WorldWideScience

Sample records for health compliance assessment

  1. Relationship between Risk Assessment and Compliance to Health and Safety in Ugandan Secondary Schools

    Science.gov (United States)

    Sekiwu, Denis; Kabanda, Milly; Naluwemba, Esther Frances; Kaggwa, Victoria Tamale

    2015-01-01

    Health hazards are part and parcel of human life necessitating the provision of safety in every organizational environment (WHO regional Office for Africa, 2004). Likewise, the area of safety and accident prevention is of great concern to school improvement. The study sought to investigate the relationship between Risk Assessment and Compliancy to…

  2. Environment, safety and health compliance assessment, Feed Materials Production Center, Fernald, Ohio

    Energy Technology Data Exchange (ETDEWEB)

    1989-09-01

    The Secretary of Energy established independent Tiger Teams to conduct environment, safety, and health (ES H) compliance assessments at US Department of Energy (DOE) facilities. This report presents the assessment of the Feed Materials Production Center (FMPC) at Fernald, Ohio. The purpose of the assessment at FMPC is to provide the Secretary with information regarding current ES H compliance status, specific ES H noncompliance items, evaluation of the adequacy of the ES H organizations and resources (DOE and contractor), and root causes for noncompliance items. Areas reviewed included performance under Federal, state, and local agreements and permits; compliance with Federal, state and DOE orders and requirements; adequacy of operations and other site activities, such as training, procedures, document control, quality assurance, and emergency preparedness; and management and staff, including resources, planning, and interactions with outside agencies.

  3. Environment, safety and health, management and organization compliance assessment, West Valley Demonstration Program, West Valley, New York

    International Nuclear Information System (INIS)

    1989-08-01

    An Environment, Safety and Health ''Tiger Team'' Assessment was conducted at the West Valley Demonstration Project. The Tiger Team was chartered to conduct an onsite, independent assessment of WVDP's environment, safety and health (ES ampersand H) programs to assure compliance with applicable Federal and State laws, regulations, and standards, and Department of Energy Orders. The objective is to provide to the Secretary of Energy the following information: current ES ampersand H compliance status of each facility; specific noncompliance items; ''root causes'' for noncompliance items; evaluation of the adequacy of ES ampersand H organization and resources (DOE and contractor) and needed modifications; and where warranted, recommendations for addressing identified problem areas

  4. Environmental compliance assessment review

    International Nuclear Information System (INIS)

    Hilliday, G.H.

    1991-01-01

    During the period 1972-1991, The United States Congress passed stringent environmental statues which the Environment Protection Agency implemented via regulations. The statues and regulations contain severe civil and criminal penalties. Civil violations resulted in fines, typically payable by the company. The act of willfully and knowingly violating the permit conditions or regulations can result in criminal charges being imposed upon the responsible part, i.e., either the company or individual. Criminal charges can include fines, lawyer fees, court costs and incarceration. This paper describes steps necessary to form an effective Environmental Compliance Assessment Review [CAR] program, train field and engineering personnel and perform a CAR audit. Additionally, the paper discusses the findings of a number of Exploration and Production [E and P] field audits

  5. 340 Facility compliance assessment

    International Nuclear Information System (INIS)

    English, S.L.

    1993-10-01

    This study provides an environmental compliance evaluation of the RLWS and the RPS systems of the 340 Facility. The emphasis of the evaluation centers on compliance with WAC requirements for hazardous and mixed waste facilities, federal regulations, and Westinghouse Hanford Company (WHC) requirements pertinent to the operation of the 340 Facility. The 340 Facility is not covered under either an interim status Part A permit or a RCRA Part B permit. The detailed discussion of compliance deficiencies are summarized in Section 2.0. This includes items of significance that require action to ensure facility compliance with WAC, federal regulations, and WHC requirements. Outstanding issues exist for radioactive airborne effluent sampling and monitoring, radioactive liquid effluent sampling and monitoring, non-radioactive liquid effluent sampling and monitoring, less than 90 day waste storage tanks, and requirements for a permitted facility

  6. Measuring compliance of conducting an occupational health risk assessment in the occupational health nurse’s practice

    Directory of Open Access Journals (Sweden)

    Nicolene de Jager

    2014-09-01

    Full Text Available Occupational health nurses (OHNs are qualified registered nurses with a postgraduate qualification in occupational health nursing. An important activity of OHNs is to identify and assess health risks in the workplace. Health risk assessments (HRAs are conducted by OHNs to determine all the occupational health stressors, for example noise, vibration and chemical substances. The authors conducted legal compliance occupational health audits and observed that 85% (n = 23 of OHNs in different settings conduct HRAs only to a limited extent. The following objective was formulated for the study: To explore and describe the extent to which OHNs conduct HRAs as it is a legal requirement for compliance; and the possible reasons for not adhering to the regulation and conduct them only to a limited extent. A quantitative, descriptive design was used in this study. A sampling frame was developed from a list of all the members of the South African Society of Occupational Health Nursing Practitioners (SASOHN in Gauteng. From the target population of OHNs in Gauteng, a systematic cluster sampling method was used. A self-developed questionnaire was distributed by mail and e-mail, and authors sent respondents reminders. The authors ensured that validity, reliability and ethical standards were adhered to. The findings revealed that OHNs are mature, experienced, predominately female practitioners who operate on behalf of a disproportionately large number of workers. Four factors influencing these nurses in conducting an HRA to a limited extent were identified: competence, ignorance about the role of the OHN, workload and attitude. Beroepsgesondheidverpleegkundiges (BGV’s is gekwalifiseerde geregistreerde verpleegkundiges met ’n nagraadse kwalifikasie in beroepsgesondheidsverpleging wat basiese gesondheidsorg in die beroepsgesondheidsprogram lewer. ’n Belangrike aktiwiteit van die BGV is om alle gesondheidsrisiko’s in die werksplek te identifiseer en te

  7. ICF's Plant Compliance Assessment System

    International Nuclear Information System (INIS)

    Baker, S.M.

    1989-01-01

    Government and private industrial facilities must manage wastes that are both radioactive and (chemically) hazardous. Until recently, these mixed wastes have been managed under rules established under the Atomic Energy Act (AEA) and the Low-Level Waste Policy At, and rules that derive from environmental legislation have not been applied. Both sets of rules now apply to mixed wastes, creating situations in which significant changes to waste steams must be made in order to bring them into compliance with environmental regulations. The first step in bringing waste streams into compliance is to determine their status with respect to the newly-applicable regulations. This process of compliance assessment is difficult because requirements to minimize human exposure to radiation can conflict with requirements of environmental regulations, many regulations are potentially applicable, the regulations are changing rapidly, and because waste streams designed to operate under AEA rules frequently cannot be easily modified to incorporate the additional regulations. Modern personal computer (PC) tools are being developed to help regulatory analysts manage the large amounts of information required to asses the compliance status of complex process plants. This paper presents the Plant Compliance Assessment System (PCAS), which performs this function by relating a database containing references to regulatory requirements to databases created to describe relevant aspects of the facility to be assessed

  8. Performance Assessment Position Paper: Time for Compliance

    International Nuclear Information System (INIS)

    Wilhite, E.L.

    2003-01-01

    This study lays out the historical development of the time frame for a low-level waste disposal facility to demonstrate compliance with the DOE performance objectives and requirements. The study recommends that 1,000 years should be used as the time for compliance for all of the performance objectives and requirements (i.e., for the all-pathways, air pathway, radon emanation, water resource protection and inadvertent intruder analyses) for all low-level waste disposal facility performance assessments at the Savannah River Site

  9. Assessment of compliance of Employees and Management to Occupational Health & Safety Act in the Department of Public Safety in the North West Province / Neo Patricia Seleka

    OpenAIRE

    2011-01-01

    The study was designed to determine the worker assessment of compliance to OHS act in the department of Public safety. One hundred and two (102) employees were selected randomly using table of random numbers from different directorates such as Human resources, Finance, Road safety, Crime prevention and Traffic management. Data were collected using a structured questionnaire which was made of personal characteristics and sections on level of compliance with OHS act, workers' ...

  10. Levels and Patterns of Objectively Assessed Physical Activity and Compliance with Different Public Health Guidelines in University Students

    Science.gov (United States)

    Arias-Palencia, Natalia María; Solera-Martínez, Monserrat; Gracia-Marco, Luis; Silva, Pedro; Martínez-Vizcaíno, Vicente; Cañete-García-Prieto, Jorge; Sánchez-López, Mairena

    2015-01-01

    Background Physical activity (PA) is associated with health enhancement. The aim of this study was to assess: 1) levels and patterns of PA in university students by using accelerometers; and 2) the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines. Methods Observational cross-sectional study (Cuenca’s Adults Study) involving 296 (206 women) healthy Spanish university students aged 18–25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA) was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (pstudents met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day. Conclusions Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used. PMID:26536605

  11. Context-Dependent Prognostics and Health Assessment: A Condition-Based Maintenance Approach That Supports Mission Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Allgood, G.O.; Kercel, S.W.

    1999-04-19

    In today's manufacturing environment, plants, systems, and equipment are being asked to perform at levels not thought possible a decade ago. The intent is to improve process operations and equipment reliability, availability, and maintainability without costly upgrades. Of course these gains must be achieved without impacting operational performance. Downsizing is also taking its toll on operations. Loss of personnel, particularly those who represent the corporate history, is depleting US industries of their valuable experiential base which has been relied on so heavily in the past. These realizations are causing companies to rethink their condition-based maintenance policies by moving away from reacting to equipment problems to taking a proactive approach by anticipating needs based on market and customer requirements. This paper describes a different approach to condition-based maintenance-context-dependent prognostics and health assessment. This diagnostic capability is developed around a context-dependent model that provides a capability to anticipate impending failures and determine machine performance over a protracted period of time. This prognostic capability links operational requirements to an economic performance model. In this context, a system may provide 100% operability with less than 100% functionality. This paradigm is used to facilitate optimal logistic supply and support.

  12. Diagnosis of compliance of health care product processing in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Camila Eugenia Roseira

    Full Text Available ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

  13. Increasing compliance with the World Health Organization Surgical Safety Checklist-A regional health system's experience.

    Science.gov (United States)

    Gitelis, Matthew E; Kaczynski, Adelaide; Shear, Torin; Deshur, Mark; Beig, Mohammad; Sefa, Meredith; Silverstein, Jonathan; Ujiki, Michael

    2017-07-01

    In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses. The purpose of this study was to examine the impact of an electronic SSC on compliance and patient safety. An anonymous OR observer selected cases at random and evaluated the compliance rate before the rollout of the electronic SSC. In June 2014, an electronic audit was performed to assess the compliance rate. Random OR observations were also performed throughout the summer in 2014. Perioperative risk events, such as consent issues, incorrect counts, wrong site, and wrong procedure were compared before and after the electronic SSC rollout. A perception survey was also administered to NorthShore OR personnel. Compliance increased from 48% (n = 167) to 92% (n = 1,037; P World Health Organization SSC is a validated tool to increase patient safety and reduce intraoperative complications. The electronic SSC has demonstrated an increased compliance rate, a reduced number of risk events, and most OR personnel believe it will have a positive impact on patient safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Ecological Compliance Assessment Project: 1994 Summary report

    International Nuclear Information System (INIS)

    Brandt, C.A.

    1994-11-01

    The Ecological Compliance Assessment Project (ECAP) began full operation on March 1, 1994. The project is designed around a baseline environmental data concept that includes intensive biological field surveys of key areas of the Hanford Site where the majority of Site activities occur. These surveys are conducted at biologically appropriate times of year to ensure that the data gathered are current and accurate. The data are entered into the ECAP database, which serves as a reference for the evaluation of review requests coming in to the project. This methodology provided the basis for over 90 percent of the review requests received. Field surveys conducted under ECAP are performed to document occurrence information for species of concern and to obtain habitat descriptions. There are over 200 species of concern on the Hanford Site, including plants, birds, mammals, reptiles, amphibians, fish, and invertebrates. In addition, Washington State has designated mature sagebrush-steppe habitat as a Priority Habitat meriting special protective measures. Of the projects reviewed, 17 resulted or will result in impacts to species or habitats of concern on the Hanford Site. The greatest impact has been on big sagebrush habitat. Most of the impact has been or will be within the 600 Area of the Site

  15. Evaluating the radiological health compliance of some beach ...

    African Journals Online (AJOL)

    Journal of Applied Sciences and Environmental Management ... Evaluating the radiological health compliance of some beach environments in Delta State ... as well as specified members of the public (customers) are not at radiological risk.

  16. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    Energy Technology Data Exchange (ETDEWEB)

    Levine, M.B.; Sigmon, C.F.

    1989-09-29

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges.

  17. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    International Nuclear Information System (INIS)

    Levine, M.B.; Sigmon, C.F.

    1989-01-01

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges

  18. The Tobacco Pack Surveillance System: A Protocol for Assessing Health Warning Compliance, Design Features, and Appeals of Tobacco Packs Sold in Low- and Middle-Income Countries.

    Science.gov (United States)

    Smith, Katherine; Washington, Carmen; Brown, Jennifer; Vadnais, Alison; Kroart, Laura; Ferguson, Jacqueline; Cohen, Joanna

    2015-01-01

    Tobacco remains the world's leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack. The objective of this study was to establish a surveillance system for tobacco packs in the 14 low- and middle-income countries with the greatest number of smokers. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended, and identifies pack designs and appeals that might violate or detract from the communication of harm-related information and undermine the impact of a country's tobacco packaging laws. The protocol outlined is intended to be applicable or adaptable for surveillance efforts in other countries. Tobacco packs were collected in 14 countries during 2013. The intention was, to the extent possible, to construct a census of "unique" pack presentations available for purchase in each country. The TPackSS team partnered with in-country field staff to implement a standardized protocol for acquiring packs from 36 diverse neighborhoods across three cities in each country. At the time of purchase, data on price and place of acquisition of each pack was recorded. The field staff, according to a standardized protocol, then photographed packs before they were shipped to the United States for coding and archiving. Each pack was coded for compliance with the country-specific health warning label laws, as well as for key design features of the pack and appeals of the branding elements. The coding protocols were developed based upon prior research, expert

  19. Revised health and safety compliance model for the Ghanaian ...

    African Journals Online (AJOL)

    The construction industry in Ghana is faced with employees' negligence in obeying rules and regulations, and acts that conflict with health and safety. The purpose of the paper was to present the revised health and safety (H&S) compliance model for the construction industry based on a developed theoretical six factor ...

  20. Training Course for Compliance Safety and Health Officers. Final Report.

    Science.gov (United States)

    McKnight, A. James; And Others

    The report describes revision of the Compliance Safety and Health Officers (CSHO) course for the Department of Labor, Occupational Safety and Health Administration (OSHA). The CSHO's job was analyzed in depth, in accord with OSHA standards, policies, and procedures. A listing of over 1,700 violations of OSHA standards was prepared, and specialists…

  1. Reliability, compliance, and security in web-based course assessments

    Directory of Open Access Journals (Sweden)

    Scott Bonham

    2008-04-01

    Full Text Available Pre- and postcourse assessment has become a very important tool for education research in physics and other areas. The web offers an attractive alternative to in-class paper administration, but concerns about web-based administration include reliability due to changes in medium, student compliance rates, and test security, both question leakage and utilization of web resources. An investigation was carried out in introductory astronomy courses comparing pre- and postcourse administration of assessments using the web and on paper. Overall no difference was seen in performance due to the medium. Compliance rates fluctuated greatly, and factors that seemed to produce higher rates are identified. Notably, email reminders increased compliance by 20%. Most of the 559 students complied with requests to not copy, print, or save questions nor use web resources; about 1% did copy some question text and around 2% frequently used other windows or applications while completing the assessment.

  2. 300 Area TEDF DOE order compliance applicability assessment

    Energy Technology Data Exchange (ETDEWEB)

    Eacker, J.A.

    1994-11-08

    This report summarizes the results of an effort to determine applicability of Department of Energy Orders at the Hanford 300 Area Treated Effluent Disposal Facility (TEDF). This assessment placed each of the reviewed orders into one of three compliance categories: (A) order applicable at a facility specific level (20 identified); (B) order applicable at a policy level (11 identified); or (C) order not applicable (21 identified). The scope of the assessment from the DOE Order standpoint was the 52 Level 1 Orders of interest to the Defense Nuclear Facility Safety Board (DNFSB). Although the TEDF is a non-nuclear facility, this order basis was chosen as a Best Management Practice to be consistent with ongoing efforts across the Hanford Site. Three tables in the report summarize the DOE order applicability by the compliance categories, with a table for Level A, Level B, and Level C applicability. The attachment to the report documents the compliance applicability assessment for each individual DOE Order.

  3. 300 Area TEDF DOE order compliance applicability assessment

    International Nuclear Information System (INIS)

    Eacker, J.A.

    1994-01-01

    This report summarizes the results of an effort to determine applicability of Department of Energy Orders at the Hanford 300 Area Treated Effluent Disposal Facility (TEDF). This assessment placed each of the reviewed orders into one of three compliance categories: (A) order applicable at a facility specific level (20 identified); (B) order applicable at a policy level (11 identified); or (C) order not applicable (21 identified). The scope of the assessment from the DOE Order standpoint was the 52 Level 1 Orders of interest to the Defense Nuclear Facility Safety Board (DNFSB). Although the TEDF is a non-nuclear facility, this order basis was chosen as a Best Management Practice to be consistent with ongoing efforts across the Hanford Site. Three tables in the report summarize the DOE order applicability by the compliance categories, with a table for Level A, Level B, and Level C applicability. The attachment to the report documents the compliance applicability assessment for each individual DOE Order

  4. Cracking the Code: Assessing Institutional Compliance with the Australian Code for the Responsible Conduct of Research

    Science.gov (United States)

    Morris, Suzanne E.

    2010-01-01

    This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance.…

  5. OCONUS Compliance Assessment Protocols - Qatar (Army Version) (CD-ROM)

    National Research Council Canada - National Science Library

    Krooks, David A

    2004-01-01

    ...: 1 CD-ROM; 4 3/4 in.; 578 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security of United States Forces in the State of Qatar, 21 May 1999, and the Overseas...

  6. The Mental Health Care Act: Stakeholder compliance with Section ...

    African Journals Online (AJOL)

    Objective. To determine compliance with Section 40 (1-3) of the Mental Health Care Act (MHCA) No 17 of 2002, viz. handing over custody by the South African Police Service (SAPS) of suspected mentally ill patients to medical services at Chris Hani Baragwanath Hospital (CHBH). Methods. The study was a retrospective ...

  7. Promoting compliance at DOE: Tiger team assessments and environmental audits

    International Nuclear Information System (INIS)

    Green, R.S.; Crawford, V.I.

    1993-01-01

    The Office of Environmental Audit, within the Department of Energy's Office of Environment, Safety and Health, has effected positive environmental results across the DOE complex. Beginning in the mid 1980's, a concerted effort was established by DOE upper management to achieve environmental consciousness and responsibility. The Office of Environmental Audit was established to conduct and Environmental survey to define environmental problems caused by 40 years of operation at DOE production and research facilities. The Office provided initial identification of DOE sites requiring environmental restoration and assured plans were developed to address these environmental problems. Initiated by massive problems in the environmental operations at DOE's Rocky Flats Plant in Colorado, Tiger Team Assessments (TTA) followed. TTAs established a compliance baseline and evaluated management with respect to environment, safety, and health. The Tiger Teams assured plans were established to correct deficiencies including root causes. As part of this comprehensive effort, the Office of Environmental Audit led the environmental component of the TTAs. With TTAs completed, the Office's future vision entails addressing new environmental regulations and world changes affecting DOE operations. To proactively continue its efforts to effect positive environmental change, the Office is headed toward a comprehensive cross-cutting program that conducts environmental management assessments, reassesses the environmental progress of formerly audited facilities, and evaluates special focuses environmental issues that span across the DOE complex. Through these efforts, the Office of Environmental Audit will determine the environmental activities which address environmental problems and identify environmental problems requiring resolution. Following trending analyses, the Office will disseminate information describing mechanisms to pursue and pitfalls to avoid to achieve environmental excellence

  8. Development of a method to assess compliance with ergonomic posture in dental students

    Science.gov (United States)

    Garcia, Patrícia Petromilli Nordi Sasso; Wajngarten, Danielle; Campos, Juliana Alvares Duarte Bonini

    2018-01-01

    CONTEXT: The ergonomic posture protocol is extremely important for the maintenance of occupational health in dentistry. The lack of compliance with this protocol results in a high risk of developing musculoskeletal disorders. AIMS: This study developed a direct observation method for the evaluation of dental student compliance with ergonomic posture protocol. SUBJECTS AND METHODS: The method is named compliance assessment of dental ergonomic posture requirements (CADEP). During the development of the method, 14 items were elaborated considering the theory of dental ergonomics. Each item should be classified as appropriate, partially appropriate, or inappropriate. After evaluation, all item values should be added, and the final score expressed as the percent of compliance with correct postures, with a score range of 0%–100%. STATISTICAL ANALYSIS USED: The reliability of CADEP was assessed through intra- and interobserver reproducibility. For the CADEP application, 73 senior year students from the undergraduate course in dentistry were evaluated. The intra- and interexaminer concordance was estimated using the intraclass correlation coefficient (ρ). A descriptive statistical analysis was performed. RESULTS: The reproducibility of evaluator 1 (ρ =0.90; confidence interval [CI] 95%: 0.83–0.94), evaluator 2 (ρ = 0.83; CI 95%: 0.70–0.90), the interexaminer in the first evaluation (ρ = 0.81; CI 95%:0.67–0.89), and in the second one (ρ = 0.76; CI 95%: 0.59–0.87) was classified as good. In the analysis of the compliance, it was verified that moderate compliance was the most prevalent among the evaluated students (65.6%, CI 95%: 60.3%–70.7%). CONCLUSIONS: CADEP was valid and reliable for the assessment of dentistry students’ compliance regarding ergonomic posture requirements. PMID:29693025

  9. Project W-519 TWRS privatization phase 1 infrastructure year 2000 compliance assessment project plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-519. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  10. Project W-211 initial tank retrieval systems year 2000 compliance assessment project plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-211. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  11. Project W-151 Tank 101-AZ Waste Retrieval System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-151. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance

  12. Environmental Compliance Assessment System Army National Guard (ECAS- ARNG)

    Science.gov (United States)

    1993-09-01

    Piopory A PucaI Officer (USP&Ro) (6) Stele Sary Odffiar (7) Suace Ahkuteaece MaMnagr (SW!O (9) Comad Lopam Officer (CLO) (00) 0ampoicnai Heaft Nuame...Tment PIM Operators (15) P A O O (20) Hetallmon Respone Teen ( BIO (OSQ (21) Sure Judge Avomw (SIA) (29) S•ate Aviation Officer 2 - 107 COMPLIANCE...eliminate damage to the environment and bio - sphere and stimulate the health and welfare of man (42 USC 4321). Under NEPA, the continuing policy of the

  13. Impact of a mobile health aplication in the nursing care plan compliance of a home care service in Belo Horizonte, Minas Gerais, Brazil.

    Science.gov (United States)

    de Britto, Felipe A; Martins, Tatiana B; Landsberg, Gustavo A P

    2015-01-01

    To assess impact of a mobile health solution in the nursing care plan compliance of a home care service. A retrospective cohort study was performed with 3,036 patients. Compliance rates before and after the implementation were compared. After the implementation of a mobile health aplication, compliance with the nursing care plan increased from 53% to 94%. The system reduced IT spending, increased the nursing team efficiency and prevented planned hiring. The use of a mobile health solution with geolocating feature by a nursing home care team increased compliance to the care plan.

  14. The Canadian Natural Health Products (NHP) regulations: industry compliance motivations.

    Science.gov (United States)

    Laeeque, Hina; Boon, Heather; Kachan, Natasha; Cohen, Jillian Clare; D'Cruz, Joseph

    2007-06-01

    This qualitative study explores corporations' motivations to comply with new natural health products (NHP) Regulations in Canada. Interviews were conducted with representatives from 20 Canadian NHP companies. Findings show that the rationale for compliance differs for large compared to small and medium-sized enterprises (SMEs). Large firms are motivated to comply with the regulations because of the deterrent fear of negative media coverage, social motivations, ability to comply and maintaining a competitive market advantage. In contrast, SMEs are motivated to comply due to the deterrent fear of legal prosecution and a sense of duty.

  15. [Health situation of prisoners at a prison compliance centre, Chile].

