, the INTERMED has been used to assess

  5. 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.

  6. 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.

  7. Human Health Risk Assessment due to Global Warming – A Case Study of the Gulf Countries

    Directory of Open Access Journals (Sweden)

    Junaid Rafi Chaudhary

    2008-11-01

    Full Text Available Accelerated global warming is predicted by the Intergovernmental Panel on Climatic Change (IPCC due to increasing anthropogenic greenhouse gas emissions. The climate changes are anticipated to have a long-term impact on human health, marine and terrestrial ecosystems, water resources and vegetation. Due to rising sea levels, low lying coastal regions will be flooded, farmlands will be threatened and scarcity of fresh water resources will be aggravated. This will in turn cause increased human suffering in different parts of the world. Spread of disease vectors will contribute towards high mortality, along with the heat related deaths. Arid and hot climatic regions will face devastating effects risking survival of the fragile plant species, wild animals, and other desert ecosystems. The paper presents future changes in temperature, precipitation and humidity and their direct and indirect potential impacts on human health in the coastal regions of the Gulf countries including Yemen, Oman, United Arab Emirates, Qatar, and Bahrain. The analysis is based on the long-term changes in the values of temperature, precipitation and humidity as predicted by the global climatic simulation models under different scenarios of GHG emission levels. Monthly data on temperature, precipitation, and humidity were retrieved from IPCC databases for longitude 41.25°E to 61.875°E and latitude 9.278°N to 27.833°N. Using an average of 1970 to 2000 values as baseline, the changes in the humidity, temperature and precipitation were predicted for the period 2020 to 2050 and 2070 to 2099. Based on epidemiological studies on various diseases associated with the change in temperature, humidity and precipitation in arid and hot regions, empirical models were developed to assess human health risk in the Gulf region to predict elevated levels of diseases and mortality rates under different emission scenarios as developed by the IPCC.The preliminary

  8. 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.

  9. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda-a cross sectional study.

    Science.gov (United States)

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham; Clarke, Sîan E; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip; Mbonye, Anthony K

    2016-07-15

    Private facilities are the first place of care seeking for many sick children. Involving these facilities in child health interventions may provide opportunities to improve child welfare. The objective of this study was to assess the potential of rural and urban private facilities in diagnostic capabilities, operations and human resource in the management of malaria, pneumonia and diarrhoea. A survey was conducted in pharmacies, private clinics and drug shops in Mukono district in October 2014. An assessment was done on availability of diagnostic equipment for malaria, record keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis was done. A total of 241 private facilities were assessed with only 47 (19.5 %) being in rural areas. Compared to urban areas, rural private facilities were more likely to be drug shops (OR 2.80; 95 % CI 1.23-7.11), less likely to be registered (OR 0.31; 95 % CI 0.16-0.60), not have trained clinicians, less likely to have people with tertiary education (OR 0.34; 95 % CI 0.17-0.66) and less likely to have zinc tablets (OR 0.38; 95 % CI 0.19-0.78). In both urban and rural areas, there was low usage of stock cards and patient registers. About half of the facilities in both rural and urban areas attended to at least one sick child in the week prior to the interview. There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health interventions need to build capacity of private facilities with special focus on rural areas where child mortality is higher and capacity of facilities lower.

  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. 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.

  12. 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.

  13. 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)

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. Indicators of dependence for different types of tobacco product users: Descriptive findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study.

    Science.gov (United States)

    Strong, David R; Pearson, Jennifer; Ehlke, Sarah; Kirchner, Thomas; Abrams, David; Taylor, Kristie; Compton, Wilson M; Conway, Kevin P; Lambert, Elizabeth; Green, Victoria R; Hull, Lynn C; Evans, Sarah E; Cummings, K Michael; Goniewicz, Maciej; Hyland, Andrew; Niaura, Raymond

    2017-09-01

    With no established standard for assessing tobacco dependence (TD) across tobacco products in surveys, the Population Assessment of Tobacco and Health (PATH) Study provides a unique platform for examining the psychometric properties and validity of multiple indicators of tobacco dependence across a range of tobacco products. A U.S. nationally representative sample from the 32,320 adult Wave 1 interviews with analyses focused on 14,287 respondents who were current established users of tobacco products. This analysis confirms a single primary latent construct underlying responses to TD indicators for cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco products. Mutually exclusive past year tobacco-user groups included: cigarette only (n=8689), e-cigarette only (n=437), cigar only (traditional, cigarillo, or filtered) (n=706), hookah only (n=461), smokeless tobacco only (n=971), cigarette plus e-cigarette (n=709), and multiple tobacco product users (n=2314). Differential Item Functioning (DIF) analyses supported use of 16 of the 24 examined TD indicators for comparisons across tobacco users. With cigarette users as a reference (mean=0.0, SD=1.0), we observed a range of TD with hookah (mean=-1.71) and cigar (mean=-1.92) only users being the lowest, and cigarette plus e-cigarette product users being the highest (mean=0.35). Regression models including sociodemographic factors supported concurrent validity with increased product use frequency and TD among cigarette-only (p<0.001), e-cigarette only (p<0.002), cigar (p<0.001), hookah only (p<0.001), and smokeless tobacco users (p<0.001). The PATH Study Adult Wave 1 Questionnaire provided psychometrically valid measures of TD that enables future regulatory investigations of nicotine dependence across tobacco products. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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.

  20. 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

  1. Self-assessment of eligibility for early medical abortion using m-Health to calculate gestational age in Cape Town, South Africa: a feasibility pilot study.

    Science.gov (United States)

    Momberg, Mariette; Harries, Jane; Constant, Deborah

    2016-04-16

    Although abortion is legally available in South Africa, barriers to access exist. Early medical abortion is available to women with a gestational age up to 63 days and timely access is essential. This study aimed to determine women's acceptability and ability to self-assess eligibility for early medical abortion using an online gestational age calculator. Women's acceptability, views and preferences of using mobile technology for gestational age (GA) determination were explored. No previous studies to ascertain the accuracy of online self-administered calculators in a non-clinical setting have been conducted. A convenience sample of abortion seekers were recruited from two health care clinics in Cape Town, South Africa in 2014. Seventy-eight women were enrolled and tasked with completing an online self-assessment by entering the first day of their last menstrual period (LMP) onto a website which calculated their GA. A short survey explored the feasibility and acceptability of employing m-Health technology in abortion services. Self-calculated GA was compared with ultrasound gestational age obtained from clinical records. Participant mean age was 28 (SD 6.8), 41% (32/78) had completed high school and 73% (57/78) reported owning a smart/feature phone. Internet searches for abortion information prior to clinic visit were undertaken by 19/78 (24%) women. Most participants found the online GA calculator easy to use (91%; 71/78); thought the calculation was accurate (86%; 67/78) and that it would be helpful when considering an abortion (94%; 73/78). Eighty-three percent (65/78) reported regular periods and recalled their LMP (71%; 55/78). On average women overestimated GA by 0.5 days (SD 14.5) and first sought an abortion 10 days (SD 14.3) after pregnancy confirmation. Timely access to information is an essential component of effective abortion services. Advances in the availability of mobile technology represent an opportunity to provide accurate and safe abortion

  2. 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.

  3. 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.

  4. 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

  5. Randomized controlled trial for assessment of Internet of Things system to guide intensive glucose control in diabetes outpatients : Nagoya Health Navigator Study protocol

    OpenAIRE

    Onoue, Takeshi; Goto, Motomitsu; Kobayashi, Tomoko; Tominaga, Takashi; Ando, Masahiko; Honda, Hiroyuki; Yoshida, Yasuko; Tosaki, Takahiro; Yokoi, Hisashi; Kato, Sawako; Maruyama, Shoichi; Arima, Hiroshi

    2017-01-01

    ABSTRACT The Internet of Things (IoT) allows collecting vast amounts of health-relevant data such as daily activity, body weight (BW), and blood pressure (BP) automatically. The use of IoT devices to monitor diabetic patients has been studied, but could not evaluate IoT-dependent effects because health data were not measured in control groups. This multicenter, open-label, randomized, parallel group study will compare the impact of intensive health guidance using IoT and conventional medical ...

  6. Health-related quality-of-life assessment in CLEOPATRA, a phase III study combining pertuzumab with trastuzumab and docetaxel in metastatic breast cancer.