    Science.gov (United States)

    Osses-Paredes, C; Riquelme-Pereira, N

    2013-02-01

    There are population groups nowadays that are regarded as vulnerable, one of which is the prison population, considered to have major health needs. Nonetheless, people deprived of liberty maintain inherent human rights such as that of health care, which in some situations may take second place. Cross-sectional descriptive study, carried out at El Manzano Prison compliance centre, Concepción, from October 2011 to February 2012 with the implementation of a preventive health exam and a socio-demographic and health questionnaire, for 18+, female and male prisoners in a closed system, on reception of written informed consent. in the study, the population was 85% men, the average age was 34 years, 91.2% receive visits, average term of imprisonment 38 months. At least 45% have a diagnosed disease, prioritizing mental disorders, and respiratory and circulatory system diseases. 56% of prisoners have requested health care infrequently, 33% of which were very satisfied and 32% satisfied with prison health services. The health of the prison population is more impaired than that of the general population, with a larger number of needs that are also different, but there is a positive perception of health by prisoners and a high degree of satisfaction with health services.

  16. Health providers' compliance with pregnant women's Bill of Rights in labor and delivery in Iran

    Directory of Open Access Journals (Sweden)

    Vajihesadat Mirlohi

    2015-01-01

    Conclusions: The results showed that the health providers' compliance with the pregnant women's Bill of Rights was not acceptable in the labor room. Therefore, necessary actions are needed to remove the barriers against pregnant women's compliance of Bill of Rights and to facilitate the compliance with it in hospitals.

  17. 78 FR 55245 - Activities and Methodology for Assessing Compliance With Building Energy Codes

    Science.gov (United States)

    2013-09-10

    ...-0036] Activities and Methodology for Assessing Compliance With Building Energy Codes AGENCY: Office of... available to states to evaluate compliance with building energy codes and general approaches towards... building energy codes and general approaches towards compliance. The comment period ended on September 5...

  18. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Science.gov (United States)

    2010-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public... Unable To Pay § 124.515 Compliance alternative for community health centers, migrant health centers and... migrant health center under section 329 of the Act is in substantial compliance with the terms and...

  19. Programmer's manual for CAMCON: Compliance Assessment Methodology CONtroller

    International Nuclear Information System (INIS)

    Rechard, R.P.; Gilkey, A.P.; Rudeen, D.K.; Byle, K.A.; Iuzzolino, H.J.

    1993-05-01

    CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system

  20. Programmer`s manual for CAMCON: Compliance Assessment Methodology CONtroller

    Energy Technology Data Exchange (ETDEWEB)

    Rechard, R.P. [Sandia National Labs., Albuquerque, NM (United States); Gilkey, A.P.; Rudeen, D.K.; Byle, K.A. [New Mexico Engineering Research Inst., Albuquerque, NM (United States); Iuzzolino, H.J. [Geo-Centers, Inc., Albuquerque, NM (United States)

    1993-05-01

    CAMCON, the Compliance Assessment Methodology CONtroller, is an analysis system that assists in assessing the compliance of the Waste Isolation Pilot Plant (WIPP) with applicable long-term regulations of the US Environmental Protection Agency, including Subpart B of the Environmental Standards for the Management and Disposal of spent Nuclear Fuel, High-Level and Transuranic Radioactive Wastes, 40 CFR 191 and 40CFR268.6, which is the portion of the Land Disposal Restrictions implementing the Resource, Conservative, and Recovery Act of 1976, as amended that states the conditions for disposal of hazardous chemical wastes. This manual provides an architectural overview of the CAMCON system. Furthermore this manual presents guidelines and presents suggestions for programmers developing the many different types of software necessary to investigate various events and physical processes of the WIPP. These guidelines include user interface requirements, minimum quality assurance requirements, coding style suggestions, and the use of numerous software libraries developed specifically for or adapted for the CAMCON system.

  1. Measuring compliance of conducting an occupational health risk ...

    African Journals Online (AJOL)

    ... health risk assessment in the occupational health nurse's practice. ... A quantitative, descriptive design was used in this study. ... A self-developed questionnaire was distributed by mail and e-mail, and authors sent respondents reminders.

  2. Emergency Response Capability Baseline Needs Assessment Compliance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Sharry, John A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2013-09-16

    This document is the second of a two-part analysis of Emergency Response Capabilities of Lawrence Livermore National Laboratory. The first part, 2013 Baseline Needs Assessment Requirements Document established the minimum performance criteria necessary to meet mandatory requirements. This second part analyses the performance of Lawrence Livermore Laboratory Emergency Management Department to the contents of the Requirements Document. The document was prepared based on an extensive review of information contained in the 2009 BNA, the 2012 BNA document, a review of Emergency Planning Hazards Assessments, a review of building construction, occupancy, fire protection features, dispatch records, LLNL alarm system records, fire department training records, and fire department policies and procedures.

  3. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    revealed varied levels of compliance on different components of infection prevention. The highest level of compliance (100%) was with single use of needles and syringes while the lowest (35.1) was with decontamination of needles and syringes with 0.5% chlorine solution prior to disposal. Compliance with hand hygiene ...

  4. Emergency Response Capability Baseline Needs Assessment - Compliance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Sharry, John A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-09-01

    This document was prepared by John A. Sharry, LLNL Fire Marshal and Division Leader for Fire Protection and was reviewed by LLNL Emergency Management Department Head, James Colson. This document is the second of a two-part analysis on Emergency Response Capabilities of Lawrence Livermore National Laboratory. The first part, 2016 Baseline Needs Assessment Requirements Document established the minimum performance criteria necessary to meet mandatory requirements. This second part analyses the performance of Lawrence Livermore Laboratory Emergency Management Department to the contents of the Requirements Document. The document was prepared based on an extensive review of information contained in the 2016 BNA, a review of Emergency Planning Hazards Assessments, a review of building construction, occupancy, fire protection features, dispatch records, LLNL alarm system records, fire department training records, and fire department policies and procedures. The 2013 BNA was approved by NNSA’s Livermore Field Office on January 22, 2014.

  5. Health care workers' compliance with hand hygiene regulations: Positive effects of a poster

    NARCIS (Netherlands)

    Karreman, Joyce; Berendsen, Femke; Pol, Bert; Dorman, Hilde

    2015-01-01

    Health care workers in nursing homes do not always comply with hand hygiene regulations, such as not wearing jewelry. Non-compliance with these regulations is a threat to patients' safety. We did two studies to investigate if compliance could be improved by a poster that reminds health care workers

  6. Diagnosis of compliance of health care product processing in Primary Health Care.

    Science.gov (United States)

    Roseira, Camila Eugenia; Silva, Darlyani Mariano da; Passos, Isis Pienta Batista Dias; Orlandi, Fabiana Souza; Padoveze, Maria Clara; Figueiredo, Rosely Moralez de

    2016-11-21

    identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied. identificar a conformidade do processamento de produtos para saúde na Atenção Primária à Saúde e avaliar possível diferença na conformidade entre as unidades caracterizadas como Unidade Básica de Saúde e Unidade Saúde da Família. estudo quantitativo, observacional, descritivo e inferencial, com a aplicação de indicadores de estrutura, processo e resultado referentes ao processamento de produtos para a saúde em dez unidades, de um município do interior de São Paulo - Brasil. todos os indicadores obtiveram índice de conformidade inferior ao ideal. Não houve diferença estatisticamente significante nos indicadores entre os dois tipos de unidades investigadas, sendo o indicador de limpeza de produtos para sa

  7. A compliance assessment of midpoint formative assessments completed by APPE preceptors.

    Science.gov (United States)

    Lea Bonner, C; Staton, April G; Naro, Patricia B; McCullough, Elizabeth; Lynn Stevenson, T; Williamson, Margaret; Sheffield, Melody C; Miller, Mindi; Fetterman, James W; Fan, Shirley; Momary, Kathryn M

    Experiential pharmacy preceptors should provide formative and summative feedback during a learning experience. Preceptors are required to provide colleges and schools of pharmacy with assessments or evaluations of students' performance. Students and experiential programs value on-time completion of midpoint evaluations by preceptors. The objective of this study was to determine the number of on-time electronically documented formative midpoint evaluations completed by preceptors during advanced pharmacy practice experiences (APPEs). Compliance rates of on-time electronically documented formative midpoint evaluations were reviewed by the Office of Experiential Education of a five-member consortium during the two-year study period prior to the adoption of Standards 2016. Pearson chi-square test and generalized linear models were used to determine if statistically significant differences were present. Average midpoint compliance rates for the two-year research period were 40.7% and 41% respectively. No statistical significance was noted comparing compliance rates for year one versus year two. However, statistical significance was present when comparing compliance rates between schools during year two. Feedback from students and preceptors pointed to the need for brief formal midpoint evaluations that require minimal time to complete, user friendly experiential management software, and methods for documenting verbal feedback through student self-reflection. Additional education and training to both affiliate and faculty preceptors on the importance of written formative feedback at midpoint is critical to remaining in compliance with Standards 2016. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Environmental Assessment of Ground Water Compliance at the Naturita, Colorado, UMTRA Project Site

    Energy Technology Data Exchange (ETDEWEB)

    None

    2003-04-23

    This Environmental Assessment addresses the environmental effects of a proposed action and the no action alternative to comply with U.S. Environmental Protection Agency (EPA) ground water standards at the Naturita, Colorado, Uranium Mill Tailings Remedial Action Project site. In 1998, the U.S. Department of Energy (DOE) completed surface cleanup at the site and encapsulated the tailings in a disposal cell 15 miles northwest near the former town of Uravan, Colorado. Ground water contaminants of potential concern at the Naturita site are uranium and vanadium. Uranium concentrations exceed the maximum concentration limit (MCL) of 0.044 milligram per liter (mg/L). Vanadium has no MCL; however, vanadium concentrations exceed the EPA Region III residential risk-based concentration of 0.33 mg/L (EPA 2002). The proposed compliance strategy for uranium and vanadium at the Naturita site is no further remediation in conjunction with the application of alternate concentration limits. Institutional controls with ground water and surface water monitoring will be implemented for these constituents as part of the compliance strategy. This compliance strategy will be protective of human health and the environment. The proposed monitoring program will begin upon regulatory concurrence with the Ground Water Compliance Action Plan (DOE 2002a). Monitoring will consist of verifying that institutional controls remain in place, collecting ground water samples to verify that concentrations of uranium and vanadium are decreasing, and collecting surface water samples to verify that contaminant concentrations do not exceed a regulatory limit or risk-based concentration. If these criteria are not met, DOE would reevaluate the proposed action and determine the need for further National Environmental Policy Act documentation. No comments were received from the public during the public comment period. Two public meetings were held during this period. Minutes of these meetings are included as

  9. Environmental Assessment of Ground Water Compliance at the Naturita, Colorado, UMTRA Project Site

    International Nuclear Information System (INIS)

    2003-01-01

    This Environmental Assessment addresses the environmental effects of a proposed action and the no action alternative to comply with U.S. Environmental Protection Agency (EPA) ground water standards at the Naturita, Colorado, Uranium Mill Tailings Remedial Action Project site. In 1998, the U.S. Department of Energy (DOE) completed surface cleanup at the site and encapsulated the tailings in a disposal cell 15 miles northwest near the former town of Uravan, Colorado. Ground water contaminants of potential concern at the Naturita site are uranium and vanadium. Uranium concentrations exceed the maximum concentration limit (MCL) of 0.044 milligram per liter (mg/L). Vanadium has no MCL; however, vanadium concentrations exceed the EPA Region III residential risk-based concentration of 0.33 mg/L (EPA 2002). The proposed compliance strategy for uranium and vanadium at the Naturita site is no further remediation in conjunction with the application of alternate concentration limits. Institutional controls with ground water and surface water monitoring will be implemented for these constituents as part of the compliance strategy. This compliance strategy will be protective of human health and the environment. The proposed monitoring program will begin upon regulatory concurrence with the Ground Water Compliance Action Plan (DOE 2002a). Monitoring will consist of verifying that institutional controls remain in place, collecting ground water samples to verify that concentrations of uranium and vanadium are decreasing, and collecting surface water samples to verify that contaminant concentrations do not exceed a regulatory limit or risk-based concentration. If these criteria are not met, DOE would reevaluate the proposed action and determine the need for further National Environmental Policy Act documentation. No comments were received from the public during the public comment period. Two public meetings were held during this period. Minutes of these meetings are included as

  10. Technical assessment of compliance with work place air sampling requirements at T Plant. Revision No. 1

    International Nuclear Information System (INIS)

    Hackworth, M.F.

    1995-01-01

    The US DOE requires its contractors to conduct air sampling to detect and evaluate airborne radioactive material in the workplace. Hanford Reservation T Plant compliance with workplace air sampling requirements has been assessed. Requirements, basis for determining compliance and recommendations are included

  11. Assessment of compliance with regulatory requirements for a best estimate methodology for evaluation of ECCS

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Un Chul; Jang, Jin Wook; Lim, Ho Gon; Jeong, Ik [Seoul National Univ., Seoul (Korea, Republic of); Sim, Suk Ku [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2000-03-15

    Best estimate methodology for evaluation of ECCS proposed by KEPCO(KREM) os using thermal-hydraulic best-estimate code and the topical report for the methodology is described that it meets the regulatory requirement of USNRC regulatory guide. In this research the assessment of compliance with regulatory guide. In this research the assessment of compliance with regulatory requirements for the methodology is performed. The state of licensing procedure of other countries and best-estimate evaluation methodologies of Europe is also investigated, The applicability of models and propriety of procedure of uncertainty analysis of KREM are appraised and compliance with USNRC regulatory guide is assessed.

  12. Parental compliance - an emerging problem in Liverpool community child health surveys 1991-2006

    Directory of Open Access Journals (Sweden)

    Koshy Gibby

    2012-04-01

    Full Text Available Abstract Background Compliance is a critical issue for parental questionnaires in school based epidemiological surveys and high compliance is difficult to achieve. The objective of this study was to determine trends and factors associated with parental questionnaire compliance during respiratory health surveys of school children in Merseyside between 1991 and 2006. Methods Four cross-sectional respiratory health surveys employing a core questionnaire and methodology were conducted in 1991, 1993, 1998 and 2006 among 5-11 year old children in the same 10 schools in Bootle and 5 schools in Wallasey, Merseyside. Parental compliance fell sequentially in consecutive surveys. This analysis aimed to determine the association of questionnaire compliance with variation in response rates to specific questions across surveys, and the demographic profiles for parents of children attending participant schools. Results Parental questionnaire compliance was 92% (1872/2035 in 1991, 87.4% (3746/4288 in 1993, 78.1% (1964/2514 in 1998 and 30.3% (1074/3540 in 2006. The trend to lower compliance in later surveys was consistent across all surveyed schools. Townsend score estimations of socio-economic status did not differ between schools with high or low questionnaire compliance and were comparable across the four surveys with only small differences between responders and non-responders to specific core questions. Respiratory symptom questions were mostly well answered with fewer than 15% of non-responders across all surveys. There were significant differences between mean child age, maternal and paternal smoking prevalence, and maternal employment between the four surveys (all p Conclusion Methodological differences or changes in socio-economic status of respondents between surveys were unlikely to explain compliance differences. Changes in maternal employment patterns may have been contributory. This analysis demonstrates a major shift in community parental

  13. OCONUS Compliance Assessment Protocols (OCAP) - Saudi Arabia (Army Version) (CD-ROM)

    National Research Council Canada - National Science Library

    Krooks, David A; Schell, Donna J

    2004-01-01

    ...: 1 CD-ROM; 4 3/4 in.; 670 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security by United States Forces in the Kingdom of Saudi Arabia (FGS-SA...

  14. Review of the performance assessment in the WIPP draft compliance application

    International Nuclear Information System (INIS)

    Lee, W.W.L.

    1996-01-01

    On March 31, 1995, the U.S. Department of Energy (USDOE) filed a draft compliance certification application (DCCA) with the U.S. Environmental Protection Agency (USEPA) to show the Waste Isolation Pilot Plant's compliance with the USEPA's environmental standards for disposal of high-level and transuranic waste. Demonstration of compliance is by a performance assessment. This paper is an early review of the performance assessment in the draft application, by the Environmental Evaluation Group, an oversight group. The performance assessment in the draft application is incomplete. Not all relevant scenarios have been analyzed. The calculation of potential consequences often does not use experimental data but rather estimates by workers developing additional data. The final compliance application, scheduled for October 1996, needs to consider additional scenarios, and be fully based on experimental data

  15. Technical assessment of compliance with workplace air sampling requirements at WRAP

    International Nuclear Information System (INIS)

    HACKWORTH, M.F.

    1999-01-01

    The purpose of this Technical Assessment is to satisfy HSRCM-1, ''Hanford Site Radiological Control Manual'' Article 551.4 for a documented study of facility Workplace Air Monitoring (WAM) programs. HSRCM-1 is the primary guidance for radiological control at Waste Management Federal Services of Hanford, Inc. (WMH). The HSRCM-1 complies with Title 10. Part 835 of the Code of Federal Regulations (10CFR835). This document provides an evaluation of the compliance of the Waste Receiving and Processing facility (WRAP) WAM program to the criteria standards, requirements, and documents compliance with the requirements where appropriate. Where necessary, it also indicates changes needed to bring specific locations into compliance

  16. Breastmilk donations: Bacteriological assessment, analysis of causes of non-compliance and suggestions for improvement.

    Science.gov (United States)

    Mullié, C; Obin, O; Outurquin, G; Grognet, S; Léké, A; Adjidé, C

    2018-05-01

    A total of 1099 breastmilk donations received by the milk bank at the Amiens University Hospital from January to June 2016 were assessed for bacteriological contamination according to French regulations. This consisted in enumerating the total aerobic flora before and after heat treatment as well as the specific enumeration of coagulase-positive staphylococci. Results above the mandatory limits for at least one of these parameters were found in 25.9% of the donations, resulting in the destruction of approximately one-quarter of the volume of the donations (∼195L). This is a huge loss in both economic and health-related terms for neonates, especially for pre-terms. To identify ways to improve the bacteriological assessment results and reduce the percentage of discarded milk, an analysis of the causes was conducted. The two main causes of non-compliance were the detection of a cultivable aerobic flora after heat treatment and the presence of coagulase-positive staphylococci above the mandatory limit (11.7% and 11.2% of the tested donations, respectively). Bacillus spp. were the leading cause of post-heat-treatment non-compliance. Therefore, the implementation of better environmental control could help reduce this kind of contamination. As for samples harboring coagulase-positive staphylococci, a further detection of toxins using molecular biology techniques could help discriminate actual health-hazardous donations that have to be destroyed while enabling the use of toxin-negative donations. Nevertheless, the economic viability of this proposal needs to be further assessed because these techniques are costly. Finally, a change in breastmilk dilutions used to enumerate the total aerobic flora to better reflect the actual level of these bacteria in the milk was proposed. Indeed, the comparison of various combinations of milk dilutions led to the conclusion that the association of the 1/10 and 1/100 dilutions was the best compromise between technical ease of

  17. Risk assessments and safe machinery ensuring compliance with the EU directives

    CERN Document Server

    Jespen, Torben

    2016-01-01

    This book describes the prerequisites for the placing on the market and the safe use of machinery in compliance with the relevant EU Directives, especially the Machinery Directive 2006/42. It provides readers with high-level knowledge concerning the Essential Health and Safety Requirements (EHSR) that machinery must fulfill. The approach and principles of the Machinery Directive were most recently made worldwide acknowledged in the ILO code of practice on safe machinery, released in 2013. The book addresses that code, as well as providing valuable insight into other EU Product and Workplace legislation. Focusing on the key aspect of safe machinery, the “machinery safety risk assessment”, which allows readers to better understand the more difficult aspects of risk assessments, the book equips readers to tackle problems at the manufacturing stage and in different use scenarios, introducing them to risk reduction techniques and functional safety aspects.

  18. Radio frequency electromagnetic field compliance assessment of multi-band and MIMO equipped radio base stations.

    Science.gov (United States)

    Thors, Björn; Thielens, Arno; Fridén, Jonas; Colombi, Davide; Törnevik, Christer; Vermeeren, Günter; Martens, Luc; Joseph, Wout

    2014-05-01

    In this paper, different methods for practical numerical radio frequency exposure compliance assessments of radio base station products were investigated. Both multi-band base station antennas and antennas designed for multiple input multiple output (MIMO) transmission schemes were considered. For the multi-band case, various standardized assessment methods were evaluated in terms of resulting compliance distance with respect to the reference levels and basic restrictions of the International Commission on Non-Ionizing Radiation Protection. Both single frequency and multiple frequency (cumulative) compliance distances were determined using numerical simulations for a mobile communication base station antenna transmitting in four frequency bands between 800 and 2600 MHz. The assessments were conducted in terms of root-mean-squared electromagnetic fields, whole-body averaged specific absorption rate (SAR) and peak 10 g averaged SAR. In general, assessments based on peak field strengths were found to be less computationally intensive, but lead to larger compliance distances than spatial averaging of electromagnetic fields used in combination with localized SAR assessments. For adult exposure, the results indicated that even shorter compliance distances were obtained by using assessments based on localized and whole-body SAR. Numerical simulations, using base station products employing MIMO transmission schemes, were performed as well and were in agreement with reference measurements. The applicability of various field combination methods for correlated exposure was investigated, and best estimate methods were proposed. Our results showed that field combining methods generally considered as conservative could be used to efficiently assess compliance boundary dimensions of single- and dual-polarized multicolumn base station antennas with only minor increases in compliance distances. © 2014 Wiley Periodicals, Inc.

  19. Role of health education and self-action plan in improving the drug compliance in bronchial asthma.

    Science.gov (United States)

    Gaude, Gajanan S; Hattiholi, Jyothi; Chaudhury, Alisha

    2014-01-01

    Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the suboptimal control of the disease. To study the adherence for aerosol therapy in bronchial asthma patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy. A prospective study was done in a total of 500 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed-up for a total of 12 weeks for calculation of nonadherence to the aerosol therapy. In nonadherent patients, we employed various health education strategies to improve the compliance in these cases. A total of 500 patients of bronchial asthma who were started on aerosol therapy over duration of 2 years were included in the study. At the end of 12 weeks, it was observed that, only 193 patients (38.6%) had regular compliance and 307 patients (61.4%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, and distant pharmacies. Nondrug factors that reduced the compliance were: Fears about side effects, anger about condition or its treatment, forgetfulness or complacency, and patient's ill attitudes toward health. After employing the various strategies for improving the compliance in these patients, the compliance increased in 176 patients (57.3%) among the earlier defaulted patients, while the remaining 131 patients (42.7%) were found to be noncompliant even after various educational techniques. Noncompliance in asthma management is a fact of life and no single compliance improving strategy probably will be as effective as a good physician

  20. Teacher Compliance and Accuracy in State Assessment of Student Motor Skill Performance

    Science.gov (United States)

    Hall, Tina J.; Hicklin, Lori K.; French, Karen E.

    2015-01-01

    Purpose: The purpose of this study was to investigate teacher compliance with state mandated assessment protocols and teacher accuracy in assessing student motor skill performance. Method: Middle school teachers (N = 116) submitted eighth grade student motor skill performance data from 318 physical education classes to a trained monitoring…

  1. 5 CFR 330.503 - Assessment of compliance with competitive principles.

    Science.gov (United States)

    2010-01-01

    ... principles. 330.503 Section 330.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Restrictions To Protect Competitive Principles § 330.503 Assessment of compliance with competitive principles. As one factor in assessing an agency's...

  2. Safety standards for near surface disposal and the safety case and supporting safety assessment for demonstrating compliance with the standards

    International Nuclear Information System (INIS)

    Metcalf, P.

    2003-01-01

    The report presents the safety standards for near surface disposal (ICRP guidance and IAEA standards) and the safety case and supporting safety assessment for demonstrating compliance with the standards. Special attention is paid to the recommendations for disposal of long-lived solid radioactive waste. The requirements are based on the principle for the same level of protection of future individuals as for the current generation. Two types of exposure are considered: human intrusion and natural processes and protection measures are discussed. Safety requirements for near surface disposal are discussed including requirements for protection of human health and environment, requirements or safety assessments, waste acceptance and requirements etc

  3. Physicians′ therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

    Directory of Open Access Journals (Sweden)

    Nahla Khamis R Ibrahim

    2010-01-01

    Full Text Available Objectives: The objectives of the study were to investigate physician′s therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. Material and Methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient′s knowledge and skills, patient′s compliance, doctor-patient relationship, and glycemic control. Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3% of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient′s knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Conclusions: Patient′s compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient′s compliance should be improved by conducting educational and training programs.

  4. Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

    Science.gov (United States)

    Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

    2015-09-01

    Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

  5. Gaming of performance measurement in health care: parallels with tax compliance.

    Science.gov (United States)

    Mears, Alex; Webley, Paul

    2010-10-01

    Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.

  6. Psychometrics of a new questionnaire to assess glaucoma adherence: the Glaucoma Treatment Compliance Assessment Tool (an American Ophthalmological Society thesis).

    Science.gov (United States)

    Mansberger, Steven L; Sheppler, Christina R; McClure, Tina M; Vanalstine, Cory L; Swanson, Ingrid L; Stoumbos, Zoey; Lambert, William E

    2013-09-01

    To report the psychometrics of the Glaucoma Treatment Compliance Assessment Tool (GTCAT), a new questionnaire designed to assess adherence with glaucoma therapy. We developed the questionnaire according to the constructs of the Health Belief Model. We evaluated the questionnaire using data from a cross-sectional study with focus groups (n = 20) and a prospective observational case series (n=58). Principal components analysis provided assessment of construct validity. We repeated the questionnaire after 3 months for test-retest reliability. We evaluated predictive validity using an electronic dosing monitor as an objective measure of adherence. Focus group participants provided 931 statements related to adherence, of which 88.7% (826/931) could be categorized into the constructs of the Health Belief Model. Perceived barriers accounted for 31% (288/931) of statements, cues-to-action 14% (131/931), susceptibility 12% (116/931), benefits 12% (115/931), severity 10% (91/931), and self-efficacy 9% (85/931). The principal components analysis explained 77% of the variance with five components representing Health Belief Model constructs. Reliability analyses showed acceptable Cronbach's alphas (>.70) for four of the seven components (severity, susceptibility, barriers [eye drop administration], and barriers [discomfort]). Predictive validity was high, with several Health Belief Model questions significantly associated (P <.05) with adherence and a correlation coefficient (R (2)) of .40. Test-retest reliability was 90%. The GTCAT shows excellent repeatability, content, construct, and predictive validity for glaucoma adherence. A multisite trial is needed to determine whether the results can be generalized and whether the questionnaire accurately measures the effect of interventions to increase adherence.

  7. Possible role of plasma ceruloplasmin and erythrocyte sedimentation rate in assessing compliance with occupational hygiene and safety practices in waste management workers.

    Science.gov (United States)

    Odewabi, Adesina O; Ogundahunsi, Omobola A; Odewabi, Adenike A; Oritogun, Kolawole S; Ekor, Martins

    2013-05-01

    Work-related health and safety risks are common among waste management workers (WMWs). This study investigated the level of compliance with safety measures in relation to levels of inflammatory markers among WMWs in Sagamu, South-West Nigeria. WMWs comprising 30 cart pushers (CPs) and 50 truck users (TUs) were recruited alongside 45 people from the normal population as control. Data on health complaints were obtained from questionnaire surveys. Inflammation was assessed by measuring plasma ceruloplasmin (Cp), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and albumin. WMWs exhibited a significantly higher prevalence of respiratory and gastrointestinal symptoms and poor compliance with health and safety measures. Significant (P footwear between TUs and CPs. ESR, Cp, and CRP increased significantly (P safety measures. ESR and Cp may be useful predictors of occupational hygiene and compliance with safety measures among Nigerian WMWs.

  8. Environmental compliance assessment findings for Weldon Spring Site Remedial Action Program

    International Nuclear Information System (INIS)

    Sigmon, C.F.; Levine, M.B.

    1990-01-01

    This report presents the results of an environmental assessment conducted at Weldon Spring Site Remedial Action Project (WSSRAP) in St. Charles County, Missouri, in accordance with the Formerly Utilized Sites Remedial Action Program (FUSRAP) Environmental Compliance Assessment Checklists. The purpose of this assessment was to evaluate the compliance of the site with applicable federal and Missouri environment regulations. Assessments activities included the following: review of site records, reports ,and files; inspection of the WSSRAP storage building, other selected buildings, and the adjacent grounds; and interviews with project personnel. This assessment was conducted on August 28-30, 1989. The assessment covered five management areas as set forth in the Checklist: Hazardous Waste Management, Polychlorinated Biphenyls (PCBs) Management; Air Emissions; Wastewater Discharges and Petroleum Management. No samples were collected. 1 ref., 2 figs., 1 tab

  9. Health beliefs affect the correct replacement of daily disposable contact lenses: Predicting compliance with the Health Belief Model and the Theory of Planned Behaviour.

    Science.gov (United States)

    Livi, Stefano; Zeri, Fabrizio; Baroni, Rossella

    2017-02-01

    To assess the compliance of Daily Disposable Contact Lenses (DDCLs) wearers with replacing lenses at a manufacturer-recommended replacement frequency. To evaluate the ability of two different Health Behavioural Theories (HBT), The Health Belief Model (HBM) and The Theory of Planned Behaviour (TPB), in predicting compliance. A multi-centre survey was conducted using a questionnaire completed anonymously by contact lens wearers during the purchase of DDCLs. Three hundred and fifty-four questionnaires were returned. The survey comprised 58.5% females and 41.5% males (mean age 34±12years). Twenty-three percent of respondents were non-compliant with manufacturer-recommended replacement frequency (re-using DDCLs at least once). The main reason for re-using DDCLs was "to save money" (35%). Predictions of compliance behaviour (past behaviour or future intentions) on the basis of the two HBT was investigated through logistic regression analysis: both TPB factors (subjective norms and perceived behavioural control) were significant (pbehaviour and future intentions) and perceived benefit (only for past behaviour) as significant factors (pbehavioural control of daily replacement (behavioural control) are of paramount importance in improving compliance. With reference to the HBM, it is important to warn DDCLs wearers of the severity of a contact-lens-related eye infection, and to underline the possibility of its prevention. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  10. Assessment of pressurized nuclear equipment compliance - ASN guide no. 8, version of 04/09/2012

    International Nuclear Information System (INIS)

    2012-01-01

    This document describes the modalities according to which the compliance assessment of pressurized nuclear equipment must be performed by inspecting organisations according to a decree of December 1999 and an order of December 2005. After an indication of reference documents and some technical definitions, this guide describes the equipment classification and the principles of intervention. These principles concern the assessment request and the various assessment tasks to be performed by the inspecting organisation

  11. 42 CFR 137.368 - Is the Secretary responsible for oversight and compliance of health and safety codes during...

    Science.gov (United States)

    2010-10-01

    ... compliance of health and safety codes during construction projects being performed by a Self-Governance Tribe... SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in Establishing and Implementing Construction Project Agreements § 137.368 Is the Secretary responsible for oversight and compliance of health...

  12. Compliance demonstration: What can be reasonably expected from safety assessment for geological repositories?

    International Nuclear Information System (INIS)

    Zuidema, P.; Smith, P.; Sumerling, T.

    1999-01-01

    When licensing a nuclear facility, it is important to demonstrate that it will comply with regulatory limits (e.g. individual dose limits) and also show that sufficient attention has been paid to optimisation of facility design and operation, such that any associated radiological impacts will be as low as reasonably achievable (ALARA). In general, in demonstrating compliance, experience can be drawn from the performance of existing and similar facilities, and monitoring plans can be specified that will confirm that actual radiological discharges during operations are within authorised limits for the facility. This is also true in respect of the operational period of a geological repository. For the post-closure phase of a repository, however, it is also necessary to show that possible releases will remain acceptably low even at long times in the future when, it is assumed, control of the facility has lapsed and there is no method of either monitoring releases or taking remedial action in the case of unexpected events or releases. In addition, within each country, a deep geological repository will be a first-of-a-kind development so that compliance arguments can be expected to be rigorously tested without any assistance from the precedent of licensing of similar facilities nationally. This puts heavy, and quite unusual, burdens on the long-term safety assessment for a geological repository to develop a case that is sufficiently strong to demonstrate compliance. This paper focuses on the problem of demonstrating compliance with long-term safety requirements for a geological repository, and explores: the overall aims and special difficulties of demonstrating compliance for a geological repository; the role of safety assessment in demonstrating compliance; the scope for optimisation of a geological repository and importance of robustness and lessons learnt from the application of safety assessment. In addition, some issues requiring further discussion and clarification

  13. 40 CFR 63.1215 - What are the health-based compliance alternatives for total chlorine?

    Science.gov (United States)

    2010-07-01

    ... congregate for work, school, or recreation. (iii) Your facility is eligible for the health-based compliance... for work, school, or recreation; (C) Use site-specific, quality-assured data wherever possible; (D... diameter, stack gas temperature, and stack gas exit velocity; (D) Plot plan showing all stack emission...

  14. A task management system for compliance with health, safety, and environmental regulations

    International Nuclear Information System (INIS)

    Crump, J.J.; O'Gorman, T.P.

    1992-01-01

    Shell Western E and P Inc. (SWEPI) has developed a new computer system to help it comply with health, safety, and environmental (HS and E) regulations. It is a task management system that functions at the detailed inventory level. It schedules work, instructs operations, and records compliance status. This article discusses design and development of the system

  15. Capnography for assessing nocturnal hypoventilation and predicting compliance with subsequent noninvasive ventilation in patients with ALS.

    Directory of Open Access Journals (Sweden)

    Sung-Min Kim

    Full Text Available BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS suffer from hypoventilation, which can easily worsen during sleep. This study evaluated the efficacy of capnography monitoring in patients with ALS for assessing nocturnal hypoventilation and predicting good compliance with subsequent noninvasive ventilation (NIV treatment. METHODS: Nocturnal monitoring and brief wake screening by capnography/pulse oximetry, functional scores, and other respiratory signs were assessed in 26 patients with ALS. Twenty-one of these patients were treated with NIV and had their treatment compliance evaluated. RESULTS: Nocturnal capnography values were reliable and strongly correlated with the patients' respiratory symptoms (R(2 = 0.211-0.305, p = 0.004-0.021. The duration of nocturnal hypercapnea obtained by capnography exhibited a significant predictive power for good compliance with subsequent NIV treatment, with an area-under-the-curve value of 0.846 (p = 0.018. In contrast, no significant predictive values for nocturnal pulse oximetry or functional scores for nocturnal hypoventilation were found. Brief waking supine capnography was also useful as a screening tool before routine nocturnal capnography monitoring. CONCLUSION: Capnography is an efficient tool for assessing nocturnal hypoventilation and predicting good compliance with subsequent NIV treatment of ALS patients, and may prove useful as an adjunctive tool for assessing the need for NIV treatment in these patients.

  16. Peer Assessment and Compliance Review (PACR) Innovative Strategies Report. California Court Appointed Special Advocates (CASA) Programs

    Science.gov (United States)

    Macro, Bronwen; Huang, Lee Ann

    2005-01-01

    This report focuses on the innovative strategies study component of the Peer Assessment and Compliance Review (PACR) project. California (Court Appointed Special Advocates) CASA programs have developed many innovative strategies to serve children in their communities. At each of the programs visited during the PACR project, the team identified at…

  17. personal characteristics and compliance to health education among

    African Journals Online (AJOL)

    Global Journal

    2016-10-08

    Oct 8, 2016 ... This study investigated personal characteristics (individual factors) ... Three research questions and one hypothesis were formulated to ... Literature ... good nutrition, exercise, clothing and travel during ... health education, she must be aware of the benefits of ..... International Journal for Women's Health.

  18. personal characteristics and compliance to health education among

    African Journals Online (AJOL)

    Global Journal

    2016-10-08

    Oct 8, 2016 ... Health education is one of the major aims of antenatal care. Health ... region to region and from state to state with its resultant perculiar complications. .... researchers because it is a referral and training centre for all cadres of ...

  19. 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.

  20. An Assessment Of Compliance Of Building Construction Projects ...

    African Journals Online (AJOL)

    indirect impacts on the environment by displacement of communities and ... These pose threats to the existence of man and the sustenance of natural vegetation. Environmental Impact Assessment (EIA) is encapsulated as a practicable ...

  1. Compliance with focused antenatal care services: do health workers in rural Burkina Faso, Uganda and Tanzania perform all ANC procedures?

    Science.gov (United States)

    Conrad, Paul; Schmid, Gerhrd; Tientrebeogo, Justin; Moses, Arinaitwe; Kirenga, Silvia; Neuhann, Florian; Müller, Olaf; Sarker, Malabika

    2012-03-01

    To assess health workers' compliance with the procedures set in the focused antenatal care (ANC) guidelines in rural Uganda, Tanzania and Burkina Faso; to compare the compliance within and among the three study sites; and to appraise the logistic and supply of the respective health facilities (HF). The cross-sectional study was conducted in the rural HF in three African countries. This descriptive observational study took place in HF in Nouna, Burkina Faso (5), Iganga, Uganda (6) and Rufiji, Tanzania (7). In total, 788 ANC sessions and service provisions were observed, the duration of each ANC service provision was calculated, and the infrastructures of the respective HF were assessed. Health workers in all HF performed most of the procedures but also omitted certain practices stipulated in the focused ANC guidelines. There was a substantial variation in provision of ANC services among HF within and among the country sites. The findings also revealed that the duration of first visits was ANC guidelines were often out of stock in most facilities. Health workers in all three country sites failed to perform all procedures stipulated in the focused ANC guideline; this could not be always explained by the lack of supplies. It is crucial to point out the necessity of the core procedures of ANC repeatedly. © 2011 Blackwell Publishing Ltd.

  2. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    USER

    the health workers' curricular, provision of in-service training in infection ... cheaper infection prevention and control methods7. In Zambia ... Zambia Infection Prevention Guidelines in 2003. This ..... Control (IPC) Policies and Guidelines or.

  3. Intervention effects on safety compliance and citizenship behaviors: Evidence from the Work, Family, and Health Study.

    Science.gov (United States)

    Hammer, Leslie B; Johnson, Ryan C; Crain, Tori L; Bodner, Todd; Kossek, Ellen Ernst; Davis, Kelly D; Kelly, Erin L; Buxton, Orfeu M; Karuntzos, Georgia; Chosewood, L Casey; Berkman, Lisa

    2016-02-01

    We tested the effects of a work-family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 health care facilities using a group-randomized trial. Based on conservation of resources theory and the work-home resources model, we hypothesized that implementing a work-family intervention aimed at increasing contextual resources via supervisor support for work and family, and employee control over work time, would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline and at 6-month and 12-month postintervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month, and organizational citizenship behaviors at the 12-month, follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors compared with employees in the control facilities. The hypothesized mediators of perceptions of family-supportive supervisor behaviors, control over work time, and work-family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family-supportive supervisor behaviors, control over work time, and work-family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes. (c) 2016 APA, all rights reserved).

  4. ATEX explosive atmospheres : risk assessment, control and compliance

    CERN Document Server

    Jespen, Torben

    2016-01-01

    This book details how safety (i.e. the absence of unacceptable risks) is ensured in areas where potentially explosive atmospheres (ATEX) can arise. The book also offers readers essential information on how to comply with the newest (April 2016) EU legislation when the presence of ATEX cannot be avoided. By presenting general guidance on issues arising out of the EU ATEX legislation – especially on zone classification, explosion risk assessment, equipment categorization, Ex-marking and related technical/chemical aspects – the book provides equipment manufacturers, responsible employers, and others with the essential knowledge they need to be able to understand the different – and often complicated – aspects of ATEX and to implement the necessary safety precautions. As such, it represents a valuable resource for all those concerned with maintaining high levels of safety in ATEX environments.

  5. Assessment of Entrepreneurship in Indonesia Towards Compliance on Facing Afta

    Directory of Open Access Journals (Sweden)

    Hendry Hartono

    2013-05-01

    Full Text Available Entrepreneurship as a process of establishment of SMEs or business ventures in many sectors, have greatly contributed in the creation of jobs, innovation and to economic growths. Economic activities of large company tend to create opportunities for SMEs through creating new market as technology implementation. Government supports are needed to provide national intermediaries for supporting the entrepreneur to start the business, also preparing them for global competitive market. Intermediaries support government for educate entrepreneur increase their skill, knowledge, and motivate them as a coach. Intermediaries can from expert individual, private institution, and higher education institution. The purposes of this paper are to assess entrepreneurship in Indonesia and to offer some recommendations that can be followed up that can significantlygive positive impact on entrepreneurship development in Indonesia ahead of the implementation of AFTA.

  6. Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial.

    Science.gov (United States)

    Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens T; Boyle, Eleanor; Andersen, Lars L; Sjøgaard, Gisela

    2015-10-01

    The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1 WS: one 60-min supervised session/week, 3 WS: three 20-min supervised sessions/week, 9 WS: nine 7-min supervised sessions/week, 3 MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3 WS and 3 MS. If no difference, training groups were collapsed (TG) and compared with REF. Results demonstrated similar degrees of compliance, mean(range) of 39(33-44)%, and total training volume, 13.266(11.977-15.096)kg. Musculoskeletal pain in neck and shoulders were reduced with approx. 50% in TG, which was significant compared with REF. Only the training groups improved significantly their muscle strength 8(4-13)% and endurance 27(12-37)%, both being significant compared with REF. No change in workability, productivity or self-rated health was demonstrated. Secondary analysis showed exercise self-efficacy to be a significant predictor of compliance. Regardless of training schedule and supervision, similar degrees of compliance were shown together with reduced musculoskeletal pain and improved muscle performance. These findings provide evidence that a great degree of flexibility is legitimate for companies in planning future implementation of physical exercise programs at the workplace. ClinicalTrials.gov, number NCT01027390. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

    Science.gov (United States)

    Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

    2014-07-01

    Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

  8. Project W-420 Ventilation Stack Monitoring System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This document contains a limited assessment of Year 2000 compliance for Project W-420. Additional information is provided as a road map to project documents and other references that may be used to verify Year 2000 compliance. This assessment describes the potential Year 2000 (Y2K) problems and describes the methods for achieving Y2K Compliance for Project W-420, Ventilation Stack Monitoring Systems Upgrades. The purpose of this assessment is to give an overview of the project. This document will not be updated and any dates contained in this document are estimates and may change. The project work scope includes upgrades to ventilation stacks and generic effluent monitoring systems (GEMS) at the 244-A Double Contained Receiver Tank (DCRT), the 244-BX DCRT, the 244-CR Vault, tanks 241-C-105 and 241-C-106, the 244-S DCRT, and the 244-TX DCRT. A detailed description of system dates, functions, interfaces, potential Y2K problems, and date resolutions can not be described since the project is in the definitive design phase, This assessment will describe the methods, protocols, and practices to ensure that equipment and systems do not have Y2K problems

  9. Does training frequency and supervision affect compliance, performance and muscular health?

    DEFF Research Database (Denmark)

    Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens Theisen

    2015-01-01

    The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance......, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1WS: one 60-min supervised session/week, 3WS: three 20-min supervised sessions/week, 9WS: nine 7-min supervised sessions/week, 3MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without...... training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3WS and 3MS. If no difference, training groups were collapsed (TG) and compared with REF...

  10. Customs Service Modernization: Impact of New Trade Compliance Strategy Needs to Be Assessed.

    Science.gov (United States)

    1999-12-01

    The Mod Act fundamentally altered the relationship between importers and Customs by shifting from Customs to the importer the legal responsibility...New Trade Compliance Strategy B-280470 • account management : Customs ’ approach to managing its work through accounts (importing companies) rather...assessment, account management , and Customs ’ responses to noncompliant importers have been implemented but have not yet reached many of the intended

  11. Environmental assessment of ground-water compliance activities at the Uranium Mill Tailings Site, Spook, Wyoming

    International Nuclear Information System (INIS)

    1997-02-01

    This report assesses the environmental impacts of the Uranium Mill Tailings Site at Spook, Wyoming on ground water. DOE previously characterized the site and monitoring data were collected during the surface remediation. The ground water compliance strategy is to perform no further remediation at the site since the ground water in the aquifer is neither a current nor potential source of drinking water. Under the no-action alternative, certain regulatory requirements would not be met

  12. The Canadian Natural Health Products (NHP regulations: industry perceptions and compliance factors

    Directory of Open Access Journals (Sweden)

    Boon Heather

    2006-05-01

    Full Text Available Abstract Background The use of natural health products, such as vitamins, minerals, and herbs, by Canadians has been increasing with time. As a result of consumer concern about the quality of these products, the Canadian Department of Health created the Natural Health Products (NHP Regulations. The new Canadian regulations raise questions about whether and how the NHP industry will be able to comply and what impact they will have on market structure. The objectives of this study were to explore who in the interview sample is complying with Canada's new NHP Regulations (i.e., submitted product licensing applications on time; and explore the factors that affect regulatory compliance. Methods Twenty key informant interviews were conducted with employees of the NHP industry. The structured interviews focused on the level of satisfaction with the Regulations and perceptions of compliance and non-compliance. Interviews were tape recorded and then transcribed verbatim. Data were independently coded, using qualitative content analysis. Team meetings were held after every three to four interviews to discuss emerging themes. Results The major finding of this study is that most (17 out of 20 companies interviewed were beginning to comply with the new regulatory regime. The factors that contribute to likelihood of regulatory compliance were: perceptions and knowledge of the regulations and business size. Conclusion The Canadian case can be instructive for other countries seeking to implement regulatory standards for natural health products. An unintended consequence of the Canadian NHP regulations may be the exit of smaller firms, leading to industry consolidation.

  13. Bureau of radiological health compliance testing procedures for cabinet S-ray systems

    International Nuclear Information System (INIS)

    Miller, E.A.; Sprau, D.

    1976-01-01

    A manual has been developed by the Bureau of Radiological Health of the Food and Drug Administration to establish procedures for the routine field testing of cabinet x-ray systems to determine compliance with the Federal Performance Standard for Cabinet X-Ray Systems, 21 CFR 1020.40. The manual provides specific instructions for testing each model of cabinet x-ray system. Results from the inspection are recorded on a data from which is designed to permit automatic data processing

  14. Continuous assessment of carotid intima-media thickness applied to estimate a volumetric compliance using B-mode ultrasound sequences

    International Nuclear Information System (INIS)

    Pascaner, A F; Craiem, D; Casciaro, M E; Graf, S; Danielo, R; Guevara, E

    2015-01-01

    Recent reports have shown that the carotid artery wall had significant movements not only in the radial but also in the longitudinal direction during the cardiac cycle. Accordingly, the idea that longitudinal elongations could be systematically neglected for compliance estimations became controversial. Assuming a dynamic change in vessel length, the standard measurement of cross-sectional compliance can be revised. In this work, we propose to estimate a volumetric compliance based on continuous measurements of carotid diameter and intima-media thickness (IMT) from B-mode ultrasound sequences. Assuming the principle of conservation of the mass of wall volume (compressibility equals zero), a temporal longitudinal elongation can be calculated to estimate a volumetric compliance. Moreover, elongations can also be estimated allowing small compressibility factors to model some wall leakage. The cross-sectional and the volumetric compliance were estimated in 45 healthy volunteers and 19 asymptomatic patients. The standard measurement underestimated the volumetric compliance by 25% for young volunteers (p < 0.01) and 17% for patients (p < 0.05). When compressibility factors different from zero were allowed, volunteers and patients reached values of 9% and 4%, respectively. We conclude that a simultaneous assessment of carotid diameter and IMT can be employed to estimate a volumetric compliance incorporating a longitudinal elongation. The cross-sectional compliance, that neglects the change in vessel length, underestimates the volumetric compliance. (paper)

  15. The impact of farmers’ participation in field trials in creating awareness and stimulating compliance with the World Health Organization’s farm-based multiple-barrier approach

    DEFF Research Database (Denmark)

    Amponsah, Owusu; Vigre, Håkan; Schou, Torben Wilde

    2016-01-01

    -barrier approach field trials. The results of the study show that participation in the field trials has statistically significant effects on farmers’ awareness of the farm-based multiple-barrier approach. Compliance has, however, been undermined by the farmers’ perception that the cost of compliance is more......The results of a study aimed as assessing the extent to which urban vegetable farmers’ participation in field trials can impact on their awareness and engender compliance with the World Health Organization’s farm-based multiple-barrier approach are presented in this paper. Both qualitative...... and quantitative approaches have been used in this paper. One hundred vegetable farmers and four vegetable farmers’ associations in the Kumasi Metropolis in Ghana were covered. The individual farmers were grouped into two, namely: (1) participants and (2) non-participants of the farm-based multiple...

  16. Environmental Assessment of Ground Water Compliance at the Gunnison, Colorado, UMTRA Project Site

    International Nuclear Information System (INIS)

    2002-01-01

    The U.S. Department of Energy (DOE) is in the process of selecting a ground water compliance strategy for the Gunnison, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project site. This Environmental Assessment (EA) discusses two alternatives and the effects associated with each. The two alternatives are (1) natural flushing coupled with institutional controls and continued monitoring and (2) no action. The compliance strategy must meet U.S. Environmental Protection Agency (EPA) ground water standards defined in Title 40 ''Code of Federal Regulations'' Part 192, Subpart B, in areas where ground water beneath and around the site is contaminated as a result of past milling operations. It has been determined that contamination in the ground water at the Gunnison site consists of soluble residual radioactive material (RRM) as defined in the Uranium Mill Tailings Radiation Control Act (UMTRCA)

  17. Interventions to improve the compliance of health care professionals to hand washing: an integrative review

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2013-12-01

    Full Text Available The objective of this study was to identify the main strategies used to improve the compliance of health care professionals to hand washing. This is an integrative literature review, which search included journals in English, Spanish and Portuguese. Twenty—three articles were included. An electronic tool was developed on Microsoft Office Excel and the main results were submitted to descriptive analysis. Of the total studies, 87.1% had before and after designs and several methods were used to monitor compliance rate (direct observation, supply use and self-reported rates. Multimodal interventions were used in 87.0%, and the most often employed were: education, feedback, alcohol being available and posters. The largest challenge identified was not only improving the compliance rates to hand washing, but, most of all, keeping them high. It was observed there is a need to use multimodal strategies that contribute to behavior change considering the local setting. Descriptors: Hand Disinfection; Health Personnel; Cross Infection; Nursing.