    Science.gov (United States)

    Cortés, J; Baselga, J; Im, Y-H; Im, S-A; Pivot, X; Ross, G; Clark, E; Knott, A; Swain, S M

    2013-10-01

    The phase III CLEOPATRA study demonstrated that combining pertuzumab with trastuzumab plus docetaxel significantly improves progression-free and overall survival in previously untreated HER2-positive metastatic breast cancer. Here, we report health-related quality-of-life (HRQoL) results from CLEOPATRA. Participants were randomly assigned to pertuzumab or placebo, each given with trastuzumab plus docetaxel every 3 weeks. Pertuzumab and trastuzumab were administered until progression and six or more docetaxel cycles were recommended. Time from randomization to a ≥ 5-point decrease in Trial Outcome Index-Physical/Functional/Breast (TOI-PFB) of the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire was analyzed as a prespecified secondary end point. A post hoc exploratory analysis investigated time to ≥ 2-point deterioration in Breast Cancer Subscale (BCS) score. Time to ≥ 5-point decline in TOI-PFB did not differ significantly between the pertuzumab and placebo arms [hazard ratio (HR), 0.97; P = 0.7161]. The median times to TOI-PFB deterioration were 18.4 and 18.3 weeks, respectively (approximately six cycles). The mean TOI-PFB declined slightly until week 18 and recovered thereafter. Pertuzumab increased time until BCS deterioration versus placebo (median 26.7 versus 18.3 weeks; HR, 0.77; P = 0.0061). Combining pertuzumab with trastuzumab and docetaxel had no adverse impact on HRQoL and may prolong time to worsening of breast cancer-specific symptoms.

  7. Assessing relationships between chemical exposure, parasite infection, fish health, and fish ecological status: a case study using chub (Leuciscus cephalus) in the Bílina River, Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Wenger, M.; Ondračková, Markéta; Machala, M.; Neča, J.; Hyršl, P.; Šimková, A.; Jurajda, Pavel; von der Ohe, P.; Segner, H.

    2010-01-01

    Roč. 29, č. 2 (2010), s. 453-466 ISSN 0730-7268 R&D Projects: GA MŠk LC522 Grant - others:6th Framework Programme EC(XE) MODELKEY (511237-GOCE) Institutional research plan: CEZ:AV0Z60930519 Keywords : multiple stressors * environmental risk assessment * exposure biomarkers * parasites * fish health Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 3.026, year: 2010

  8. Audit and Assessment Studies

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Craig [Tlingit-Haida Regional Housing Authority, Juneau, AK (United States)

    2016-03-22

    Project to assess 46 low-income multifamily residences owned and managed by THRHA in up to 14 southeast Alaska communities. The Objective of project was to identify efficiency measures to reduce energy costs by 30% for low-income multifamily housing by; 1. Decreasing energy demand by increasing multifamily housing energy efficiency; 2. Reducing household energy consumption through energy conservation education and installation of energy upgrades; and 3. Projecting energy savings based on fossil fuel reduction to environmentally and economically benefit Tribal southeast communities

  9. 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

  10. 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.

  11. Health-related quality of life assessment in people with multiple sclerosis and their family caregivers. A multicenter study in Catalonia (Southern Europe)

    Science.gov (United States)

    Aymerich, Marta; Guillamón, Imma; Jovell, Albert J

    2009-01-01

    Objectives: To measure the health-related quality of life (HRQoL) of multiple sclerosis (MS) patients and their caregivers, and to assess which factors can best describe HRQoL. Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL. Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS) and 551 caregivers (mean age 45.4 years) participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3). Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3). Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL. Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context. PMID:19936174

  12. 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.

  13. 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.

  14. 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.

  15. Mobile App Delivery of the EORTC QLQ-C30 Questionnaire to Assess Health-Related Quality of Life in Oncological Patients: Usability Study.

    Science.gov (United States)

    Kessel, Kerstin A; Vogel, Marco Me; Alles, Anna; Dobiasch, Sophie; Fischer, Hanna; Combs, Stephanie E

    2018-02-20

    Mobile apps are evolving in the medical field. However, ongoing discussions have questioned whether such apps are really valuable and whether patients will accept their use in day-to-day clinical life. Therefore, we initiated a usability study in our department. We present our results of the first app prototype and patient testing of health-related quality of life (HRQoL) assessment in oncological patients. We developed an app prototype for the iOS operating system within eight months in three phases: conception, initial development, and pilot testing. For the HRQoL assessment, we chose to implement only the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30; German version 3). Usability testing was conducted for three months. Participation was voluntary and pseudonymized. After completion of the QLQ-C30 questionnaire using iPads provided by our department, we performed a short survey with 10 questions. This survey inquired about patients' opinions regarding general aspects, including technical advances in medicine, mobile and app assistance during cancer treatment, and the app-specific functions (eg, interface and navigation). After logging into the app, the user can choose between starting a questionnaire, reviewing answers (administrators only), and logging out. The questionnaire is displayed with the same information, questions, and answers as on the original QLQ-C30 sheet. No alterations in wording were made. Usability was tested with 81 patients; median age was 55 years. The median time for completing the HRQoL questionnaire on the iPad was 4.0 minutes. Of all participants, 84% (68/81) owned a mobile device. Similarly, 84% (68/81) of participants would prefer a mobile version of the HRQoL questionnaire instead of a paper-based version. Using the app in daily life during and after cancer treatment would be supported by 83% (67/81) of participants. In the prototype version of the app, data were