  18. Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam.

    Science.gov (United States)

    Salmon, Sharon; McLaws, Mary-Louise

    2015-10-01

    It is accepted by hospital clinical governance that every clinician's "duty of care" includes hand hygiene, yet globally, health care workers (HCWs) continue to struggle with compliance. Focus group discussions were conducted to explore HCWs' barriers to hand hygiene in Vietnam. Twelve focus group discussions were conducted with HCWs from 6 public hospitals across Hanoi, Vietnam. Discussions included participants' experiences with and perceptions concerning hand hygiene. Tape recordings were transcribed verbatim and then translated into English. Thematic analysis was conducted by 2 investigators. Expressed frustration with high workload, limited access to hand hygiene solutions, and complicated guidelines that are difficult to interpret in overcrowded settings were considered by participants to be bona fide reasons for noncompliance. No participant acknowledged hand hygiene as a duty of care practice for her or his patients. Justification for noncompliance was the observation that visitors did not perform hand hygiene. HCWs did acknowledge a personal duty of care when hand hygiene was perceived to benefit her or his own health, and then neither workload or environmental challenges influenced compliance. Limited resources in Vietnam are amplified by overcrowded conditions and dual bed occupancy. Yet without a systematic systemic duty of care to patient safety, changes to guidelines and resources might not immediately improve compliance. Thus, introducing routine hand hygiene must start with education programs focusing on duty of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Public Health Impact and Economic Costs of Volkswagen’s Lack of Compliance with the United States’ Emission Standards

    Directory of Open Access Journals (Sweden)

    Lifang Hou

    2016-09-01

    Full Text Available The U.S. Environmental Protection Agency (EPA recently issued a notice of violation against Volkswagen (VW for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx. We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA’s Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles’ lack of compliance on the health and well-being of the U.S. population.

  20. Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance.

    Science.gov (United States)

    Anthony, Jodi; Goldman, Roberta; Rees, Vaughan W; Frounfelker, Rochelle L; Davine, Jessica; Keske, Robyn R; Brooks, Daniel R; Geller, Alan C

    2018-01-01

    As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

  1. Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

    Science.gov (United States)

    Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

    2014-12-01

    Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

  2. Compliance Framing - Framing Compliance

    OpenAIRE

    Lutz-Ulrich Haack; Martin C. Reimann

    2012-01-01

    Corporations have to install various organizational measures to comply with legal as well as internal guidelines systematically. Compliance management systems have the challenging task to make use of an internal compliance-marketing approach in order to ensure not only an adequate but also effective compliance-culture. Compliance-literature and findings of persuasive goal-framing-theory give opposite implications for establishing a rather values- versus rule-based compliance-culture respectiv...

  3. Compliance with European Guidelines for Diagnostic Mammography in a Decentralized Health-Care Setting

    International Nuclear Information System (INIS)

    Jensen, A.; Mikkelsen, G.J.; Vestergaard, M.; Lynge, E.; Vejborg, I.

    2005-01-01

    Purpose: To evaluate the compliance of Danish mammography clinics with requirements concerning organization, activity volume, and assessment procedures from two European guidelines for quality assurance in diagnostic mammography (EUSOMA and EUREF). Material and Methods: We used individual records on all diagnostic mammographies performed in Denmark in 2000, and questionnaires given to Danish mammography clinics in 2000, 2002, and 2004. Results: The study showed a marked centralization of the diagnostic activity from 2000 to 2004 to a smaller number of public breast assessment centers with full multidisciplinary breast assessment. However, a relatively large number of these centers did not comply with the activity volume requirement of 2000 mammograms per clinic per year. The number of private diagnostic mammography clinics performing basic diagnostic mammography has remained fairly stable in the period 2000 to 2004. Compared with public breast assessment centers, the private diagnostic mammography clinics had a lower compliance with activity volume requirements. Conclusion: A marked proportion of Danish public breast assessment centers operate with less than optimal activity volume, suggesting that further centralization would be appropriate. The situation in private diagnostic mammography clinics may cause concern, as our study showed that the majority of these clinics did not meet the activity volume requirements

  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. Regulatory compliance for a Yucca Mountain Repository: A performance assessment perspective

    International Nuclear Information System (INIS)

    Dyer, J.R.; Van Luik, A.E.; Gil, A.V.; Brocoum, S.J.

    1997-01-01

    The U.S. Department of Energy's Yucca Mountain Site Characterization Project is scheduled to submit a License Application in the year 2002. The License Application is to show compliance with the regulations promulgated by the U.S. Nuclear Regulatory Commission which implement standards promulgated by the U.S. Environmental Protection Agency. These standards are being revised, and it is not certain what their exact nature will be in term of either the performance measure(s) or the time frames that are to be addressed. This paper provides some insights pertaining to this regulatory history, an update on Yucca Mountain performance assessments, and a Yucca Mountain Site Characterization Project perspective on proper standards based on Project experience in performance assessment for its proposed Yucca Mountain Repository system. The Project's performance assessment based perspective on a proper standard applicable to Yucca Mountain may be summarized as follows: a proper standard should be straight forward and understandable; should be consistent with other standards and regulations; and should require a degree of proof that is scientifically supportable in a licensing setting. A proper standard should have several attributes: (1) propose a reasonable risk level as its basis, whatever the quantitative performance measure is chosen to be, (2) state a definite regulatory time frame for showing compliance with quantitative requirements, (3) explicitly recognize that the compliance calculations are not predictions of actual future risks, (4) define the biosphere to which risk needs to be calculated in such a way as to constrain potentially endless speculation about future societies and future human actions, and (5) have as its only quantitative requirement the risk limit (or surrogate performance measure keyed to risk) for the total system

  6. [Degree of compliance with health care quality criteria in the treatment of lower airway obstruction in Spanish pediatric emergency departments, reasons for noncompliance, and recommendations for improvement].

    Science.gov (United States)

    Claret Teruel, Gemma; Solé Ribalta, Anna; González Balenciaga, María; Paniagua Calzón, Natalia Marta; Korta Murua, Javier

    2016-06-01

    To determine the degree of compliance with health care quality criteria in the treatment of patients with lower airway obstruction in Spanish pediatric emergency departments (PEDs), to explore the reasons for noncompliance, and to make recommendations for improvement. We carried out a retrospective, cross-sectional study of a series of patients under the age of 14 years to determine the degree of compliance with 5 quality indicators. The patients were attended in 22 PEDs on days 1 and 15 of each month in 2013. We also distributed a questionnaire to chiefs of department to discover possible reasons for noncompliance. Finally, a group of experts followed a process to produce consensus-based recommendations to improve quality of care through compliance with the indicators. We included 2935 patients with a median (interquartile range) age of 2.8 (1.4-5.1) years. The overall rates of compliance were 39.8% for assessment of severity, 0.1% for measurement of peak flow, 64.4% for delay in attending a patient with severe shortness of breath, 59.1% for checking oxygen saturation and respiratory frequency, and 34.3% for treatment with inhalers and a spacer. The most common reasons for noncompliance were lack of time or material and the absence of the recommendation in protocols. The following improvement steps were recommended: reassess the usefulness of peak flow measurement in PEDs, reformulate the criteria for delay in attending patients with severe dyspnea, and adopt new indicators and templates that facilitate the recording of vital constants and scores on severity scales. An acceptable level of compliance was not achieved on any of the health care quality indicators for a variety of reasons. A series of steps should be taken to improve compliance.

  7. Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?

    Science.gov (United States)

    Bouchard, Chantal; Jean, Olivier

    2017-10-01

    Tracer methodology has been used by Accreditation Canada since 2008 to collect evidence on the quality and safety of care and services, and to assess compliance with accreditation standards. Given the importance of this methodology in the accreditation program, the objective of this study is to assess the quality of the methodology and identify its strengths and weaknesses. A mixed quantitative and qualitative approach was adopted to evaluate consistency, appropriateness, effectiveness and stakeholder synergy in applying the methodology. An online questionnaire was sent to 468 Accreditation Canada surveyors. According to surveyors' perceptions, tracer methodology is an effective tool for collecting useful, credible and reliable information to assess compliance with Qmentum program standards and priority processes. The results show good coherence between methodology components (appropriateness of the priority processes evaluated, activities to evaluate a tracer, etc.). The main weaknesses are the time constraints faced by surveyors and management's lack of cooperation during the evaluation of tracers. The inadequate amount of time allowed for the methodology to be applied properly raises questions about the quality of the information obtained. This study paves the way for a future, more in-depth exploration of the identified weaknesses to help the accreditation organization make more targeted improvements to the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Knowledge, Awareness and Compliance with Universal Precautions among Health Care Workers at the University Hospital of the West Indies, Jamaica

    Directory of Open Access Journals (Sweden)

    K Vaz

    2010-09-01

    Full Text Available Background: Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. Objective: To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. Method: A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Results: Almost two-thirds (64.0% of the respondents were very knowledgeable of universal precautions with significantly more females (75.4% than males (42.9% (p<0.0001. More nurses (90.0%, medical doctors (88.0% and medical technologists (70% were very knowledgeable of universal precautions (p<0.0001. More respondents (92.9% who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001. 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001. Conclusions: There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  9. Knowledge, awareness and compliance with universal precautions among health care workers at the University Hospital of the West Indies, Jamaica.

    Science.gov (United States)

    Vaz, K; McGrowder, D; Alexander-Lindo, R; Gordon, L; Brown, P; Irving, R

    2010-10-01

    Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Almost two-thirds (64.0%) of the respondents were very knowledgeable of universal precautions with significantly more females (75.4%) than males (42.9%) (p<0.0001). More nurses (90.0%), medical doctors (88.0%) and medical technologists (70%) were very knowledgeable of universal precautions (p<0.0001). More respondents (92.9%) who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001). 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001). There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

  10. Project W-420 Ventilation Stack Monitoring System Year 2000 Compliance Assessment Project Plan

    International Nuclear Information System (INIS)

    BUSSELL, J.H.

    1999-01-01

    This assessment describes the potential Year 2000 (Y2K) problems and describes the methods for achieving Y2K Compliance for Project W-420, Ventilation Stack Monitoring Systems Upgrades. The purpose of this assessment is to give an overview of the project. This document will not be updated and any dates contained in this document are estimates and may change. The project work scope includes upgrades to ventilation stacks and generic effluent monitoring systems (GEMS) at the 244-A Double Contained Receiver Tank (DCRT), the 244-BX DCRT, the 244-CR Vault, tanks 241-C-105 and 241-C-106, the 244-S DCRT, and the 244-TX DCRT. A detailed description of system dates, functions, interfaces, potential Y2K problems, and date resolutions can not be described since the project is in the definitive design phase, This assessment will describe the methods, protocols, and practices to ensure that equipment and systems do not have Y2K problems

  11. Assessment of public perception and environmental compliance at a pulp and paper facility: a Canadian case study.

    Science.gov (United States)

    Hoffman, Emma; Bernier, Meagan; Blotnicky, Brenden; Golden, Peter G; Janes, Jeffrey; Kader, Allison; Kovacs-Da Costa, Rachel; Pettipas, Shauna; Vermeulen, Sarah; Walker, Tony R

    2015-12-01

    Communities across Canada rely heavily on natural resources for their livelihoods. One such community in Pictou County, Nova Scotia, has both benefited and suffered, because of its proximity to a pulp and paper mill (currently owned by Northern Pulp). Since production began in 1967, there have been increasing impacts to the local environment and human health. Environmental reports funded by the mill were reviewed and compared against provincial and federal regulatory compliance standards. Reports contrasted starkly to societal perceptions of local impacts and independent studies. Most environmental monitoring reports funded by the mill indicate some levels of compliance in atmospheric and effluent emissions, but when compliance targets were not met, there was a lack of regulatory enforcement. After decades of local pollution impacts and lack of environmental compliance, corporate social responsibility initiatives need implementing for the mill to maintain its social licence to operate.

  12. Preoperative assessment of lung cancer patients: evaluating guideline compliance (re-audit).

    Science.gov (United States)

    Jayia, Parminderjit Kaur; Mishra, Pankaj Kumar; Shah, Raajul R; Panayiotou, Andrew; Yiu, Patrick; Luckraz, Heyman

    2015-03-01

    Guidelines have been issued for the management of lung cancer patients in the United Kingdom. However, compliance with these national guidelines varies in different thoracic units in the country. We set out to evaluate our thoracic surgery practice and compliance with the national guidelines. An initial audit in 2011 showed deficiencies in practice, thus another audit was conducted to check for improvements in guideline compliance. A retrospective study was carried out over a 12-month period from January 2013 to January 2014 and included all patients who underwent radical surgical resection for lung cancer. Data were collected from computerized records. Sixty-eight patients had radical surgery for lung cancer between January 2013 and January 2014. Four patients were excluded from the analysis due to incomplete records. Our results showed improvements in our practice compared to our initial audit. More patients underwent surgery within 4 weeks of computed tomography and positron-emission tomography scanning. An improvement was noticed in carbon monoxide transfer factor measurements. Areas for improvement include measurement of carbon monoxide transfer factor in all patients, a cardiology referral in patients at risk of cardiac complications, and the use of a global risk stratification model such as Thoracoscore. Guideline-directed service delivery provision for lung cancer patients leads to improved outcomes. Our results show improvement in our practice compared to our initial audit. We aim to liaise with other thoracic surgery units to get feedback about their practice and any audits regarding adherence to the British Thoracic Society and National Institute for Health and Care Excellence guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Performance assessment in support of compliance certification application for the WIPP project

    International Nuclear Information System (INIS)

    Jow, H.N.; Anderson, D.R.; Marietta, M.; Helton, J.; Basabilvazo, G.

    1998-03-01

    The Waste Isolation Pilot Plant (WIPP) is being developed by the US Department of Energy for the geologic (deep underground) disposal of transuranic (TRU) waste. A Compliance Certification Application (CCA) of the WIPP (1) for such disposal was submitted to the US Environmental Protection Agency (EPA) in October, 1996, and is currently under review, with a decision anticipated in late 1997. An important component of the CCA is a performance assessment (PA) for the WIPP carried out by Sandia National Laboratories. The final outcome of the PA is a complementary cumulative distribution function (CCDF) for radionuclide releases from the WIPP to the accessible environment and an assessment of the confidence with which this CCDF can be estimated. This paper describes the computational process used to develop the CCDF. The results of uncertainty and sensitivity analysis are also presented

  14. Canister storage building compliance assessment DOE Order 6430.1A, General Design Criteria

    International Nuclear Information System (INIS)

    BLACK, D.M.

    1999-01-01

    This document presents the Project's position on compliance with DOE Order 6430.1A ''General Design Criteria.'' No non-compliances are shown. The compliance statements have been reviewed and approved by DOE. Open items are scheduled to be closed prior to project completion

  15. Canister storage building compliance assessment SNF project NRC equivalency criteria - HNF-SD-SNF-DB-003

    International Nuclear Information System (INIS)

    BLACK, D.M.

    1999-01-01

    This document presents the Project's position on compliance with the SNF Project NRC Equivalency Criteria - HNF-SD-SNF-DE-003, Spent Nuclear Fuel Project Path Forward Additional NRC Requirements. No non-compliances are shown. The compliance statements have been reviewed and approved by DOE. Open items are scheduled to be closed prior to project completion

  16. Application of transtheoretical model to assess the compliance of chronic periodontitis patients to periodontal therapy

    Directory of Open Access Journals (Sweden)

    Shilpa Emani

    2016-01-01

    Full Text Available Background: The present cross-sectional survey study was conducted to assess whether the transtheoretical model for oral hygiene behavior was interrelated in theoretically consistent directions in chronic periodontitis patients and its applicability to assess the compliance of the chronic periodontitis patients to the treatment suggested. Materials and Methods: A total of 150 chronic periodontitis patients were selected for the proposed study. The selected patients were given four questionnaires that were constructed based on transtheoretical model (TTM, and the patients were divided subsequently into five different groups (precontemplation, contemplation, preparation, action, and maintenance groups based on their answers to the questionnaires. Then, each patient was given four appointments for their periodontal treatment spaced with a time gap of 10 days. The patients visit for each appointments scheduled to them was documented. The results obtained were assessed using TTM. Results: Higher mean pro scores of decisional balance, self-efficacy, and process of change scores was recorded in maintenance group followed by action group, preparation group, contemplation group, and precontemplation group, respectively, whereas higher mean cons score was recorded in precontemplation group followed by contemplation group, preparation group, action group, and maintenance group, respectively. The difference scores of TTM constructs were statistically highly significant between all the five groups. Furthermore, the number of appointment attended in were significantly more than maintenance group followed by action group, preparation group, contemplation group, and precontemplation group. Conclusion: Within the limitations of this study, it can be concluded that transtheoretical model can be successfully applied to chronic periodontitis patients to assess their compliance to the suggested periodontal treatment.

  17. 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...

  18. 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

  19. An assessment tool to ensure compliance for the Imperial Oil Cold Lake operations

    Energy Technology Data Exchange (ETDEWEB)

    Wright, R. [HFP Acoustical Consultants Corp., Calgary, AB (Canada); Nixon, J.K. [Imperial Oil Resources Canada, Calgary, AB (Canada)

    2005-07-01

    In order to address noise issues at Imperial Oil Resources' (IOR) Cold Lake facility, HFP Acoustical Consultants Corp. was hired to develop a noise assessment tool. The innovative tool which has been used successfully by IOR for the past 2 years to self-monitor IOR's predicted sound level contributions for the Cold Lake Operations Lease area, consists of a noise computer model and a noise assessment spreadsheet. The tool is designed to ensure that the sound levels are below those designated by the Alberta Energy and Utilities Board's (EUB) Permissible Sound Level of 40 dBa from a facility to the nearest or most impacted residence. The tool has exceeded design expectations and goals and the spreadsheet has proven to be effective in predicting non-compliance concerns prior to a new facility being constructed or operated. The tool has been incorporated into IOR's corporate project planning process. The tool has shown that the noise contributions from the Cold Lake Lease area are below the EUB Permissible Sound Levels. IOR does not believe that the noise contribution from this area will increase over the life of the project unless a facility is added close to a residence. The IOR-EUB Compliance Self-Assessment Framework, which allows IOR to self-manage noise for its operations, made it possible for IOR to implement this new, site specific regulatory tool which provides accurate, immediate and auditable due-diligence documentation. 6 refs., 2 figs.

  20. 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.

  1. The Mental Health Care Act: Stakeholder compliance with respect to Section 40 of the Act.

    Directory of Open Access Journals (Sweden)

    Greg Wayne Jonsson

    2009-06-01

    Full Text Available Objective. To determine compliance with Section 40 (1-3 of the Mental Health Care Act (MHCA No 17 of 2002, viz. handing over custody by the South African Police Service (SAPS of suspected mentally ill patients to medical services at Chris Hani Baragwanath Hospital (CHBH. Methods. The study was a retrospective record review of patients who were 18 years and older, referred by SAPS to CHBH. In accordance with Section 40 of the MHCA, a MHCA form 22 is completed when suspected mentally ill patients are handed over by SAPS to the medical services. MHCA forms 22 that were completed during the period July 2007 to December 2007 were obtained from hospital records and analysed to determine the compliance of SAPS and medical practitioners in completing them. Results. During the study period, 708 of the 718 patients handed over by SAPS to the Emergency Department of CHBH were entered on MHCA forms 22. SAPS officials had correctly completed 86% of the forms, whereas the medical practitioners had only correctly completed 9.9% of the forms. Of the 718 patients handed over by SAPS, 319 (44% were discharged for outpatient care. Conclusion. The findings of this study suggest that not all parties fully comply with Section 40 of the Mental Health Care Act No 17 of 2002. We suggest that the situation can be improved by training of all parties; amendments to the MHCA form 22; partnership between mental health care practitioners and members of SAPS; and combining resources towards implementing a crisis intervention model similar to that in other countries.

  2. Smartphone text message service to foster hand hygiene compliance in health care workers.

    Science.gov (United States)

    Kerbaj, Jad; Toure, Youssoupha; Soto Aladro, Alberto; Boudjema, Sophia; Giorgi, Roch; Dufour, Jean Charles; Brouqui, Philippe

    2017-03-01

    Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence. The study is a historical comparison proof-of-concept study. Eighteen health care workers were monitored during 12 months by a radiofrequency identification system. Afterward we sent 2 types of text messages, congratulation or encouragement, and we studied the evolution of hand hygiene adherence. We recorded 15,723 hand hygiene opportunities, 8,973 before intervention and 6,750 during and after the intervention. Using a multilevel logistic regression analysis, we found a significant increase in hand hygiene adherence during the intervention (odds ratio, 1.68) compared with the historical period. Despite limitations due to the type of study, a text message encouraging personnel to be more vigilant is effective in increasing hand hygiene adherence in health care workers. Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. 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...

  5. ENVIRONMENTAL ASSESSMENT FOR THE NPDES STORM WATER COMPLIANCE ALTERNATIVES AT THE SRS

    International Nuclear Information System (INIS)

    Shedrow, C

    2006-01-01

    The U.S. Department of Energy (DOE) prepared this environmental assessment (EA) to evaluate the potential environmental impacts associated with proposed and alternative actions to achieve water quality permit compliance at 38 storm water outfalls located at the Savannah River Site (SRS) (Figure 1-1). Effluent monitoring data indicates that some of these outfalls may not presently comply with new National Pollutant Discharge Elimination System (NPDES) Storm Water General Permit effluent standards that became effective July 1, 2005 (SCR000000). The NPDES permit requires that best management practices (BMPs) be implemented and maintained, as necessary, to ensure that storm water discharges at SRS do not cause or contribute to the contravention of applicable state water quality standards (WQS)

  6. Compliance assessment of an uranium hexafluoride package 30B with overpack to the IAEA standards

    International Nuclear Information System (INIS)

    Andreuccetti, P.; Aquaro, D.; Forasassi, G.; Beone, G.; Eletti, G.; Orsini, A.

    1988-01-01

    At the Dipartimento di Costruzioni Meccaniche e Nucleari (DCMN) of the Pisa University a research program was carried out in order to assess the compliance to the updated IAEA standards of the UF6 30B container, complete with its sandwich phenolic foam filled external overpack. The research program, performed in collaboration with ENEA and several interested Italian firms, included 9 mt free drop, perforation, thermal and leaktightness tests, on two complete packages with dummy load. The heat transfer conditions, with the UF6 real contents, were simulated by means of numerical analyses with the TRUMP computer code and calculation procedures set up using the available experimental data. The attained results seem to be useful from the point of view of the foreseen purposes

  7. ENVIRONMENTAL ASSESSMENT FOR THE NPDES STORM WATER COMPLIANCE ALTERNATIVES AT THE SRS

    Energy Technology Data Exchange (ETDEWEB)

    Shedrow, C

    2006-11-01

    The U.S. Department of Energy (DOE) prepared this environmental assessment (EA) to evaluate the potential environmental impacts associated with proposed and alternative actions to achieve water quality permit compliance at 38 storm water outfalls located at the Savannah River Site (SRS) (Figure 1-1). Effluent monitoring data indicates that some of these outfalls may not presently comply with new National Pollutant Discharge Elimination System (NPDES) Storm Water General Permit effluent standards that became effective July 1, 2005 (SCR000000). The NPDES permit requires that best management practices (BMPs) be implemented and maintained, as necessary, to ensure that storm water discharges at SRS do not cause or contribute to the contravention of applicable state water quality standards (WQS).

  8. Remote mood monitoring for adults with bipolar disorder: An explorative study of compliance and impact on mental health service use and costs.

    Science.gov (United States)

    Simon, J; Budge, K; Price, J; Goodwin, G M; Geddes, J R

    2017-09-01

    Remote monitoring of mood disorders may be an effective and low resource option for patient follow-up, but relevant evidence remains very limited. This study explores real-life compliance and health services impacts of mood monitoring among patients with bipolar disorder in the UK. Patients with a diagnosis of bipolar disorder who were registered users of the True Colours monitoring system for at least 12months at study assessment were included in this retrospective cohort study (n=79). Compliance was measured as the proportion of valid depression and mania scale messages received in comparison to their expected numbers over the first 12months of monitoring. Mental health service use data were extracted from case notes, costed using national unit costs, and compared 12months before (pre-TC period) and 12months after (TC period) patients' engagement with monitoring. Associations with relevant patient factors were investigated in a multiple regression model. Average compliance with monitoring was 82%. Significant increases in the annual use and costs of psychiatrist contacts and total mental health services were shown for patients newly referred to the clinic during the pre-TC period but not for long-term patients of the clinic. Psychiatric medication costs increased significantly between the pre-TC and TC periods (£235, P=0.005) unrelated to patients' referral status. Remote mood monitoring has good compliance among consenting patients with bipolar disorder. We found no associations between observed changes in mental health service costs and the introduction of monitoring except for the increase in psychiatric medication costs. Copyright © 2017 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

  9. Recommendations of ICRP-60 for occupationally exposed pregnant women. Compliance evaluation in six health centres

    International Nuclear Information System (INIS)

    Espana, M.L.; Prieto, C.; Perez, L.; Tomasi, L.; Lopez Franco, P.

    1997-01-01

    The decrease in the limits of dose equivalent at the entry of the abdomen of occupationally exposed pregnant women, as recommended by ICRP-60, necessitates to evaluate with dosimeter the various professional positions in different services existing in a health care centre, to guarantee that such limits cannot be exceeded, and thus ensure the protection of the foetus. The results obtained in this work, related exclusively to external radiation dose, show that the radiation protection system currently in force is in compliance with the regulation in the majority of the professional positions evaluated, though stricter criteria for pregnant women workers must be established with the aim of obtaining a better dose optimization. The fact that pregnant operators are working in Nuclear Medicine requires an additional effort to ensure that doses in excess of the limits stated are prevented

  10. Home Circadian Phase Assessments with Measures of Compliance Yield Accurate Dim Light Melatonin Onsets.

    Science.gov (United States)

    Burgess, Helen J; Wyatt, James K; Park, Margaret; Fogg, Louis F

    2015-06-01

    There is a need for the accurate assessment of circadian phase outside of the clinic/laboratory, particularly with the gold standard dim light melatonin onset (DLMO). We tested a novel kit designed to assist in saliva sampling at home for later determination of the DLMO. The home kit includes objective measures of compliance to the requirements for dim light and half-hourly saliva sampling. Participants were randomized to one of two 10-day protocols. Each protocol consisted of two back-to-back home and laboratory phase assessments in counterbalanced order, separated by a 5-day break. Laboratory or participants' homes. Thirty-five healthy adults, age 21-62 y. N/A. Most participants received at least one 30-sec epoch of light > 50 lux during the home phase assessments (average light intensity 4.5 lux), but on average for light > 50 lux or sampling errors. There was no significant difference between the home and laboratory DLMOs (P > 0.05); on average the home DLMOs occurred 9.6 min before the laboratory DLMOs. The home DLMOs were highly correlated with the laboratory DLMOs (r = 0.91, P dim light melatonin onsets (DLMOs) demonstrates that including objective measures of light exposure and sample timing during home saliva sampling can lead to accurate home DLMOs. Circadian Phase Assessments at Home, http://clinicaltrials.gov/show/NCT01487252, NCT01487252. © 2015 Associated Professional Sleep Societies, LLC.

  11. Evidence-based practices to increase hand hygiene compliance in health care facilities: An integrated review.

    Science.gov (United States)

    Neo, Jun Rong Jeffrey; Sagha-Zadeh, Rana; Vielemeyer, Ole; Franklin, Ella

    2016-06-01

    Hand hygiene (HH) in health care facilities is a key component to reduce pathogen transmission and nosocomial infections. However, most HH interventions (HHI) have not been sustainable. This review aims to provide a comprehensive summary of recently published evidence-based HHI designed to improve HH compliance (HHC) that will enable health care providers to make informed choices when allocating limited resources to improve HHC and patient safety. The Medline electronic database (using PubMed) was used to identify relevant studies. English language articles that included hand hygiene interventions and related terms combined with health care environments or related terms were included. Seventy-three studies that met the inclusion criteria were summarized. Interventions were categorized as improving awareness with education, facility design, and planning, unit-level protocols and procedures, hospital-wide programs, and multimodal interventions. Past successful HHIs may not be as effective when applied to other health care environments. HH education should be interactive and engaging. Electronic monitoring and reminders should be implemented in phases to ensure cost-effectiveness. To create hospitalwide programs that engage end users, policy makers should draw expertise from interdisciplinary fields. Before implementing the various components of multimodal interventions, health care practitioners should identify and examine HH difficulties unique to their organizations. Future research should seek to achieve the following: replicate successful HHI in other health care environments, develop reliable HHC monitoring tools, understand caregiver-patient-family interactions, examine ways (eg, hospital leadership, financial support, and strategies from public health and infection prevention initiatives) to sustain HHC, and use simulated lab environments to refine study designs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc

  12. Electronic Communication of Protected Health Information: Privacy, Security, and HIPAA Compliance.

    Science.gov (United States)

    Drolet, Brian C; Marwaha, Jayson S; Hyatt, Brad; Blazar, Phillip E; Lifchez, Scott D

    2017-06-01

    Technology has enhanced modern health care delivery, particularly through accessibility to health information and ease of communication with tools like mobile device messaging (texting). However, text messaging has created new risks for breach of protected health information (PHI). In the current study, we sought to evaluate hand surgeons' knowledge and compliance with privacy and security standards for electronic communication by text message. A cross-sectional survey of the American Society for Surgery of the Hand membership was conducted in March and April 2016. Descriptive and inferential statistical analyses were performed of composite results as well as relevant subgroup analyses. A total of 409 responses were obtained (11% response rate). Although 63% of surgeons reported that they believe that text messaging does not meet Health Insurance Portability and Accountability Act of 1996 security standards, only 37% reported they do not use text messages to communicate PHI. Younger surgeons and respondents who believed that their texting was compliant were statistically significantly more like to report messaging of PHI (odds ratio, 1.59 and 1.22, respectively). A majority of hand surgeons in this study reported the use of text messaging to communicate PHI. Of note, neither the Health Insurance Portability and Accountability Act of 1996 statute nor US Department of Health and Human Services specifically prohibits this form of electronic communication. To be compliant, surgeons, practices, and institutions need to take reasonable security precautions to prevent breach of privacy with electronic communication. Communication of clinical information by text message is not prohibited under Health Insurance Portability and Accountability Act of 1996, but surgeons should use appropriate safeguards to prevent breach when using this form of communication. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. The EUR assessment process, methodology and highlights of the compliance analysis for the EU-APWR standard design - 15235

    International Nuclear Information System (INIS)

    Facciolo, L.; Welander, D.; Nuutinen, P.

    2015-01-01

    In August 2007 the European Utility Requirements organisation (EUR) received an initial application from Mitsubishi Heavy Industries asking for submitting the EU-APWR standard design to the EUR assessment. The EU-APWR is an advanced PWR, 1700 MWe class, 4-loops, 14 ft active core fuel length. The EU-APWR Standard Design documentation has been assessed against the EUR Volume 2 - Generic Nuclear Island requirements - Revision D. The assessment is divided into 20 chapters for a total of over 4000 individual requirements. A Synthesis Report for each chapter was written by the assessment performers. The Synthesis Reports showed that the EU-APWR Standard Design was in compliance with 77% of the EUR requirements. The percentage increases to 85% when taking into account the requirements where the design has been considered in compliance with the objectives. The requirements resulting in a non-compliance assessment correspond to less than 2%. This confirms the overall good level of compliance. From the Utilities point of view it is possible to state that the differences in standards, codes and regulations applied in Japan and in Europe contribute to a series of discrepancies between the EU-APWR Standard Design and the EUR, regarding, for instance, outage durations, operational capability, layout, personal protection or radiation monitoring. Some disagreements are easy to overcome, others require particular attention

  14. Enhancement of hand hygiene compliance among health care workers from a hemodialysis unit using video-monitoring feedback.

    Science.gov (United States)

    Sánchez-Carrillo, Laura Arelí; Rodríguez-López, Juan Manuel; Galarza-Delgado, Dionisio Ángel; Baena-Trejo, Laura; Padilla-Orozco, Magaly; Mendoza-Flores, Lidia; Camacho-Ortiz, Adrián

    2016-08-01

    The importance of hand hygiene in the prevention of health care-associated infection is well known. Experience with hand hygiene compliance (HHC) evaluation in hemodialysis units is scarce. This study was a 3-phase, prospective longitudinal intervention study during a 5-month period in a 13-bed hemodialysis unit at a university hospital in Northern Mexico. The unit performs an average of 1,150 hemodialysis procedures per month. Compliance was evaluated by a direct observer and a video assisted observer. Feedback was given to health care workers in the form of educational sessions and confidential reports and video analysis of compliance and noncompliance. A total of 5,402 hand hygiene opportunities were registered; 5,201 during 7,820 minutes of video footage and 201 by direct observation during 1,180 minutes. Lower compliance during the baseline evaluation was observed by video monitoring compared with direct observation (P hand hygiene compliance. Video-assisted monitoring of hand hygiene is an excellent method for the evaluation of HHC in a hemodialysis unit; enhanced HHC can be achieved through a feedback program to the hemodialysis staff that includes video examples and confidential reports. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Science.gov (United States)

    Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

    2017-01-01

    This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  16. Does Direct Radiologist-Patient Verbal Communication Affect Follow-Up Compliance of Probably Benign Assessments?

    Science.gov (United States)

    Bosma, Melissa S; Neal, Colleen H; Klein, Katherine A; Noroozian, Mitra; Patterson, Stephanie K; Helvie, Mark A

    2016-03-01

    The aim of this study was to determine whether direct verbal communication of results by a radiologist affected follow-up compliance rates for probably benign breast imaging findings. This study was institutional review board approved and HIPAA compliant. A retrospective search identified all patients from January 1, 2010 to December 31, 2010 who had breast findings newly assessed as probably benign (BI-RADS category 3). Patients were categorized by whether the radiologist or the technologist verbally communicated the result and follow-up recommendation. Patient adherence to 6-, 12-, and 24-month follow-up imaging recommendations was recorded. Compliance data were available for 770 of 819 patients in the study. Overall compliance was 83.0% (639 of 770) for 6-month examinations, 68.1% (524 of 770) for 6- and 12-month examinations, and 57.4% (442 of 770) for 6-, 12-, and 24-month examinations. For patients who initially underwent diagnostic mammography alone, there was no significant difference in compliance between those who had and those who did not have radiologist-patient communication (6 months, 81.9% vs 80.8% [P = .83]; 6 and 12 months, 70.8% vs 67.3% [P = .58]; 6, 12, and 24 months, 54.2% vs 58.4% [P = .53]). For patients who initially underwent diagnostic mammography alone versus ultrasound with or without diagnostic mammography, there was no significant difference in compliance (6 months, 81.1% vs 84.3% [P = .24]; 6 and 12 months, 68.1% vs 68.0% [P = .96]; 6, 12, and 24 months, 57.4% vs 57.4% [P = .00]). High initial compliance was achieved by radiologist or technologist verbal communication of findings and recommendations. Direct communication by the radiologist did not increase compliance compared with communication by a technologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. The enhanced inspection of collectively agreed working conditions : An assessment of the compliance files, based on the Social Pact 2013

    NARCIS (Netherlands)

    Cremers, Jan

    2017-01-01

    Executive summary of a report (originally in Dutch). In the autumn of 2016, trade union FNV asked the author to assess the new procedure related to compliance with bargaining agreements and to analyse both the union demands and the resulting reports with findings from the labour inspectorate. In

  18. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve

  19. 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 ...

  20. Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.; Zhang, Jian; Wang, Weimin

    2016-02-15

    The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energy code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.

  1. A pilot Internet "Value of Health" Panel: recruitment, participation and compliance

    Directory of Open Access Journals (Sweden)

    Ratcliffe Julie

    2006-11-01

    Full Text Available Abstract Objectives To pilot using a panel of members of the public to provide preference data via the Internet Methods A stratified random sample of members of the general public was recruited and familiarised with the standard gamble procedure using an Internet based tool. Health states were perdiodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained; Participation (a the proportion of people trained who provided any preferences and (b the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed. The influence of covariates on these outcomes was investigated using univariate and multivariate analyses. Results A panel of 112 people was recruited. 23% of those approached (n = 5,320 responded to the invitation, and 24% of respondents (n = 1,215 were willing to participate (net = 5.5%. However, eventual recruitment rates, following training, were low (2.1% of those approached. Recruitment from areas of high socioeconomic deprivation and among ethnic minority communities was low. Eighteen sets of health state descriptions were considered over 14 months. 74% of panel members carried out at least one valuation task. People from areas of higher socioeconomic deprivation and unmarried people were less likely to participate. An average of 41% of panel members expressed preferences on each set of descriptions. Compliance ranged from 3% to 100%. Conclusion It is feasible to establish a panel of members of the general public to express preferences on a wide range of health state descriptions using the Internet, although differential recruitment and attrition are important challenges. Particular attention to recruitment and retention in areas of high socioeconomic deprivation and among ethnic minority communities is necessary

  2. Integrating Compliance, Communication, and Culture: Delivering Health Care to an Aging Population

    Science.gov (United States)

    Langer, Nieli

    2008-01-01

    Older adults often get lost in the process of assessment, diagnosis and service brokering. If our concern as care providers is to enable older persons to remain independent or in the community for as long as possible, we must tap into their personal values, cultural identity and health beliefs in order to foster enhanced health care communication.…

  3. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    Science.gov (United States)

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Relationship between degree of risk, cost and level of compliance to occupational health and safety regulations in construction

    Directory of Open Access Journals (Sweden)

    Abimbola Olukemi Windapo

    2013-06-01

    Full Text Available This paper investigates the role of statutory health and safety (H&S regulations in managing construction project risks. The study examines whether the decision made by contractors to comply with the regulations, the cost of compliance and savings of H&S regulatory requirements is influenced by the degree or level of risk, which the regulations are trying to prevent. The rationale for the examination stems from previous studies which establish that building designers and contractors perceive the cost of complying with regulations as additional burdens, which they have to conform to, and which are in some cases unnecessary, and also the fact that construction related injuries and fatalities are on the increase. Qualitative and quantitative data obtained from a descriptive survey and H&S site audit by the Master Builder Association of the Western Cape (MBAWC were used as the measurements of risk, level of compliance to regulations, cost of compliance and savings. By correlating the quantitative and qualitative data, there is empirical evidence to support a negative relationship between the degree of risk, level and cost of compliance and cost savings. Based on the study’s findings, this paper concludes that the decision made by contractors to comply with H&S regulatory requirements is influenced by the perceived cost saving on account of compliance and that cost savings are influenced by the probability of accident occurrence which is an element of the degree of risk which the regulation is trying to prevent or control. 

  5. Relationship between degree of risk, cost and level of compliance to occupational health and safety regulations in construction

    Directory of Open Access Journals (Sweden)

    Abimbola Olukemi Windapo

    2013-06-01

    Full Text Available This paper investigates the role of statutory health and safety (H&S regulations in managing construction project risks. The study examines whether the decision made by contractors to comply with the regulations, the cost of compliance and savings of H&S regulatory requirements is influenced by the degree or level of risk, which the regulations are trying to prevent. The rationale for the examination stems from previous studies which establish that building designers and contractors perceive the cost of complying with regulations as additional burdens, which they have to conform to, and which are in some cases unnecessary, and also the fact that construction related injuries and fatalities are on the increase. Qualitative and quantitative data obtained from a descriptive survey and H&S site audit by the Master Builder Association of the Western Cape (MBAWC were used as the measurements of risk, level of compliance to regulations, cost of compliance and savings. By correlating the quantitative and qualitative data, there is empirical evidence to support a negative relationship between the degree of risk, level and cost of compliance and cost savings. Based on the study’s findings, this paper concludes that the decision made by contractors to comply with H&S regulatory requirements is influenced by the perceived cost saving on account of compliance and that cost savings are influenced by the probability of accident occurrence which is an element of the degree of risk which the regulation is trying to prevent or control.

  6. Improving hand hygiene compliance for the reduction of nosocomial infections: recommendations for behaviour change in a health care setting

    OpenAIRE

    Reason, Florence Paige

    2008-01-01

    Nosocomial infection rates are highly dependent on hand hygiene compliance within health care facilities. This paper examines the literature concerning elements of effective hand hygiene interventions and relevant behaviour change theory, in addition to current practice surrounding hand hygiene interventions in leading institutions, in order to inform and propose recommendations for the improvement and success of the University Health Network’s current hand hygiene initiative. The results of ...

  7. 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...

  8. The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics.

    Science.gov (United States)

    Jadav, Smruti; Rajan, Suja S; Abughosh, Susan; Sansgiry, Sujit S

    2015-01-01

    Considerable disparities in breast cancer screening exist between Hispanic and non-Hispanic white (NHW) women. Identifying and quantifying the factors contributing to these racial-ethnic disparities can help shape interventions and policies aimed at reducing these disparities. This study, for the first time, identified and quantified individual-level sociodemographic and health-related factors that contribute to racial-ethnic disparities in breast cancer screening using the nonlinear Blinder-Oaxaca decomposition method. Analysis of the retrospective pooled cross-sectional Medical Expenditure Panel Survey data from 2000 to 2010 was conducted. Women aged 40 years and older were included in the study. Logistic regressions were used to estimate racial-ethnic disparities in breast cancer screening. Nonlinear Blinder-Oaxaca decomposition method was used to identify and quantify the contribution of each individual-level factor toward racial-ethnic disparities. Based on the unadjusted analyses, Hispanic women had lower odds of receiving mammogram screening (MS) (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.69-0.80) and breast cancer screening (OR: 0.75; 95% CI: 0.70-0.81) as compared with NHW women. However, the relationship reversed in adjusted analyses, such that Hispanic women had higher odds of receiving MS (OR: 1.27; 95% CI: 1.16-1.40) and breast cancer screening (OR: 1.28; 95% CI: 1.17-1.40) as compared with NHW women. The Blinder-Oaxaca decomposition estimated that improving insurance status, access to care, education, and income will considerably increase screening rates among Hispanic women. The study projects that improving health care access and health education will considerably increase breast cancer screening compliance among Hispanic women. Policies like the Affordable Care Act, and patient navigation and health education interventions, might considerably reduce screening disparities in the Hispanic population.

  9. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

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

  10. Year 2000 compliance issues.

    Science.gov (United States)

    1999-03-01

    This month, we continue our coverage of the year 2000 (Y2K) problem as it affects healthcare facilities and the professionals who work in them. We present the following articles: "Checking PCs for Y2K Compliance"--In this article, we describe the probable sources of Y2K-related errors in PCs and present simple procedures for testing the Y2K compliance of PCs and application software. "Y2K Assessment Equipment Expectations"--In this article, we review the Y2K compliance data from a small sampling of hospitals to help answer the question "What percentage of medical equipment will likely be susceptible to Y2K problems?" "Y2K Labeling of Medical Devices"--In this article, we discuss the pros and cons of instituting a program to label each medical device with its Y2K status. Also in this section, we present an updated list of organizations that support ECRI's Position Statement on the testing of medical devices for Y2K compliance, which we published in the December 1998 issue of Health Devices (27[12]). And we remind readers of the services ECRI can offer to help healthcare institutions cope with the Y2K problem.

  11. The health care provider's role and patient compliance to health promotion advice from the user's perspective: analysis of the 2006 National Health Interview Survey data.

    Science.gov (United States)

    Ndetan, Harrison; Evans, Marion Willard; Bae, Sejong; Felini, Martha; Rupert, Ronald; Singh, Karan P

    2010-01-01

    The recommendations of health care providers have been shown to be a predictor of future healthy behaviors. However, patient adherence to these recommendations may differ based upon the type of health care professional providing the information. This study explored patient compliance in the United States over a 12-month period and contracted the patient response to recommendations given by chiropractors versus medical doctors. Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n = 24 275). Analyses were performed separately for recommendation and compliance of weight loss, increase exercise, and diet change by health profession subtype (chiropractor and medical doctor). About 30.5% of the respondents reported receiving advice from their provider. Among these, 88.0% indicated they complied with the advice they received. Patients who were advised were more likely to comply (odds ratio [OR] [95% CI], 10.41[9.34-11.24]). Adjusting for seeing a physical therapist, age, and body mass index, chiropractors were less likely to advice patients compared to medical doctors (OR [95% CI], 0.38 [0.30-0.50]). In general, there was a 21% increased odds that patients who received and complied with health promotion advice from their health care provider would report an improved health status (OR [95% CI], 1.21 [1.10-1.33]) compared with those who did not comply or were not advised. Chiropractors in the United States give health promotion recommendation to their patients but are less likely to do so than general medical doctors. Patients tend to comply with health providers' recommendations and those who do report better health. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  12. 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.

  13. Chemical assessment of ballast water exchange compliance: Implementation in North America and New Zealand

    Directory of Open Access Journals (Sweden)

    Monaca eNoble

    2016-05-01

    Full Text Available Fluorescence by naturally occurring dissolved organic matter (FDOM is a sensitive indicator of ballast water source, with high FDOM in coastal ballast water decreasing typically dramatically when replaced by oceanic seawater during ballast water exchange. In this study, FDOM was measured in 92 ships arriving at Pacific ports on the US west coast and in New Zealand, and used to assess their compliance with ballast water regulations that required 95% replacement of port water to minimize invasive species risks. Fluorescence in many ships that reported ballast water exchange was significantly higher than is usual for oceanic seawater, and in several cases, significantly higher than in other ships with similar provenance and ballast water management. Pre-exchange source port conditions represented the largest source of uncertainty in the analysis, because residual coastal FDOM when highly fluorescent can significantly influence the fluorescence signature of exchanged ballast water. A meta-analysis comparing the intensities of FDOM in un-exchanged ballast tanks with calculated pre-exchange intensities assuming that ships all correctly implemented and reported ballast water exchange revealed notable discrepancies. Thus, the incidence of high-FDOM port waters was seven times lower in reality than would be expected on the basis of these calculations. The results suggest that a significant rate of reporting errors occur due to a combination of factors that may include inadequate ballast water exchange and unintentional or deliberate misreporting of ballast water management.

  14. The Public Health Challenge of Consumer Non-Compliance to Toy Product Recalls and Proposed Solutions

    Directory of Open Access Journals (Sweden)

    Xiayang Yu

    2018-03-01

    Full Text Available This paper addresses the public health issue of toy product recalls in the United States, an under-addressed topic in scholarly literature, yet highly relevant to the prevention of pediatric injuries. Toy-related injuries led to 274,000 emergency room visits and seven fatalities in 2016 in the United States, and toy-related injury rates have remained stable over the last five years despite declining incidences of recalls. While dangerous toys not being recalled and the misuse of “safe” products are possible contributing factors, consumer non-response to recall notices also contributes to unintentional child injury from dangerous toys. We discuss the process of recalling toys, and the role of the U.S. Consumer Product Safety Commission in that process. We also review potential factors behind significant consumer non-response to recall notifications, citing economic and psychological theories as explanations for the actions of multiple stakeholders in the recall process. We close by proposing reforms at the regulatory, consumer, and retailer levels that might boost compliance with recall notifications and ultimately reduce injury morbidity and mortality.

  15. [Compliance with the requirements of paediatric emergency departments in Spain: a self-assessment survey].

    Science.gov (United States)

    Sánchez Etxaniz, J; Luaces I Cubells, C; Benito Fernández, J

    2011-08-01

    Paediatric emergency medicine in Spain is practiced in differently configured departments, staffing and organisation. Our goal was to determine the situation in Paediatric Emergency Departments (PED) and their adaptation to the quality standards proposed by the Spanish Society of Paediatric Emergencies. A self-assessment questionnaire on standards performance was sent to 47 PED directors by e-mail. It consisted of 101 items, 69 considered mandatory. According to the fulfilment of these 69 items 4 PED groups were selected: group I: in the best position (met 69), group II: requiring minimal changes (meeting 62-68), group III: requiring major changes (meeting 41-61); group IV: requiring a lot of major changes (meeting less than 41). Thirty nine questionnaires were completed in full. The PED included in the study tended to an average of 35310 annual emergencies (5000-115000). No PED was included in group I, 6 in II 27 in III and 6 in IV. There was a tendency towards higher compliance with standards in larger PED, but there was no significant relationship between the number of emergencies and the number of items fulfilled. 1. Staffing and architectural and organizational aspects may not be adequate to achieve optimal patient outcome in many PED in Spain. This fact does not appear to be related to the annual patient census. 2. The areas for improvement mainly affect functional issues that must be undertaken by those responsible. 3. A significant number of PED have serious architectural and staffing deficiencies, which would require economic measures by their managers. 4. Our self-assessment questionnaire identifies improvement actions. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  16. Dose assessment for potential radionuclide emissions from stacks on the Hanford Site: NESHAP compliance

    International Nuclear Information System (INIS)

    Davis, W.E.; Barnett, J.M.; Kenoyer, J.L.