  16. 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.

  17. Characteristics of Hookah Tobacco Smoking Sessions and Correlates of Use Frequency Among US Adults: Findings From Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study.

    Science.gov (United States)

    Robinson, Joelle N; Wang, Baoguang; Jackson, Kia J; Donaldson, Elisabeth A; Ryant, Chase A

    2018-05-03

    Hookah tobacco smoking has increased in the United States. However, information on hookah use frequency and other characteristics of hookah use is limited. Investigators analyzed data from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of US youth and adults. Our analysis draws on baseline data from adult (ages ≥18 years) ever (N = 10 624) and past year (n = 3947) hookah users. Bivariate and regression analyses were conducted to identify associations between demographics, use characteristics, and hookah use frequency. Overall, 16.4% of adults reported ever smoking tobacco from a hookah. Of those, 31.9% reported smoking hookah within the past year. Among 3947 past-year hookah tobacco smokers, 10.7% were daily/weekly users, 13.7% were monthly users, 42.1% smoked every couple of months, and 33.5% smoked about once a year. Among daily/weekly hookah users, 66% were young adults (ages 18-24 years). When comparing daily/weekly hookah users to those who smoked every couple of months, more frequent hookah use was associated with younger age, male gender, a greater number of times the hookah is refilled during a session, fewer people sharing, and hookah ownership. Although there were few demographic differences between daily/weekly users and less frequent hookah tobacco smokers, some notable differences in use behaviors exist among use frequency groups. Unlike other tobacco products, hookah is often smoked communally, over an extended time period. A detailed understanding of hookah user characteristics and experiences could inform hookah-specific measures, messaging, and regulations. To our knowledge, this is one of the first studies to characterize hookah use frequency, session length, and other hookah use experiences using a nationally representative sample of US adult hookah smokers. Understanding characteristics of hookah tobacco smokers, their use experiences, and patterns of hookah use

  18. 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.

  19. Is Clinical Assessment of Addiction Severity of Individuals with Substance Use Disorder, Using the Addiction Severity Index, A Predictor of Future Inpatient Mental Health Hospitalization? A Nine-Year Registry Study.

    Science.gov (United States)

    Padyab, Mojgan; Armelius, Bengt-Åke; Armelius, Kerstin; Nyström, Siv; Blom, Björn; Grönlund, Ann-Sofie; Lundgren, Lena

    2018-04-23

    In Sweden, the Addiction Severity Index (ASI) is the Swedish National Board of Health and Welfare's recommended substance use disorder assessment tool and used routinely for patient intakes. Our study of 213 individuals assessed for substance use disorder with the ASI used nine years of the National Patient Register and examined whether clinical social workers' assessments of addiction severity at baseline were associated with later hospitalizations for mental health disorder (MHD). ASI composite scores and interviewer severity rating were used to measure clients' problems in seven areas (mental health, family and social relationships, employment, alcohol, drug use, health, and legal) at baseline. A stepwise regression method was used to assess the relative importance of ASI composite scores, MHD hospitalization two years prior to baseline, age, and gender for MHD hospitalization seven years post-baseline. Almost two-thirds of the individuals (63%) were hospitalized at least once for MHD in the seven years post-baseline. At the multivariable level, MHD hospitalization prior to baseline was the strongest predictor of future MHD hospitalization, followed by ASI composite scores for drug use, employment, mental health and, last, male gender. A key finding is that higher ASI composite scores for drug use and mental health are predictors of future need for MHD treatment. Future studies will replicate this effort with a national population of individuals with substance use disorder.

  20. 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...