    1994-03-01

    The purpose of this document is to present the assessment results for the registered stacks on the Hanford Site for potential emissions, i.e. emissions with no control devices in place. Further, the document will identify those stacks requiring continuous monitoring, i.e. the effective dose equivalent from potential emissions >0.1 mrem/yr. The stack assessment of potential emissions was performed on 84 registered stacks on the Hanford Site. These emission sources represent individual point sources presently registered under Washington Administrative code 246-247 with the Washington Department of Health. The methods used in assessing the potential emissions from the stacks are described

  17. Nigeria; Publication of Financial Sector Assessment Program Documentation––Detailed Assessment of Compliance of the Basel Core Priciples for Effective Banking Supervision

    OpenAIRE

    International Monetary Fund

    2013-01-01

    The assessment of the implementation of the Basel Core Principles (BCP) was conducted for effective banking supervision in Nigeria. The assessment team reviewed the legal framework for banking supervision and held extensive discussions with the staff of the Central Bank of Nigeria (CBN) and the Nigeria Deposit Insurance Corporation (NDIC). It is assessed that Nigeria has recorded significant improvement in its level of compliance with the BCPs, which is attributed to the enhancement of the su...

  18. Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ataur R Khan

    2012-01-01

    Full Text Available Purpose: The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia. Materials and Methods: A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant. Results: The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 - 72.02%. The non-compliance of males (69.34% was higher than females (65.45%, P = .003. The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023 in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57,level of education (Illiteracy (OR = 5.27, CI = 4.63 - 7.19, urban population (OR =5.22, CI= 3.65 - 8.22, irregularity of the follow-up (OR = 8.41, CI = 4.90 - 11.92, non-adherence to drug prescription (OR = 4.55 , CI = 3.54 - 5.56, non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 - 6., insulin (OR = 1.29, CI = .71 - 1.87, and insulin with oral Metformin (OR = 1.20, CI = .65 - 1.75. Conclusion: The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need

  19. Changes in compliance rates of evaluation criteria after health care accreditation: Mainly on radiologic technologists working at University Hospitals in Daejeon area

    International Nuclear Information System (INIS)

    Ko, Eun Ju; Kim, Hyun Joo; Lee, Jin Yong; Bae, Seok Hwan

    2013-01-01

    This study aimed to assess whether the changes in compliance rates of evaluation criteria after healthcare accreditation among radiologic technologists working at four university hospitals which had acquired healthcare accreditation in Daejeon metropolitan area. In this study, the evaluation criteria of healthcare accreditation were reclassified and reevaluated to three areas which include patient safety, staff safety, and environmental safety. Each area has eight, three, and five questions, respectively. Each compliance rate was quantitatively measured on a scale of 0 to 10 before and after in this study. The result shows that the overall compliance rates were decreased on all areas compared to the time healthcare accreditation was obtained. The compliance rate of hand hygiene was drastically reduced. To maintain the compliance rates, not only individuals but healthcare organizations should simultaneously endeavor. In particular, healthcare organizations should make an effort to provide continuous education opportunity to their workers and supervise the compliance regularly

  20. Effect of Safety Education on Knowledge of and Compliance with ...

    African Journals Online (AJOL)

    Objective: Compliance with road safety signs is important in the reduction of motorcycle accidents. The aim of this study was to implement health education intervention and assess its impact on the knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria. Method: This ...

  1. Needs assessment and treatment compliance at state opioid substitution treatment programes in Georgia.

    Science.gov (United States)

    Piralishvili, G; Gamkrelidze, I; Nikolaishvili, N; Chavchanidze, M

    2013-01-01

    conduct needs assessments and treatment compliance evaluations in MMT and Suboxone Substitution State Programs in Georgia (Republic of). 506 patients (2 females) were surveyed (92% on Methadone, 8% on Suboxone) from 6 Tbilisi and 4 regional State Programs in 2011 November. Mean age - 40±8,56 (22-65) year; 254 (51.4%) were in treatment for 1-3 year. Evaluation was carried out on the base of structured self-questionnaire that covers demographics, drug use history, general drug use trends, psychotherapeutic sessions' acceptance and open label question regarding treatment challenges and satisfaction. 305 (60.3%) attended individual and 57 (11.3%) group psychotherapy sessions with 50.79% attending once/month or rare. The main reason given for therapy non-attendance - no needs for it (29.48%); the main drugs before admission - heroin (80.04%), buprenorphine (53.49%); Main drugs used in Georgia nowadays - desomorphine ("crocodile"), alcohol and marihuana. Commonly used drugs by program patients (136 positive answers) - alcohol-13.62%, marihuana-10.39%, pregabalin - 8.17%, opioids- 6.62% (mostly-"crocodile"), home-made stimulants-6.23%, sedatives -5.45%. 55.4% are extremely satisfied with treatment, 82.4% - with program staff. Patients' main wishes- free of charge programs (46.4%) and provide take-home doses (22.07%). Methadone and Suboxone ST are being well accepted in Georgia and appear to be reducing illegal opioid use. However, the psychotherapeutic sessions' attendance is very low.

  2. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Directory of Open Access Journals (Sweden)

    Yasaira Rodriguez Torres

    Full Text Available This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p 90% in 13 elements while Electronic Health Record B had high compliance (>90% in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

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

    Science.gov (United States)

    Ozturk, Kirstin; Karadayı, Bilgehan; Şener, Olgun

    2018-01-01

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

  4. Beyond compliance using environmental, health and safety management information systems (EMISs) to provide quantified competitive advantages

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, J.V.; Mayer, G.

    1999-07-01

    In the last 20 years, federal, state and local regulations have provided regulatory incentives for industry to better manage environmental, health and safety (EHS) practices. In order for voluntary EHS management practices to move beyond compliance and continue improving, specific, quantifiable benefits must result. That is, companies must achieve some competitive advantage from implementing EHS improvements that are considered voluntary. Recently, many private companies and public agencies have been giving significant consideration toward the implementation of an EHS management information system (EMIS). Currently considered voluntary, the automation of EHS data collection, storage, retrieval and reporting is subject to the same benefit expectations that other EHS improvements are subject to. The benefits resulting from an EMIS typically result from a reduction in either direct or indirect costs. Direct costs, consisting primarily of labor hours, permit fees, disposal costs, etc., are definable and easily to quantify. Indirect costs, which are comprised of reduced risks and liabilities, are less easily quantifiable. In fact, many have abandoned hope of ever quantifying expected benefits from indirect costs, and simply lump all indirect benefits into a qualitative, catch-all category called intangible benefits. However, by statistically analyzing individual risk events over an expected project life, anticipated benefits can be objectively and accurately quantified. Through the use of a case study, this paper will describe the process of quantifying direct and indirect benefits resulting from the implementation of an EMIS. The paper will describe the application of a statistical model to estimate indirect benefits and will demonstrate how the results of the benefit quantification can be used to make sound, business based decisions based on a required rate of return/return on investment.

  5. The usefulness of assessing suggestibility and compliance in prisoners with unidentified intellectual disabilities.

    Science.gov (United States)

    Søndenaa, Erik; Rasmussen, Kirsten; Palmstierna, Tom; Nøttestad, Jim Aage

    2010-10-01

    This present study explored the relationship of interrogative suggestibility (n = 133) and compliance (n = 118) to intellectual functioning among prison inmates. The Norwegian versions of the Gudjonsson Suggestibility Scale (GSS) and the Gudjonsson Compliance Scale (GCS) were used. The results supported previous findings of a negative correlation between the Gudjonsson scales and IQ, and the scales were found useful throughout the IQ range. The impact of a memory artifact was discussed in the light of recent studies and criticism of the scales. © 2010 The Authors. Scandinavian Journal of Psychology © 2010 The Scandinavian Psychological Associations.

  6. Intervention Effects on Safety Compliance and Citizenship Behaviors: Evidence from the Work, Family, and Health Study

    Science.gov (United States)

    Hammer, Leslie B.; Johnson, Ryan C.; Crain, Tori L.; Bodner, Todd; Kossek, Ellen Ernst; Davis, Kelly; Kelly, Erin L.; Buxton, Orfeu M.; Karuntzos, Georgia; Chosewood, L. Casey; Berkman, Lisa

    2015-01-01

    We tested the effects of a work-family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 healthcare facilities using a group-randomized trial. Based on Conservation of Resources theory and the Work-Home Resources Model, we hypothesized that implementing a work-family intervention aimed at increasing contextual resources via supervisor support for work and family and employee control over work time would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline, 6-month and 12-month post-intervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month and organizational citizenship behaviors at the 12-month follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors, compared to employees in the control facilities. The hypothesized mediators of perceptions of family supportive supervisor behaviors, control over work time, and work-family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family supportive supervisor behaviors, control over work time, and work-family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes. PMID:26348479

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

    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...

  8. 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.

  9. 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

  10. 40 CFR 63.997 - Performance test and compliance assessment requirements for control devices.

    Science.gov (United States)

    2010-07-01

    ... operations at affected sources in subcategories where the applicability criteria includes a TRE index value... or operator make product that does not meet an existing specification for sale to a customer; or (C... satisfaction that the regulated source is in compliance with the relevant standard; or (E) Approves the use of...

  11. Assessment of compliance costs resulting from implementation of the proposed Great Lakes water quality guidance

    International Nuclear Information System (INIS)

    Fenner, K.; Podar, M.; Snyder, B.

    1993-01-01

    The primary purpose of the study was to develop an estimate of the incremental cost to direct dischargers resulting from the implementation of the proposed Great Lakes Water Quality Guidance (GLWQG). This estimate reflects the incremental cost of complying with permit requirements developed using the Implementation Procedures and water quality criteria proposed in the GLWQG versus permit requirements based on existing State water quality standards. Two secondary analyses were also performed, one to develop a preliminary estimate of the costs that would be incurred by indirect dischargers to publicly owned treatment works (POTWs), and another to evaluate the cost-effectiveness of the GLWQG. Finally, several sensitivity analyses were performed to evaluate the impact of several major assumptions on the estimated compliance costs. To estimate compliance costs, permit limitations and conditions based on existing State water quality standards were compared to water quality-based limitations and conditions based on the proposed GLWQG criteria and Implementation Procedures for a sample of plants. The control measures needed to comply with the proposed GLWQG-based effluent limitations were evaluated. Individual plant compliance costs were estimated for these control measures based on information on treatment technology and cost analyses available in the literature. An overall compliance cost was projected from the sample based on statistical methods

  12. 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.

  13. 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.

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

    International Nuclear Information System (INIS)

    1992-05-01

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

  15. Longitudinal Patterns of Compliance with OSHA Health and Safety Regulations in the Manufacturing Sector

    OpenAIRE

    Wayne B. Gray; Carol Adaire Jones

    1989-01-01

    We examine the impact of OSHA enforcement on company compliance with agency regulations in the manufacturing sector, with a unique plant-level data set of inspection and compliance behavior during 1972-1983, the first twelve years of the agency operation. The analysis suggests that, for an individual inspected plant, the average effect of OSHA inspections during this period was to reduce expected citations by 3.0 or by .36 s.d. The total effect on expected citations of additional inspections ...

  16. A joint, multilateral approach to improve compliance with hand hygiene in 4 countries within the Baltic region using the World Health Organization's SAVE LIVES: Clean Your Hands model.

    Science.gov (United States)

    Lytsy, Birgitta; Melbarde-Kelmere, Agita; Hambraeus, Anna; Liubimova, Anna; Aspevall, Olov

    2016-11-01

    The aim of this prospective multicenter study was to explore the usefulness of a modified World Health Organization (WHO) hand hygiene program to increase compliance with hand hygiene among health care workers (HCWs) in Latvia, Lithuania, Saint Petersburg (Russia), and Sweden and to provide a basis for continuing promotion of hand hygiene in these countries. The study was carried out in 2012. Thirteen hospitals participated, including 38 wards. Outcome data were handrub consumption, compliance with hand hygiene measured with a modified WHO method, and assessment of knowledge among HCWs. Interventions were education of the nursing staff, posters and reminders in strategic places in the wards, and feedback of the results to nursing staff in ward meetings. Feedback of results was an effective tool for education at the ward level. The most useful outcome measurement was handrub consumption, which increased by at least 50% in 30% of the wards. In spite of this, handrub consumption remained at a low level in many of the wards. There are several reasons for this, and the most important were self-reported nursing staff shortage and fear of adverse effects from using alcoholic handrub and verified skin irritation. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Patterns of sedentary behavior and compliance with public health recommendations in Spanish adolescents: the AFINOS study.

    Science.gov (United States)

    Martínez Gómez, David; Veiga, Oscar L; Zapatera, Belén; Cabanas-Sánchez, Verónica; Gomez-Martinez, Sonia; Martinez-Hernández, David; Marcos, Ascensión

    2012-12-01

    The aims of the present study were: (i) describe patterns of sedentary behavior in Spanish adolescents; and (ii) determine the proportion of adolescents that do not meet the public health recommendations for sedentary behavior. This study comprised 1,724 Spanish adolescents (882 girls), aged 13 to 16 years. Patterns of sedentary behavior (TV viewing, use of computer games, console games and surfing the Internet) were assessed using the HELENA sedentary behavior questionnaire. The total proportion of adolescents watching TV, using computer and console games, and surfing the internet for more than two hours daily was 24%, 9%, 7%, and 17%, respectively, on weekdays, and 50%, 22%, 16%, and 35%, respectively, on weekends. Over 63% of the adolescents from the study did not meet the recommendation for sedentary behavior (health, public health interventions in Spain that take these factors into consideration are needed.

  18. Self-assessment of treatment compliance with antimuscarinic drugs and lower urinary tract condition among women with urinary incontinence.

    Science.gov (United States)

    Kosilov, Kirill; Loparev, Sergey; Kuzina, Irina; Shakirova, Olga; Zhuravskaya, Natalya; Lobodenko, Alexandra

    2017-11-01

    Our aim was to determine the efficiency of the Medication Compliance Self-Report Inventory (MASRI) in self-reporting antimuscarinic drug treatment compliance among women with urinary incontinence (UI). The study assessed 347 women aged 18-65 (averaging 49.7) years with more than one urinary incontinence (UI) episode per day. Treatment compliance was tested at the beginning and at weeks 4, 8, and 12 using the MASRI, the Brief Medication Questionnaire (BMQ), and visual pill counts. The MASRI's constructive, concurrent, and discriminate validity was studied in comparison with an external standard that uses the chi-square and Spearman coefficient. Receiver operating characteristic (ROC) analysis was performed to identify optimum MASRI cutoffs that would predict noncompliance. Furthermore, the functional condition of the lower urinary tract was tested using voiding diaries, uroflowmetry, and cystometry. The correlation between the percentage of noncompliant women according to the MASRI, and individuals with a belief barrier with respect to the BMQ screen was r = 0.81 (p ≤0.05), r = 0.84 (p ≤0.05), and r = 0.79 (p ≤0.05). The correlation between the percentage of noncompliant women according to the MASRI and of women who missed >20% of their doses according to the Regimen Screen of the BMQ was r = 0.79, p ≤0.05, r = 0.82, p ≤0.01, r = 0.77, and p ≤0.05 at the control points. Finally, the percentage of noncompliant patients who self-reported correctly according to the MASRI data compared with the BMQ was 95.6%, 95.7%, and 96.6% at the control points. The MASRI entails acceptable validity for accurately predicting treatment compliance with antimuscarinic drugs among women who have had UI for >3 months.

  19. Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting

    International Nuclear Information System (INIS)

    Hussain, A.R.; Abbas, S.M.; Reza, T.E

    2013-01-01

    Objective: To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. Methods: The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was re-validated and analysed. Results: One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. Conclusion: While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media. (author)

  20. Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting.

    Science.gov (United States)

    Hussain, Aleem Raza; Abbas, Syed Muslim; Uzma, Qudsia; Reza, Tahira Ezra

    2013-07-01

    To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was revalidated and analysed. One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media.

  1. Prognostic value of physicians' assessment of compliance regarding all-cause mortality in patients with type 2 diabetes: primary care follow-up study

    Directory of Open Access Journals (Sweden)

    Rüter Gernot

    2006-07-01

    Full Text Available Abstract Background Whether the primary care physician's assessment of patient compliance is a valuable prognostic marker to identify patients who are at increased risk of death, or merely reflects measurement of various treatment parameters such as HbA1C or other laboratory markers is unclear. The objective of this prospective cohort study was to investigate the prognostic value of the physicians' assessment of patient compliance and other factors with respect to all-cause mortality during a one year follow-up period. Methods A prospective cohort study was conducted among 1014 patients with type 2 diabetes aged 40 and over (mean age 69 years, SD 10.4, 45% male who were under medical treatment in 11 participating practices of family physicians and internists working in primary care in a defined region in South Germany between April and June 2000. Baseline data were gathered from patients and physicians by standardized questionnaire. The physician's assessment of patient compliance was assessed by means of a 4-point Likert scale (very good, rather good, rather bad, very bad. In addition, we carried out a survey among physicians by means of a questionnaire to find out which aspects for the assessment of patient compliance were of importance to make this assessment. Active follow-up of patients was conducted after one year to determine mortality. Results During the one year follow-up 48 (4.7% of the 1014 patients died. Among other factors such as patient type (patients presenting at office, nursing home or visited patients, gender, age and a history of macrovascular disease, the physician's assessment of patient compliance was an important predictor of all-cause mortality. Patients whose compliance was assessed by the physician as "very bad" (6% were significantly more likely to die during follow-up (OR = 2.67, 95% CI 1.02–6.97 after multivariable adjustment compared to patients whose compliance was assessed as "rather good" (45% or "very good

  2. Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols.

    Science.gov (United States)

    Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

    2018-01-01

    The study aim was to evaluate if continual patient position monitoring, taking into account self-turns and clinician-assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. While patient turning has clinical benefits, current models to help staff remember to turn patients, such as "turn clocks" and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2-hr windows (such as turning on "even" hours) rather than on individual patient activity, including self-turns. This is a first inpatient, non-randomized, pre-/postintervention study. Data collection occurred from May 2013-February 2014 on a 39-bed medical unit in a community hospital. Baseline patient turning data were recorded by a sensor; however, the patient data were not displayed at the nurses' station to establish compliance with the hospital's turning protocol. Postintervention, patient position information was wirelessly displayed on nurses' station computer monitors in real time. A Student t test was used to compare baseline to postintervention "mean time in compliance." Data from 138 patients ( N  =   7,854 hr of monitoring) were collected. The baseline phase yielded 4,322 hr of position monitoring data and the postintervention phase yielded 3,532 hr of data. Statistically significant improvement was demonstrated in the percentage of time a patient's position changed at least every 2 hr from baseline to postintervention.

  3. Technical assessment of compliance with workplace air sampling requirements in the 300 Area

    International Nuclear Information System (INIS)

    Olsen, P.A.

    1995-01-01

    The purpose of this Technical Work Document is to satisfy HSRCM-1, the ''Hanford Site Radiological Control Manual.'' Article 551.4 of that manual states a requirement for a documented study of facility workplace air sampling programs (WPAS). This first revision of the original Supporting Document covers the period from January 1, 1995 to December 31, 1995. HSRCM-1 is the primary guidance for radiological control at Westinghouse Hanford Company (WHC). It was written to implement DOE/EH-0256T ''US Department of Energy Radiological Control Manual'' as it applies to programs at Hanford. As such, it complies with Title 10, Part 835 of the Code of Federal Regulations. There are also several Department of Energy (DOE) Orders, national consensus standards, and reports that provide criteria, standards, and requirements for workplace air sampling programs. This document provides a summary of these, as they apply to WHC facility workplace air sampling programs. This document also provides an evaluation of the compliance of 300 Areas' workplace air sampling program to the criteria, standards, and requirements and documents compliance with the requirements where appropriate. Where necessary, it also indicates changes needed to bring specific locations into compliance. The areas evaluated were the 340 Facility, the Advanced Reactor Operations Division Facilities, the N Reactor Fuels Supply Facility, and The Geotechnical Engineering Laboratory

  4. Trend of glycated hemoglobin testing in diabetic patients: to assess compliance with clinical practice guidelines

    International Nuclear Information System (INIS)

    Ghayur, S.; Tariq, H.

    2013-01-01

    Objective: To determine appropriate use of glycated hemoglobin (HbA1c) testing in accordance with current recommended guidelines. Study Design: Descriptive study. Place and Duration of Study: Chemical Pathology Department Shifa International Hospital, Islamabad from Oct 2011 to Oct 2012. Material and Methods: We randomly selected 170 known diabetic patients' data from our Laboratory Information System (LIS) who were retrospective analyzed for HbA1c to check for intervals and test frequency for each patient in one year. Patients with follow-up for at least one year at Shifa International Hospital, Islamabad and having their routine investigations in our chemical pathology laboratory were included. The concentrations of HbA1c for all the specimens were measured immunoturbidimetrically using a microparticle agglutination inhibition method. Four guidelines namely World Health Organization (WHO), American Diabetic Association (ADA), Canadian Diabetic Association (CDA) and National Institute for Health and Clinical Excellence (NICE) about HbA1c testing were utilized for data interpretation. All tests ordered within a 2 months period or more than 6 months following the previous order were labeled as inappropriate. Results: Only 35.8% of the patients were being properly monitored as per guidelines. Out of 64% patients who were inappropriately monitored, 12.9% had repeat orders within 2 months while 51.1% of patients were being monitored at longer interval against recommended guidelines. Conclusions: Glycated hemoglobin is a useful tool to objectively assess the prior glycemic control of patients with type 1 and type 2 diabetes. The study highlights that in large proportion of diabetic patients, HbA1c is not utilized properly as a tool to assess the risk of diabetic complications but in a small proportion is also tested unnecessarily which adds to avoidable health expenditure. (author)

  5. Performance assessment in support of the 1996 compliance certification application for the Waste Isolation Pilot Plant: A decision analysis perspective

    International Nuclear Information System (INIS)

    Helton, J.C.; Basabilvazo, G.

    1998-01-01

    The Waste Isolation Pilot Plant (WIPP) is under development by the US Department of Energy (DOE) for the geologic disposal of transuranic waste. The primary regulatory requirements (i.e., 40 CFR 191 and 40 CFR 194) placed on the WIPP by the US Environmental Protection Agency (EPA) involve a complementary cumulative distribution function (CCDF) for normalized radionuclide releases to the accessible environment. The interpretation and use of this CCDF from a decision analysis perspective is discussed and illustrated with results from the 1996 performance assessment for the WIPP, which was carried out to support a compliance certification application by the DOE to the EPA for the WIPP

  6. [Assessment of compliance for oral medicines with MMSE, Mini-Mental State Examination, in hospitalized elderly patients].

    Science.gov (United States)

    Miura, Masatomo; Kakei, Masafumi; Iwasawa, Saaya; Morii, Tsukasa; Miura, Takeshi; Sasaki, Hiroshi; Satoh, Takehiro; Fujita, Hiroki; Narita, Takuma; Shirakawa, Hideko; Yamada, Yuichiro; Suzuki, Toshio

    2007-10-01

    The minimental state examination (MMSE) is a widely used, standardized method to assess cognitive function including movement-related disorders with high reliability. We studied the relationship between MMSE scores and the ability to take oral medications correctly (ingestion compliance) in 70 elderly inpatients (mean age 71.3+/-7.0 years). Patients with abnormal glucose tolerance as determined by an HbA(1c) level of 5.8% or greater including diabetes showed a trend of lower MMSE scores compared with patients with normal glucose tolerance, and the scores were negatively correlated with HbA1c, age, and systolic blood pressure (P<0.05). Self-management in taking oral medications was very difficult in 4 patients whose MMSE scores were 21 points or less. Thus ingestion supervisions by nurses were required in these patients. Furthermore, 9 of 12 noncompliant patients had MMSE scores ranging from 22 to 26 points. We instructed these patients to take medications in a one-dose package as a useful tool to improve compliance. The MMSE score was 27 or higher in 44 of 54 compliant patients, and 10 patients had scores ranging from 21 to 26. The sensitivity and specificity for noncompliance at an MMSE score cut-off point of 26 were 75.0% and 81.5%, respectively. In conclusion, it is necessary to coordinate ingestion methods matched to each patient according to their abilities to comply with medication schedules. They should be preevaluated with the MMSE to improve ingestion compliance. The MMSE is a recommended test in hospitalized elderly patients for the assessment of the ability to take medications safely.

  7. Association of platelet responsiveness with clopidogrel metabolism: role of compliance in the assessment of "resistance".

    Science.gov (United States)

    Serebruany, Victor; Cherala, Ganesh; Williams, Craig; Surigin, Serge; Booze, Christopher; Kuliczkowski, Wiktor; Atar, Dan

    2009-12-01

    Noncompliance is probably the major cause of clopidogrel "resistance." However, noncompliance is difficult to prove without confirming that the drug has been administered. Therefore, detection of plasma clopidogrel and/or metabolite(s) as the reliable objective method to confirm compliance is important. We sought to correlate the inhibition of platelet aggregation (IPA) with plasma levels of unchanged clopidogrel (UC), active thiol metabolite (ATM), and inactive carboxyl metabolite (ICM) in a large cohort of patients with coronary artery disease and ischemic stroke treated with clopidogrel. We conducted secondary post-hoc analyses of IPA and plasma UC, ATM, and ICM in a dataset consisting of presumably compliant patients with coronary disease (n = 422) and post-stroke (n = 209). Overall noncompliance rate was 22% (n = 138), while such risks were significantly higher in stroke survivors (n = 79, or 38%) when compared to patients with coronary disease (14%; n = 59; P = .001). Only ICM (19,154 +/- 7,228 ng/ml) was suitable for detecting compliance, while UC (15.2 +/- 9.4 ng/ml), and ATM (8.1 +/- 3.7 ng/ml) in most cases are barely detectable, and diminish over time in the stored samples. The best correlation with IPA (r2 = 0.847) was observed for active metabolite, followed by unchanged clopidogrel (r2 = 0.602), and finally inactive metabolite (r2 = 0.529). The predictive value for noncompliance was also high for inactive metabolite (c-statistic = 0.911). Therapy with clopidogrel is associated with double-digit underestimated risks for noncompliance, especially in stroke survivors, supporting the hypothesis that lack of IPA, and clopidogrel "resistance" are attributed to hidden noncompliance. Plasma ICM, but not UC, or ATM is a useful marker to monitor compliance to clopidogrel in registries and clinical trials.

  8. Assessment of wastewater treatment facility compliance with decreasing ammonia discharge limits using a regression tree model.

    Science.gov (United States)

    Suchetana, Bihu; Rajagopalan, Balaji; Silverstein, JoAnn

    2017-11-15

    A regression tree-based diagnostic approach is developed to evaluate factors affecting US wastewater treatment plant compliance with ammonia discharge permit limits using Discharge Monthly Report (DMR) data from a sample of 106 municipal treatment plants for the period of 2004-2008. Predictor variables used to fit the regression tree are selected using random forests, and consist of the previous month's effluent ammonia, influent flow rates and plant capacity utilization. The tree models are first used to evaluate compliance with existing ammonia discharge standards at each facility and then applied assuming more stringent discharge limits, under consideration in many states. The model predicts that the ability to meet both current and future limits depends primarily on the previous month's treatment performance. With more stringent discharge limits predicted ammonia concentration relative to the discharge limit, increases. In-sample validation shows that the regression trees can provide a median classification accuracy of >70%. The regression tree model is validated using ammonia discharge data from an operating wastewater treatment plant and is able to accurately predict the observed ammonia discharge category approximately 80% of the time, indicating that the regression tree model can be applied to predict compliance for individual treatment plants providing practical guidance for utilities and regulators with an interest in controlling ammonia discharges. The proposed methodology is also used to demonstrate how to delineate reliable sources of demand and supply in a point source-to-point source nutrient credit trading scheme, as well as how planners and decision makers can set reasonable discharge limits in future. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Pilot study: Assessing the effect of continual position monitoring technology on compliance with patient turning protocols

    OpenAIRE

    Schutt, Suann Cirigliano; Tarver, Christine; Pezzani, Michelle

    2017-01-01

    Abstract Aim The study aim was to evaluate if continual patient position monitoring, taking into account self‐turns and clinician‐assisted turns, would increase the percentage of time a patient's position changed at least every 2 hr. Background While patient turning has clinical benefits, current models to help staff remember to turn patients, such as “turn clocks” and timers, have not resulted in high compliance with turning protocols. In addition, reminders are based on arbitrary 2‐hr windo...

  10. Criminal Compliance

    Directory of Open Access Journals (Sweden)

    Cristina Antonella Andretta

    2015-10-01

    The article discusses the concepts of both compliance and criminal compliance, its main components and structure as well as the main rules relating to its global application, and finally his emergence in the Ecuadorian legal system.

  11. 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

  12. 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…

  13. 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…

  14. Technical assessment of TRUSAF for compliance with work place air sampling. Revision 1

    International Nuclear Information System (INIS)

    Butler, J.D.

    1995-01-01

    The purpose of this Technical Work Document is to satisfy WHC-CM-1-6, the ''WHC Radiological Control Manual.'' This first revision of the original Supporting Document covers the period from January 1, 1994 to December 31, 1994. WHC-CM-1-6 is the primary guidance for radiological control at Westinghouse Hanford Company (WHC). As such, it complies with Title 10, Part 835 of the Code of Federal Regulations. In addition to WHC-CM-1-6, there is HSRCM-1, the ''Hanford Site Radiological Control Manual'' and several Department of Energy (DOE) Orders, national consensus standards, and reports that provide criteria, standards, and requirements for workplace air sampling programs. This document provides a summary of these, as they apply to WHC facility workplace air sampling programs. this document also provides an evaluation of the compliance of the TRUSAF workplace air sampling program to the criteria, standards, and requirements and documents. Where necessary, it also indicates changes needed to bring specific locations into compliance

  15. 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...

  16. Assessment of Health, Safety and Environmental Risks of Zahedan City Gasoline Stations

    Directory of Open Access Journals (Sweden)

    S. Y. Far

    2018-04-01

    Full Text Available The purpose of this study was to assess the risk and determine the health, safety and environmental status of fuel stations in Zahedan. In this study, failure mode and effects analysis (FMEA method was used for risk assessment in accordance with the HSE guidelines, national and international standards and laws. In this cross-sectional study, 2 governmental stations and 6 active private stations were evaluated after the necessary coordination with the relevant units. As a result of risk assessment, 27 health risks, 55 safety risks and 22 environmental risks were identified. From among all the identified risks, 67 risks had a Risk Priority Number (RPN of less than 91, 31 risks had an RPN ranging between 91 and 201, and 6 risks had an RPN of over 201. The findings of the study indicated that compliance with the HSE requirements was 51.85%, in the area of health, 47.57% in the area of safety and 27.45% in the environmental area. Overall compliance with the HSE requirements was 42.54%. In order to distribute fuel considering health, reducing risk and increasing compliance with the requirements for safety improvement, health and environmental conditions of fuel supplies are essential.

  17. Program management assessment of Federal Facility Compliance Agreement regarding CAA-40 C.F.R. Part 61, Subpart H at the Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    1997-01-01

    An assessment of Los Alamos National Laboratory's management system related to facility compliance with an element of the Clean Air Act was performed under contract by a team from Northern Arizona University. More specifically, a Federal Facilities Compliance Agreement (FFCA) was established in 1996 to bring the Laboratory into compliance with emissions standards of radionuclides, commonly referred to as Rad/NESHAP. In the fall of 1996, the four-person team of experienced environmental managers evaluated the adequacy of relevant management systems to implement the FFCA provisions. The assessment process utilized multiple procedures including document review, personnel interviews and re-interviews, and facility observations. The management system assessment was completed with a meeting among team members, Laboratory officials and others on November 1, 1996 and preparation of an assessment report

  18. Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

    Science.gov (United States)

    Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

    2018-03-07

    To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

  19. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

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

  20. Social media in the health-care setting: benefits but also a minefield of compliance and other legal issues.

    Science.gov (United States)

    Moses, Richard E; McNeese, Libra G; Feld, Lauren D; Feld, Andrew D

    2014-08-01

    Throughout the past 20 years, the rising use of social media has revolutionized health care as well as other businesses. It allows large groups of people to create and share information, ideas, and experiences through online communications, and develop social and professional contacts easily and inexpensively. Our Gastroenterology organizations, among others, have embraced this technology. Although the health-care benefits may be many, social media must be viewed through a legal lens, recognizing the accompanying burdens of compliance, ethical, and litigation issues. Theories of liability and risk continue to evolve as does the technology. Social media usage within the medical community is fraught with potential legal issues, requiring remedial responses to meet patients' needs and comply with current laws, while not exposing physicians to medical malpractice and other tort risks.

  1. 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

  2. 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.

  3. Comprehensive Assessment of Compliance with Antimuscarinic Drug Treatment in the Case of Urge Urinary Incontinence of Older Patients.

    Science.gov (United States)

    Kosilov, Kirill V; Loparev, Sergey A; Kuzina, Irina G; Shakirova, Olga V; Zhuravskaya, Natalya S; Lobodenko, Alexandra

    2017-01-01

    To investigate the heterogeneous factors affecting the stability of patients older than 60 years in the UI treatment with Antimuscarinics. The prevalence of Urge Incontinence (UI) in older persons reaches 29.3%. The symptoms of urinary incontinence in older people reduce the health related life quality. In 1257 patients over 60 years (857 (68.2%) women - average age 67.8, 400 (31.8%) men - 71.4), who received AM for one year, demographic, socio-economic and health parameters were studied. OABq-SF questionnaires, MOS SF-36, urination diaries, uroflowmetry, income information from the tax offices and outpatient records were used. The compliance to AM treatment within 6 months was retained in 44.2%, and within the year - 26.8% of older patients. At least 40% of the total number of patients refused to continue the treatment for medical reasons. The persons taking Solifenacin (p≤ 0.01), Trospium (p≤ 0.05), or Darifenacin (p≤ 0.05), suffering from severe UI symptoms (p≤ 0.01), and experiencing minor side effects (p≤ 0.01), well-informed about UI treatment methods (p≤ 0.01) prevailed among the treatment compliant patients. At least 20.4% of the patients discontinued their treatment due to economic reasons. The persons with significantly larger annual income (p≤ 0.05) and annual medical cost (p≤ 0.01) prevailed among the treatment compliant patients. About 12.2% of the patients stopped their treatment for reasons related to the social background and psychological status. In this experiment, we found that AM treatment compliance in older patients, in addition to medical parameters and health conditions, is largely affected by the economic as well as social, demographic and psychological factors. The study results can be claimed by practitioners involved in correcting UI symptoms in older people. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. 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.

  5. Assessment of marine gas hydrate deposits: A comparative study of seismic, electromagnetic and seafloor compliance methods

    Energy Technology Data Exchange (ETDEWEB)

    Willoughby, E. C.; Schwalenberg, K.; Edwards, R.N.; Spence, G.D.; Hyndman, R.D.

    2005-07-01

    The existence, distribution and concentration of marine natural gas hydrate are mostly diagnosed using seismic data. The base of the hydrate stability zone marks an acoustic impedance contrast, which generally mimics seafloor topography and is associated with a bright, negative-polarity reflector, known as the Bottom Simulating Reflector (BSR). However, limitations of seismic methods include uncertainty in the origin of the BSR, which does not distinguish between low velocity gas and high velocity hydrate, blanking, and lack of clear upper boundary reflections. Sufficiently accurate hydrate layer velocities have been obtained at few sites, and these could better evaluate hydrate content with reference to velocities in similar sediments without hydrate- a situation very difficult to find. Therefore, estimation of the total mass of a deposit is difficult using seismic data alone. We have developed two supplementary geophysical imaging techniques for the evaluation of marine hydrate: A deep-towed controlled-source electromagnetic (CSEM) and a seafloor compliance experiment. These methods are sensitive to physical properties of the sedimentary section, which are modified by the presence of gas hydrate, namely the resistivity and the bulk shear modulus depth profile, respectively. CSEM data are gathered by inline receivers towed behind an AC transmitter; high precision timing allows measurement of the EM field propagation time through marine sediments which is proportional to resistivity, which is increased by the presence of insulating hydrate. Seafloor compliance is the transfer function between pressure induced on the seafloor by surface gravity waves and the associated deformation of the seafloor. It is mostly sensitive to shear modulus anomalies. Shear modulus is increased by hydrates, which can cement grains together. Here we present field data at a gas hydrate site, south of ODP Hole 889B in northern Cascadia, over a proposed new IODP transect, where these three

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. The effect of a health communication campaign on compliance with mass drug administration for schistosomiasis control in western Kenya--the SCORE project.

    Science.gov (United States)

    Omedo, Martin; Ogutu, Michael; Awiti, Alphonce; Musuva, Rosemary; Muchiri, Geoffrey; Montgomery, Susan P; Secor, W Evan; Mwinzi, Pauline

    2014-11-01

    Compliance with mass drug administration (MDA) can be affected by rumors and mistrust about the drug. Communication campaigns are an effective way to influence attitudes and health behaviors in diverse public health contexts, but there is very little documentation about experiences using health communications in schistosomiasis control programs. A qualitative study was conducted with community health workers (CHWs) as informants to explore the effect of a health communication campaign on their experiences during subsequent praziquantel MDA for schistosomiasis. Discussions were audio-recorded, transcribed verbatim, translated into English where applicable, and analyzed thematically using ATLAS.ti software. According to the CHWs, exposure to mass media messages improved awareness of the MDA, which in turn, led to better treatment compliance. Our findings suggest that communication campaigns influence health behaviors and create awareness of schistosomiasis control interventions, which may ultimately improve praziquantel MDA. © The American Society of Tropical Medicine and Hygiene.

  11. SAR compliance assessment of PMR 446 and FRS walkie-talkies.

    Science.gov (United States)

    Vermeeren, Günter; Joseph, Wout; Martens, Luc

    2015-10-01

    The vast amount of studies on radiofrequency dosimetry deal with exposure due to mobile devices and base station antennas for cellular communication systems. This study investigates compliance of walkie-talkies to exposure guidelines established by the International Commission on Non-Ionizing Radiation Protection and the Federal Communications Committee. The generic walkie-talkie consisted of a helical antenna and a ground plane and was derived by reverse engineering of a commercial walkie-talkie. Measured and simulated values of antenna characteristics and electromagnetic near fields of the generic walkie-talkie were within 2% and 8%, respectively. We also validated normalized electromagnetic near fields of the generic walkie-talkie against a commercial device and observed a very good agreement (deviation based on magnetic near field. Finally, we found that SAR of commercial devices is within current SAR limits for general public exposure for a worst-case duty cycle of 100%, that is, about 3 times and 6 times lower than the limit on the 1 g SAR (1.6 W/kg) and 10 g SAR (2 W/kg), respectively. But, an effective radiated power as specified by the Private Mobile Radio at 446 MHz (PMR 446) radio standard can cause localized SAR exceeding SAR limits for 1 g of tissue. © 2015 Wiley Periodicals, Inc.

  12. 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

  13. 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

  14. Compliance with the Dietary Approaches to Stop Hypertension (DASH diet: a systematic review.

    Directory of Open Access Journals (Sweden)

    Mandy Wing-Man Kwan

    Full Text Available BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH diet has been recognized as effective to lower blood pressure in feeding trials, but compliance with the diet must be persistent to maximize health benefits in clinical practice. This paper reports a systematic review of the latest evidence on the method to assess DASH compliance and the corresponding patients' compliance in interventional settings. METHODS: The databases including MEDLINE, EBM Reviews, EMBASE, and CINAHL Plus were searched for original research studies published in the period of January 1992-December 2012 that evaluated compliance with DASH diet. Studies written in English language, with DASH intervention, with complete documentation of the degree of DASH compliance and the assessment method used were included in this review. The search terms included: dietary approaches to stop hypertension, DASH, compliance, adherence, consistency, and concordance. RESULTS: Nine studies were included. Different types of interventions were identified, ranging from feeding trial to dietary counseling. These studies differed in the assessment methods used to evaluate DASH compliance, which included objective approaches like measurement of urinary excretion, and subjective approaches like dietary intake assessment for DASH target comparison and construction of DASH scoring systems. Compliance levels were lower in educational interventions than that of the original DASH feeding trial. CONCLUSIONS: To conclude, although no consensus existed regarding the best approach to assess DASH compliance, its suboptimal compliance warrants attention. This study implied a need to investigate effective approaches to sustain the DASH dietary pattern beyond counselling alone.

  15. Achieving compliance with environmental health-related land use planning conditions in Hong Kong: perspectives from traditional motivation theories.

    Science.gov (United States)

    Man, Rita Li Yi

    2009-11-01

    Environmental health-related land use planning conditions can enhance the environment in Hong Kong. Previous research by others has shown, however, that a lack of compliance with planning conditions often occurs. And as no direct enforcement of planning conditions exists in Hong Kong, it is of interest to understand possible ways in which to increase the motivation of land developers and property owners to comply with planning conditions. The author looked at motivation from the perspective of three traditional motivation theories: Theory X, Theory Y, and incentive theory. While the majority of this article focuses on the enforcement and the legal tests in land use planning conditions, it also presents the results of the first study of the motivations behind Hong Kong land developers to comply with land use planning conditions.

  16. 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.

  17. 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

  18. The validity of compliance monitors to assess wearing time of thoracic-lumbar-sacral orthoses in children with spinal cord injury.

    Science.gov (United States)

    Hunter, Louis N; Sison-Williamson, Mitell; Mendoza, Melissa M; McDonald, Craig M; Molitor, Fred; Mulcahey, M J; Betz, Randal R; Vogel, Lawrence C; Bagley, Anita

    2008-06-15

    Prospective multicenter observation. To determine the validity of 3 commercially available at recording thoracic-lumbar-sacral orthosis (TLSO) wearing time of children with spinal cord injury (SCI) and to assess each monitor's function during daily activities. A major limitation to studies assessing the effectiveness of spinal prophylactic bracing is the patient's compliance with the prescribed wearing time. Although some studies have begun to use objective compliance monitors, there is little documentation of the validity of the monitors during activities of daily life and no comparisons of available monitors. Fifteen children with SCI who wore a TLSO for paralytic scoliosis were observed for 4 days during their rehabilitation stay. Three compliance monitors (2 temperature and 1 pressure sensitive) were mounted onto each TLSO. Time of brace wear from the monitors was compared with the wear time per day recorded in diaries. Observed versus monitored duration of brace wear found the HOBO (temperature sensitive) to be the most valid compliance monitor. The HOBO had the lowest average of difference and variance of difference scores. The correlation between the recorded daily entries and monitored brace wear time was also highest for the HOBO in analysis of dependent and independent scores. Bland-Altman plots showed that the pressure sensitive monitor underestimated wear time whereas the temperature monitors overestimated wear time. Compliance to prescribed wearing schedule has been a barrier to studying TLSO efficacy. All 3 monitors were found to measure TLSO compliance, but the 2 temperature monitors were more in agreement with the daily diaries. Based on its functional advantages compared with the HOBO, the StowAway TidbiT will be used to further investigate the long-term compliance of TLSO bracing in children with SCI.

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

    Science.gov (United States)

    Walsh, Tiffany M; Volsko, Teresa A

    2008-10-01

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

  20. Association Between Employee Dental Claims, Health Risks, Workplace Productivity, and Preventive Services Compliance.

    Science.gov (United States)

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

    2017-08-01

    This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy claims, and dental claims. Employees with no dental claims were significantly more likely to have a variety of health risk factors (such as obesity and tobacco use), health conditions (such as diabetes), absenteeism, and lost on-the-job productivity, and were significantly less likely to be compliant with clinical preventive services compared with those with preventive dental claims. Employees with preventive dental claims had fewer health risks and medical conditions and better health and productivity measures. Study employees underutilized free dental care; employers should incorporate preventive dental care awareness into their worksite wellness programs.

  1. OCONUS Compliance Assessment Protocols -- OEBGD (Air Force and Marine Corps Version)

    Science.gov (United States)

    2010-06-01

    circuit breakers, reclosers , and cables. Also included here are criteria to control and abate threats to human health and the environment from...Contaminated Electrical Equipment - any electrical equipment including, but not limited to, transformers, capacitors, circuit breakers, reclosers

  2. Increasing Compliance in Students with Intellectual Disabilities Using Functional Behavioral Assessment and Self-Monitoring

    Science.gov (United States)

    Wadsworth, Jamie P.; Hansen, Blake D.; Wills, Sarah B.

    2015-01-01

    Noncompliance in three elementary age students with intellectual disabilities was assessed using functional behavioral assessments. Escape was identified as the primary function of the behavior in all three students, and access to tangible items was identified in one of the students as a secondary function. Teacher-monitoring and self-monitoring…

  3. Compliance status

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford's compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute

  4. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  5. Performing compliance

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    the local policy workers front-staged some practices in the implementation process and back-staged others. The local policy workers deliberately performed ‘guideline compliance’ by using information control and impression management techniques. The findings suggest that local guideline compliance should...... be regarded as a staged performance in which deliberate techniques are used to produce and manage certain impressions of compliance....

  6. 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

  7. 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.

  8. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study.

    Science.gov (United States)

    Musinguzi, Geofrey; Anthierens, Sibyl; Nuwaha, Fred; Van Geertruyden, Jean-Pierre; Wanyenze, Rhoda K; Bastiaens, Hilde

    2018-01-01

    Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB). Data was analyzed following a semantic thematic analysis approach. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  9. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Geofrey Musinguzi

    2018-01-01

    Full Text Available Background and Methods. Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. Methods. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB. Data was analyzed following a semantic thematic analysis approach. Results. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Conclusion. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  10. Assessment of a volume-dependent dynamic respiratory system compliance in ALI/ARDS by pooling breathing cycles

    International Nuclear Information System (INIS)

    Zhao, Zhanqi; Möller, Knut; Guttmann, Josef

    2012-01-01

    New methods were developed to calculate the volume-dependent dynamic respiratory system compliance (C rs ) in mechanically ventilated patients. Due to noise in respiratory signals and different characteristics of the methods, their results can considerably differ. The aim of the study was to establish a practical procedure to validate the estimation of intratidal dynamic C rs . A total of 28 patients from intensive care units of eight German university hospitals with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) were studied retrospectively. Dynamic volume-dependent C rs was determined during ongoing mechanical ventilation with the SLICE method, dynostatic algorithm and adaptive slice method. Conventional two-point compliance C 2P was calculated for comparison. A number of consecutive breathing cycles were pooled to reduce noise in the respiratory signals. C rs -volume curves produced with different methods converged when the number of pooling cycles increased (n ≥ 7). The mean volume-dependent C rs of 20 breaths was highly correlated with mean C 2P (C 2P,mean = 0.945 × C rs,mean − 0.053, r 2 = 0.968, p < 0.0001). The Bland–Altman analysis indicated that C 2P,mean was lower than C rs,mean (−2.4 ± 6.4 ml cm −1 H 2 O, mean bias ± 2 SD), but not significant according to the paired t-test (p > 0.05). Methods for analyzing dynamic respiratory mechanics are sensitive to noise and will converge to a unique solution when the number of pooled cycles increases. Under steady-state conditions, assessment of the volume-dependent C rs in ALI/ARDS patients can be validated by pooling respiratory data of consecutive breaths regardless of which method is applied. Confidence in dynamic C rs determination may be increased with the proposed pooling. (note)

  11. Corporate compliance: framework and implementation.

    Science.gov (United States)

    Fowler, N

    1999-01-01

    The federal government has created numerous programs to combat fraud and abuse. The government now encourages healthcare facilities to have a corporate compliance program (CCP), a plan that reduces the chances that the facility will violate laws or regulations. A CCP is an organization-wide program comprised of a code of conduct and written policies, internal monitoring and auditing standards, employee training, feedback mechanisms and other features, all designed to prevent and detect violations of governmental laws, regulations and policies. It is a system or method ensuring that employees understand and will comply with laws that apply to what they do every day. Seven factors, based on federal sentencing guidelines, provide the framework for developing a CCP. First, a facility must establish rules that are reasonably capable of reducing criminal conduct. Second, high-level personnel must oversee the compliance effort. Third, a facility must use due care in delegating authority in the compliance initiative. Fourth, standards must be communicated effectively to employees, and fifth, a facility must take reasonable steps to achieve compliance. Sixth, standards must be enforced consistently across the organization and last, standards must be modified or changed for reported concerns, to ensure they are not repeated. PROMINA Health System, Inc. in Atlanta, Ga., designed a program to meet federal guidelines. It started with a self-assessment to define its areas or risk. Next, it created the internal structure and assigned organizational responsibility for running the CCP. PROMINA then developed standards of business and professional conduct, established vehicles of communication and trained employees on the standards. Finally, it continues to develop evidence of the program's effectiveness by monitoring and documenting its compliance activities.

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    Hyuckmyun Kwon

    2010-09-01

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

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

    Science.gov (United States)

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

    2010-09-01

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

  15. 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

  16. Development of an assessment scale for treatment compliance in type 2 Diabetes Mellitus in Turkish population: Psychometric evaluation

    Directory of Open Access Journals (Sweden)

    Ayla Demirtaş

    2017-07-01

    Conclusion: The results of the study demonstrated that the scale with 30 items is a valid and reliable scale for the evaluation of patient compliance with type 2 DM treatment. Thus, by using this scale, nurses and healthcare providers can evaluate the treatment compliance of patients with type 2 DM.