  1. 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

  2. Assessment of critical thinking: a Delphi study.

    Science.gov (United States)

    Paul, Sheila A

    2014-11-01

    Nurse educators are responsible for preparing nurses who critically analyze patient information and provide meaningful interventions in today's complex health care system. By using the Delphi research method, this study, utilized the specialized and experiential knowledge of Certified Nurse Educators. This original Delphi research study asked Certified Nurse Educators how to assess the critical-thinking ability of nursing students in the clinical setting. The results showed that nurse educators need time, during the clinical experience, to accurately assess each individual nursing student. This study demonstrated the need for extended student clinical time, and a variety of clinical learning assessment tools. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. 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...

  4. Cohort profile update: 2004 Pelotas (Brazil) Birth Cohort Study. Body composition, mental health and genetic assessment at the 6 years follow-up.

    Science.gov (United States)

    Santos, Iná S; Barros, Aluísio J D; Matijasevich, Alicia; Zanini, Roberta; Chrestani Cesar, Maria Aurora; Camargo-Figuera, Fabio Alberto; Oliveira, Isabel O; Barros, Fernando C; Victora, Cesar G

    2014-10-01

    This is an update of the 2004 Pelotas Birth Cohort profile, originally published in 2011. In view of the high prevalence of overweight and mental health problems among Brazilian children, together with the availability of state-of-the-art equipment to assess body composition and diagnostic tests for mental health in childhood, the main outcomes measured in the fifth follow-up (mean age 6.8 years) included child body composition, mental health and cognitive ability. A total of 3722 (90.2%) of the original mothers/carers were interviewed and their children examined in a clinic where they underwent whole-body dual X-ray absorptiometry (DXA), air displacement plethysmography and a 3D photonic scan. Saliva samples for DNA were obtained. Clinical psychologists applied the Development and Well-Being Assessment questionnaire and the Wechsler Intelligence Scale for Children to all children. Results are being compared with those of the two earlier cohorts to assess the health effects of economic growth and full implementation of public policies aimed at reducing social inequalities in the past 30 years. For further information visit the programme website at [http://www.epidemio-ufpel.org.br/site/content/coorte_2004/questionarios.php]. Applications to use the data should be made by contacting 2004 cohort researchers and filling in the application form available at [http://www.epidemio-ufpel.org.br/site/content/estudos/formularios.php]. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  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. 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. 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

  10. Assessing Exposures to Magnetic Resonance Imaging’s Complex Mixture of Magnetic Fields for In Vivo, In Vitro, and Epidemiologic Studies of Health Effects for Staff and Patients

    Directory of Open Access Journals (Sweden)

    Jennifer Frankel

    2018-03-01

    Full Text Available A complex mixture of electromagnetic fields is used in magnetic resonance imaging (MRI: static, low-frequency, and radio frequency magnetic fields. Commonly, the static magnetic field ranges from one to three Tesla. The low-frequency field can reach several millitesla and with a time derivative of the order of some Tesla per second. The radiofrequency (RF field has a magnitude in the microtesla range giving rise to specific absorption rate values of a few Watts per kilogram. Very little attention has been paid to the case where there is a combined exposure to several different fields at the same time. Some studies have shown genotoxic effects in cells after exposure to an MRI scan while others have not demonstrated any effects. A typical MRI exam includes muliple imaging sequences of varying length and intensity, to produce different types of images. Each sequence is designed with a particular purpose in mind, so one sequence can, for example, be optimized for clearly showing fat water contrast, while another is optimized for high-resolution detail. It is of the utmost importance that future experimental studies give a thorough description of the exposure they are using, and not just a statement such as “An ordinary MRI sequence was used.” Even if the sequence is specified, it can differ substantially between manufacturers on, e.g., RF pulse height, width, and duty cycle. In the latest SCENIHR opinion, it is stated that there is very little information regarding the health effects of occupational exposure to MRI fields, and long-term prospective or retrospective cohort studies on workers are recommended as a high priority. They also state that MRI is increasingly used in pediatric diagnostic imaging, and a cohort study into the effects of MRI exposure on children is recommended as a high priority. For the exposure assessment in epidemiological studies, there is a clear difference between patients and staff and further work is needed on this

  11. 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

  12. 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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Shea Beverley

    2006-09-01

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

  15. Health Care Industry Study

    Science.gov (United States)

    2002-01-01

    press conference with President Toledo of Peru on March 23, 2002, President Bush proclaimed, “education, jobs, and health care are the greatest...allow patients with chronic illnesses such as diabetes and high blood pressure to “visit” their doctors “on-line” while in the comfort and privacy of...to maintain a healthy lifestyle. As a result, non-communicable disease such as 10 heart disease, stroke, diabetes , and cancer are prevalent throughout

  16. Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina); J.L. Bosch (Johanna); L.R. Arends (Lidia); M.H. Heijenbrok-Kal (Majanka); M.G.M. Hunink (Myriam)

    2007-01-01

    textabstractObjectives: The Medical Outcomes Study Short Form 36-Item Health Survey (SF-36) is the most widely used generic instrument to estimate quality of life of patients on renal replacement therapy. Purpose of this study was to summarize and compare the published literature on quality of

  17. Health risk assessment as an approach to manage an old landfill and to propose integrated solid waste treatment: A case study in Italy.

    Science.gov (United States)

    Paladino, O; Massabò, M

    2017-10-01

    The aim of the present paper is to show how an approach based on human health risk analysis can be used as a decisional tool for the evaluation of impacts on population and for deciding between different waste treatment processes. The situation in which the increasing production of solid wastes cannot be confined in the old existing Municipal Solid Waste landfill (settled in Genoa, Liguria Region, Italy) is used as a case study. Risk assessment for human health due to air, surface water, groundwater and soil contamination is performed in different scenarios for the old landfill and compared with alternative Waste-to-Energy management solutions that consider thermal treatment by gasification of the total waste or gasification of the dry fraction coupled with anaerobic digestion of the wet fraction, plus biogas combustion with or without sludge and bottom ash/slag disposal in the old landfill. Hazard Index (HI) and Cancer Risk (CR) in case of operating landfill and under the suspected situation of failure of the sealing system, were respectively 1.15 and 1.1∗10 -7 . Unacceptable HI were found due to groundwater contamination, while HI due to river pollution was slightly under the threshold. Vegetables ingestion was the most important pathway and ammonia the most responsible of toxic adverse effects. Fish ingestion and dermal contact with contaminated water were found to be the most important exposure pathways for carcinogenic risk, due mainly to BTEX. HI and CR in the supposed scenario of total waste gasification were respectively 9.4∗10 -1 and 1.1∗10 -5 while they were respectively 3.2∗10 -1 and 6∗10 -6 in case of gasification of the dry fraction. CR in both scenarios was over the threshold mainly due to dioxins, where milk and meat ingestion were found to be the highest risk pathways. Inhalation resulted as the highest not-carcinogenic risk exposure pathway, mainly due to NOx. Decision making was made by weighing up the different scenarios, and results

  18. 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.

  19. 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 ...

  20. 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…

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

    Science.gov (United States)

    Ljunge, Martin

    2016-09-01

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

  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. Reproducibility and Validity of Dietary Patterns Assessed by a Food Frequency Questionnaire Used in the 5-Year Follow-Up Survey of the Japan Public Health Center-Based Prospective Study

    OpenAIRE

    Nanri, Akiko; Shimazu, Taichi; Ishihara, Junko; Takachi, Ribeka; Mizoue, Tetsuya; Inoue, Manami; Tsugane, Shoichiro

    2012-01-01

    Background Analysis of dietary pattern is increasingly popular in nutritional epidemiology. However, few studies have examined the validity and reproducibility of dietary patterns. We assessed the reproducibility and validity of dietary patterns identified by a food frequency questionnaire (FFQ) used in the 5-year follow-up survey of the Japan Public Health Center-Based Prospective Study (JPHC Study). Methods The participants were a subsample (244 men and 254 women) from the JPHC Study. Princ...

  4. Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany.

    Science.gov (United States)

    Samkange-Zeeb, Florence; Ernst, Sinja Alexandra; Klein-Ellinghaus, Funda; Brand, Tilman; Reeske-Behrens, Anna; Plumbaum, Till; Zeeb, Hajo

    2015-12-03

    The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation.

  5. Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany

    Directory of Open Access Journals (Sweden)

    Florence Samkange-Zeeb

    2015-12-01

    Full Text Available The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation.

  6. Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany

    Science.gov (United States)

    Samkange-Zeeb, Florence; Ernst, Sinja Alexandra; Klein-Ellinghaus, Funda; Brand, Tilman; Reeske-Behrens, Anna; Plumbaum, Till; Zeeb, Hajo

    2015-01-01

    The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation. PMID:26633455

  7. 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.

  8. 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.

  9. 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.

  10. 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