  17. Water Quality Monitoring Around Submerged Wastewater Outfalls in Southern California: From Compliance Assessment to Impact of Climate Change

    Science.gov (United States)

    Nezlin, N. P.

    2016-02-01

    Routine monitoring near major submerged ocean outfalls in southern California is focused on the assessment of the effects of wastewater discharge on water-quality (WQ), including dissolved oxygen, pH, transmissivity, and phytoplankton biomass. The proposed WQ compliance assessment using DO as an indicator includes 1) identification of the area affected by effluent wastewater using Colored Dissolved Organic Matter (CDOM) as an effluent plume tracer, 2) selection of reference sampling sites representing `natural' conditions, and 3) comparison between DO profiles in the reference and plume-affected zones. This strategy is implemented as an interactive web-based tool including convenient data visualization options. At the same time, the data of WQ monitoring (regular quarterly observations starting 1998-present) provides an excellent platform to analyze the spatial and temporal (seasonal and interannual) variations in near-shore ocean ecosystem. An illustrative example is the trends in the depths of the euphotic layer and subsurface chlorophyll maximum layer (SCML), abruptly deepening during the most recent four-year period (2011-2014). These dramatic changes are associated with declining intensity of the North Pacific gyre circulation (NPGO index), decreasing upwelling and increasing transport of warm water from equatorial Pacific (PDO and ENSO cycles).

  18. Relationship of Interpersonal Behaviors and Health-Related Control Appraisals to Patient Satisfaction and Compliance in a University Health Center

    Science.gov (United States)

    Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.

    2007-01-01

    Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before…

  19. Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment.

    Science.gov (United States)

    Dehury, Ranjit Kumar; Samal, Janmejaya

    2016-08-01

    A competent health system is of paramount importance in delivering the desired health services in a particular community. The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.

  20. Performance assessment of select covers and disposal cell compliance with EPA [Environmental Protection Agency] groundwater standards

    International Nuclear Information System (INIS)

    1989-06-01

    This document describes the technical approach to the assessment of the performance of a full component topslope cover, three sideslope covers, and hence the way in which a Uranium Mill Tailings Remedial Action (UMTRA) Project disposal cell complies with the US Environmental Protection Agency (EPA) groundwater protection standards. 4 refs

  1. A College Administrator's Framework to Assess Compliance with Accreditation Mandates

    Science.gov (United States)

    Davis†, Jerry M.; Rivera, John-Juan

    2014-01-01

    A framework to assess the impact of complying with college accreditation mandates is developed based on North's (1996) concepts of transaction costs, property rights, and institutions; Clayton's (1999) Systems Alignment Model; and the educational production function described by Hanushek (2007). The framework demonstrates how sought…

  2. 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.

  3. 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

  4. Performing Compliance: The Work of Local Policy Workers during the Implementation of National Health Promotion Guidelines

    Science.gov (United States)

    Wimmelmann, Camila Lawaetz

    2017-01-01

    Guidelines are increasingly used to regulate how local authorities engage in practices. Focusing on the Danish national health promotion guidelines, this article reveals that the local policy workers did not implement the guidelines as proposed. Using a dramaturgical framework, it illustrates how the local policy workers front-staged some…

  5. Building Safer Secondary Schools in Uganda through Collective Commitment to Health and Safety Compliance

    Science.gov (United States)

    Sekiwu, Denis; Kabanda, Milly

    2014-01-01

    The area of safety and accident prevention is of great concern to managers, because of the increasing number of deaths and accidents at work places. Using a case of Wakiso district, the study sought to investigate the relationship between collective commitment and management of health and safety in Ugandan secondary schools. The study employed a…

  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 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

  7. Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

    Science.gov (United States)

    Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

    2010-04-01

    To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency

  8. 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.

  9. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    Science.gov (United States)

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  10. The importance of people compliance (social desirability bias) in the assessment of epilepsy prevalence in rural areas of developing countries. Results of the Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Oscar H; Mera, Robertino M

    2016-12-01

    Epilepsy is a major health issue in rural areas of developing countries. However, heterogeneity of epilepsy prevalence in different studies precludes assessment of the magnitude of the problem. Using similar protocols, two population-based surveys were conducted 12 years apart (2003 and 2015) in a rural Ecuadorian village (Atahualpa). The only difference was a higher people compliance with interviewers during the second survey. Epilepsy prevalence in the 2003 survey was 13.5 per 1,000 (18/1,332) in villagers aged ≥20 years. This rate increased to 26.8 per 1,000 (41/1,530) in the 2015 survey. Thirty-three persons with epilepsy detected during the second survey lived in the village in 2003; six of them had seizures starting after 2003. Of the remaining 27 cases, 13 (48%) denied their problem during the first survey. Further interview revealed that denial was related to lack of confidence with unacquainted field personnel. Social Desirability Scale-17 scores were lower in those who admitted having epilepsy than in those who denied their condition (p = 0.048). Lack of confidence with interviewers and a social desirability bias account for a sizable proportion of epilepsy denial in the study population, and may explain heterogeneity of epilepsy prevalence reported in studies conducted in poor rural settings. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  11. 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...

  12. 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

  13. 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)

  14. Evaluation of replacement tritium facility (RTF) compliance with DOE safety goals using probabilistic consequence assessment methodology

    International Nuclear Information System (INIS)

    O'Kula, K.R.; East, J.M.; Moore, M.L.

    1993-01-01

    The Savannah River Site (SRS), operated by the Westinghouse Savannah River Company (WSRC) for the US Department of Energy (DOE), is a major center for the processing of nuclear materials for national defense, deep-space exploration, and medical treatment applications in the United States. As an integral part of the DOE's effort to modernize facilities, implement improved handling and processing technology, and reduce operational risk to the general public and onsite workers, transition of tritium processing at SRS from the Consolidated Tritium Facility to the Replacement Tritium Facility (RTF) began in 1993. To ensure that operation of new DOE facilities such as RTF present minimum involuntary and voluntary risks to the neighboring public and workers, indices of risk have been established to serve as target levels or safety goals of performance for assessing nuclear safety. These goals are discussed from a historical perspective in the initial part of this paper. Secondly, methodologies to quantify risk indices are briefly described. Lastly, accident, abnormal event, and normal operation source terms from RTF are evaluated for consequence assessment purposes relative to the safety targets

  15. Defense Health Care: Oversight of Military Services' Post-Deployment Health Reassessment Completion Rates Is Limited

    National Research Council Canada - National Science Library

    Williamson, Randall B

    2008-01-01

    .... DOD oversees the military services compliance with PDHRA requirements through its deployment health assessment quality assurance program and is required to report on the quality assurance program...

  16. [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.

  17. Transcultural adaptation into Spanish of the Induction Compliance Checklist for assessing children's behaviour during induction of anaesthesia.

    Science.gov (United States)

    Jerez-Molina, Carmen; Lázaro-Alcay, Juan J; Ullán-de la Fuente, Ana M

    2017-10-17

    Cross-cultural adaptation into Spanish of the Induction Compliance Checklist (ICC) for assessing children's behaviour during induction of anaesthesia. A descriptive cross-sectional observational study was conducted on a sample of 81 children aged 2 to 12 years operated in an ambulatory surgery unit of a paediatric hospital in Barcelona. Adaptation by translation-back translation of the tool and analysis of the scale's validity and reliability. Face validity of the tool was guaranteed through a discussion group and inter-observer reliability was evaluated, obtaining an intraclass correlation index of r = 0.956. The ICC scale validated for the Spanish population can be an effective tool for the presurgical evaluation of activities carried out to minimise children's anxiety. The ICC is an easy-to-use scale completed by operating room staff in one minute and would provide important information about children's behaviour, specifically during induction. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  18. Guidebook for performance assessment parameters used in the Waste Isolation Pilot Plant compliance certification application. Volume 1: Main report

    International Nuclear Information System (INIS)

    Howarth, S.M.; Martell, M.A.; Weiner, R.; Lattier, C.

    1998-06-01

    The Waste Isolation Pilot Plant (WIPP) Compliance Certification Application (CCA) Performance Assessment (PA) Parameter Database and its ties to supporting information evolved over the course of two years. When the CCA was submitted to the Environmental Protection Agency (EPA) in October 1996, information such as identification of parameter value or distribution source was documented using processes established by Sandia National Laboratories WIPP Quality Assurance Procedures. Reviewers later requested additional supporting documentation, links to supporting information, and/or clarification for many parameters. This guidebook is designed to document a pathway through the complex parameter process and help delineate flow paths to supporting information for all WIPP CCA parameters. In addition, this report is an aid for understanding how model parameters used in the WIPP CCA were developed and qualified. To trace the source information for a particular parameter, a dual-route system was established. The first route uses information from the Parameter Records Package as it existed when the CCA calculations were run. The second route leads from the EPA Parameter Database to additional supporting information

  19. Guidebook for performance assessment parameters used in the Waste Isolation Pilot Plant compliance certification application. Volume 2: Appendices

    International Nuclear Information System (INIS)

    Howarth, S.M.; Martell, M.A.; Weiner, R.; Lattier, C.

    1998-06-01

    The Waste Isolation Pilot Plant (WIPP) Compliance Certification Application (CCA) Performance Assessment (PA) Parameter Database and its ties to supporting information evolved over the course of two years. When the CCA was submitted to the Environmental Protection Agency (EPA) in October 1996, information such as identification of parameter value or distribution source was documented using processes established by Sandia National Laboratories WIPP Quality Assurance Procedures. Reviewers later requested additional supporting documentation, links to supporting information, and/or clarification for many parameters. This guidebook is designed to document a pathway through the complex parameter process and help delineate flow paths to supporting information for all WIPP CCA parameters. In addition, this report is an aid for understanding how model parameters used in the WIPP CCA were developed and qualified. To trace the source information for a particular parameter, a dual-route system was established. The first route uses information from the Parameter Records package as it existed when the CCA calculations were run. The second route leads from the EPA Parameter Database to additional supporting information

  20. Modeling gas and brine migration for assessing compliance of the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Vaughn, P.; Butcher, B.; Helton, J.; Swift, P.

    1993-10-01

    At the request of the WIPP Project Integration Office (WPIO) of the DOE, the WIPP Performance Assessment (PA) Department of Sandia National Laboratories (SNL) has completed preliminary uncertainty and sensitivity analyses of gas and brine migration away from the undisturbed repository. This paper contains descriptions of the numerical model and simulations, including model geometries and parameter values, and a summary of major conclusions from sensitivity analyses. Because significant transport of contaminants can only occur in a fluid (gas or brine) medium, two-phase flow modeling can provide an estimate of the distance to which contaminants can migrate. Migration of gas or brine beyond the RCRA ''disposal-unit boundary'' or the Standard's accessible environment constitutes a potential, but not certain, violation and may require additional evaluations of contaminant concentrations

  1. 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.

  2. Clinical 3D printing: A protected health information (PHI) and compliance perspective.

    Science.gov (United States)

    Feldman, Henry; Kamali, Parisa; Lin, Samuel J; Halamka, John D

    2018-07-01

    Advanced manufacturing techniques such as 3-dimensional (3D) printing, while mature in other industries, are starting to become more commonplace in clinical care. Clinicians are producing physical objects based on patient clinical data for use in planning care and educating patients, all of which should be managed like any other healthcare system data, except it exists in the "real" world. There are currently no provisions in the Health Insurance Portability and Accountability Act (HIPAA) either in its original 1996 form or in more recent updates that address the nature of physical representations of clinical data. We submit that if we define the source data as protected health information (PHI), then the objects 3D printed from that data need to be treated as both (PHI), and if used clinically, part of the clinical record, and propose some basic guidelines for quality and privacy like all documentation until regulatory frameworks can catch up to this technology. Many of the mechanisms designed in the paper and film chart era will work well with 3D printed patient data. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. 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.

  4. Assessment of Compliance to Treatment of Diabetes and Hypertension amongst Previously Diagnosed Patients from Rural Community of Raigad District of Maharashtra.

    Science.gov (United States)

    Kakumani, Kiranmayi Venkata; Waingankar, Prasad

    2016-12-01

    Substantial burden of diabetes and hypertension is on rise in India, leading to a twin epidemic. India, being a rural country, has unique problems regarding the treatment compliance which is a serious risk for morbidity and mortality. To assess the compliance to treatment of hypertension and diabetes amongst the diagnosed patients from rural area and to study reasons of non-compliance and knowledge and attitude. Community based, cross sectional, observational study conducted in the rural communities of Tara and Barapada villages of Raigad district of Maharashtra. Survey was conducted covering population of 2115 across 360 families, 250 at Barapada and 110 at Tara. All the cases of diabetes and hypertension diagnosed for more than one year were included. A structured and pre-tested questionnaire was administered including details on demography, medical documentation, treatment details and factors assessing the compliance, knowledge and attitude towards the diseases. When reviewed the treatment adherence pattern based on documentary evidence and interview of the patient, on history of taking medication strictly since the detection illness, it was found that more than 70% of the Diabetics and more than 75% of the Hypertensive have discontinued the treatment in between. The most common reasons of non-compliance is the lack of sufficient motivation for treatment adherence as many mentioned (61.4% diabetics, 55.8% hypertensives) difficulty to remember to take daily medication due to work or forgetfulness. This is followed by lack of money (50%diabetics, 55.8% hypertensives) and living far away from doctor in city (43% diabetics and 46% hypertensives). The study findings are only tip of iceberg and the non-adherence to the treatment of diabetes and hypertension in rural population is at alarmingly high. Illiteracy, lack of faith in treatment and motivation, unawareness and self-neglect as well as financial constraints and lack of specialist care in rural area is playing

  5. New approaches in human health risk assessment.

    Science.gov (United States)

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

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

  6. New approaches in human health risk assessment

    Directory of Open Access Journals (Sweden)

    Khaled Abass

    2016-12-01

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

  7. Assessment of computer-related health problems among post-graduate nursing students.

    Science.gov (United States)

    Khan, Shaheen Akhtar; Sharma, Veena

    2013-01-01

    The study was conducted to assess computer-related health problems among post-graduate nursing students and to develop a Self Instructional Module for prevention of computer-related health problems in a selected university situated in Delhi. A descriptive survey with co-relational design was adopted. A total of 97 samples were selected from different faculties of Jamia Hamdard by multi stage sampling with systematic random sampling technique. Among post-graduate students, majority of sample subjects had average compliance with computer-related ergonomics principles. As regards computer related health problems, majority of post graduate students had moderate computer-related health problems, Self Instructional Module developed for prevention of computer-related health problems was found to be acceptable by the post-graduate students.

  8. Job Burnout Reduces Hand Hygiene Compliance Among Nursing Staff.

    Science.gov (United States)

    Manomenidis, Georgios; Panagopoulou, Efharis; Montgomery, Anthony

    2017-10-13

    Health professional burnout has been associated with suboptimal care and reduced patient safety. However, the extent to which burnout influences hand hygiene compliance among health professionals has yet to be explored. The aim of the study was to examine whether job burnout reduces hand washing compliance among nursing staff. A diary study was conducted. Forty registered nurses working in a general city hospital in Thessaloniki, Greece, completed a questionnaire, while they were monitored for hand hygiene compliance following the World Health Organization protocol for hand hygiene assessment. Burnout was measured using validated items from the Maslach Burnout Inventory. Data were collected from September to October 2015. Multiple regression analysis showed that controlling for years in practice, burnout was negatively associated with hand hygiene compliance (R = 0.322, F(3,36) = 5.704, P compliance to hand hygiene among nurses. Given the crucial role of hand hygiene compliance for the prevention of in-hospital infections, this study highlights the need for interventions targeting the prevention of burnout among nursing staff.

  9. 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.

  10. Compliance With the Mediterranean Diet and Physical Activity Level of Users of the PAFES (Plan for Physical Activity, Sport and Health Web Site

    Directory of Open Access Journals (Sweden)

    Darío López

    2014-05-01

    Full Text Available Background: The Physical Activity Plan Sport and Health web site (www.pafes.cat allows users to assess the level of adherence to the Mediterranean Diet (MD and level of physical activity (PA by two interactive questionnaires: the MD questionnaire adapted from the study Prevention with Mediterranean Diet (Predimed and the abbreviated version of the International Physical Activity questionnaire (IPAQ.Methods: A descriptive analysis was performed on the results of both questionnaires during the period 2009 to 2010.Results: Of the 1376 questionnaires analyzed on adherence to the MD, 12.5% of users have a high compliance, 67.2% moderate, and 20.3% low. Almost all (95.8% used olive oil as the main added fat, 82.2% and 78.4% reported a low intake of butter and derivatives, and sugary drinks, respectively, and 70.9% referred to an adequate intake of vegetables. On the negative side, 82.3% reported a low intake of legumes, 71.6% a high intake of red meat, 67.6% and 25% lower intake of fruit and nuts, respectively. As regards PA, of the 1221 questionnaires analyzed, 79.4% of the population met the PA health recommendations, 36.5% at a high level, and 42.9% moderate.Conclusions: Web questionnaires can be a useful tool in the promotion and dissemination of both habits. As a suggestion for improvement, we propose the inclusion of demographic variables to determine the profile of users who completed the questionnaires.

  11. 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 ...

  12. Compliance with physical exercise

    DEFF Research Database (Denmark)

    Gram, Anne Sofie; Bønnelycke, Julie; Rosenkilde Larsen, Mads

    2014-01-01

    Aims: Sixty-one healthy, sedentary, moderately overweight young men participated in a randomised controlled trial to examine the effects of two different doses of endurance exercise on health behaviour and exercise compliance. Methods: Participants were randomised to a sedentary control group......), a post hoc thematic analysis was conducted to connect qualitative and quantitative data in a joint analysis. Results: Of the subjects interviewed, exercise compliance expressed as 95% CI was [96.8; 103%] in the MOD group and [82.9; 99.6%] in the HIGH group. The different doses of daily exercise equally...... or quantitative methodology alone. The preconditions of the TBP were fulfilled, and it represents a methodological model to explain the high degree of compliance and motivation to exercise....

  13. Tiger team assessment of the Oak Ridge Y-12 Plant, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1990-02-01

    This document contains findings identified during the Tiger Team Compliance Assessment of the Department of Energy's (DOE's) Y-12 Plant in Oak Ridge, Tennessee. The Y-12 Plant Tiger Team Compliance Assessment is comprehensive in scope. It covers the Environmental, Safety, and Health (including Occupational Safety and Health Administration (OSHA) compliance), and Management areas and determines the plant's compliance with applicable federal (including DOE), state, and local regulations and requirements. 4 figs., 12 tabs.

  14. 42 CFR 124.503 - Compliance level.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance level. 124.503 Section 124.503 Public... Unable To Pay § 124.503 Compliance level. (a) Annual compliance level. Subject to the provisions of this... persons unable to pay if it provides for the fiscal year uncompensated services at a level not less than...

  15. Environmental compliance and cleanup

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the roles of the principal agencies, organizations, and public in environmental compliance and cleanup of the Hanford Site. Regulatory oversight, the Federal Facility Agreement and Consent Order, the role of Indian tribes, public participation, and CERCLA Natural Resource Damage Assessment Trustee Activities are all discussed.

  16. Validating year 2000 compliance

    NARCIS (Netherlands)

    A. van Deursen (Arie); P. Klint (Paul); M.P.A. Sellink

    1997-01-01

    textabstractValidating year 2000 compliance involves the assessment of the correctness and quality of a year 2000 conversion. This entails inspecting both the quality of the conversion emph{process followed, and of the emph{result obtained, i.e., the converted system. This document provides an

  17. Environmental compliance and cleanup

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the roles of the principal agencies, organizations, and public in environmental compliance and cleanup of the Hanford Site. Regulatory oversight, the Federal Facility Agreement and Consent Order, the role of Indian tribes, public participation, and CERCLA Natural Resource Damage Assessment Trustee Activities are all discussed

  18. An educational intervention to improve hand hygiene compliance in Vietnam.

    Science.gov (United States)

    Phan, Hang Thi; Tran, Hang Thi Thuy; Tran, Hanh Thi My; Dinh, Anh Pham Phuong; Ngo, Ha Thanh; Theorell-Haglow, Jenny; Gordon, Christopher J

    2018-03-07

    Hand hygiene compliance is the basis of infection control programs. In developing countries models to improve hand hygiene compliance to reduce healthcare acquired infections are required. The aim of this study was to determine hand hygiene compliance following an educational program in an obstetric and gynecological hospital in Vietnam. Health care workers from neonatal intensive care, delivery suite and a surgical ward from Hung Vuong Hospital, Ho Chi Minh City, Vietnam undertook a 4-h educational program targeting hand hygiene. Compliance was monitored monthly for six months following the intervention. Hand hygiene knowledge was assessed at baseline and after six months of the study. There were 7124 opportunities over 370 hand hygiene recording sessions with 1531 opportunities at baseline and 1620 at 6 months following the intervention. Hand hygiene compliance increased significantly from baseline across all sites (43.6% [95% Confidence interval CI: 41.1-46.1] to 63% [95% CI: 60.6-65.3]; p hygiene compliance increased significantly after intervention (p hygiene compliance for an extended period of time. Hand hygiene knowledge increased during the intervention. This hand hygiene model could be used in developing countries were resources are limited.

  19. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-06-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

  20. Elementary Assessment Handbook; a self-assessment handbook for compliance with the laws relating to elementary school boards of trustees and the state board of education policies for the general operation of a school district.

    Science.gov (United States)

    Arizona State Dept. of Education, Phoenix.

    As an alternative to assessments conducted by the State Department of Education, Arizona school districts can use this handbook for self evaluation of their compliance with school law, which is basically controlled by Arizona Revised Statute (ARS) Title 15 and State Board of Education policy. This handbook is divided into seven parts which…

  1. 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.

  2. Enhanced performance feedback and patient participation to improve hand hygiene compliance of health-care workers in the setting of established multimodal promotion: a single-centre, cluster randomised controlled trial.

    Science.gov (United States)

    Stewardson, Andrew James; Sax, Hugo; Gayet-Ageron, Angèle; Touveneau, Sylvie; Longtin, Yves; Zingg, Walter; Pittet, Didier

    2016-12-01

    Hand hygiene compliance of health-care workers remains suboptimal despite standard multimodal promotion, and evidence for the effectiveness of novel interventions is urgently needed. We aimed to assess the effect of enhanced performance feedback and patient participation on hand hygiene compliance in the setting of multimodal promotion. We did a single-centre, cluster randomised controlled trial at University of Geneva Hospitals (Geneva, Switzerland). All wards hosting adult, lucid patients, and all health-care workers and patients in these wards, were eligible. After a 15-month baseline period, eligible wards were assigned by computer-generated block randomisation (1:1:1), stratified by the type of ward, to one of three groups: control, enhanced performance feedback, or enhanced performance feedback plus patient participation. Standard multimodal hand hygiene promotion was done hospital-wide throughout the study. The primary outcome was hand hygiene compliance of health-care workers (according to the WHO Five Moments of Hand Hygiene) at the opportunity level, measured by direct observation (20-min sessions) by 12 validated infection control nurses, with each ward audited at least once every 3 months. This trial is registered with ISRCTN, number ISRCTN43599478. We randomly assigned 67 wards to the control group (n=21), enhanced performance feedback (n=24), or enhanced performance feedback plus patient participation (n=22) on May 19, 2010. One ward in the control group became a high-dependency unit and was excluded from analysis. During 1367 observation sessions, 12 579 hand hygiene opportunities were recorded. Between the baseline period (April 1, 2009, to June 30, 2010) and the intervention period (July 1, 2010, to June 30, 2012), mean hand hygiene compliance increased from 66% (95% CI 62-70) to 73% (70-77) in the control group (odds ratio [OR] 1·41, 95% CI 1·21-1·63), from 65% (62-69) to 75% (72-77) in the enhanced performance feedback group (1·61, 1·41-1

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. Wireless Technologies, Ubiquitous Computing and Mobile Health: Application to Drug Abuse Treatment and Compliance with HIV Therapies.

    Science.gov (United States)

    Boyer, Edward W; Smelson, David; Fletcher, Richard; Ziedonis, Douglas; Picard, Rosalind W

    2010-06-01

    Beneficial advances in the treatment of substance abuse and compliance with medical therapies, including HAART, are possible with new mobile technologies related to personal physiological sensing and computational methods. When incorporated into mobile platforms that allow for ubiquitous computing, these technologies have great potential for extending the reach of behavioral interventions from clinical settings where they are learned into natural environments.

  10. E-health: Web-guided therapy and disease self-management in ulcerative colitis. Impact on disease outcome, quality of life and compliance.

    Science.gov (United States)

    Elkjaer, Margarita

    2012-07-01

    Ulcerative Colitis (UC) together with Crohn's disease (CD) belongs to inflammatory bowel diseases (IBD). IBD is to date as frequent as Insulin Dependent Diabetes (IDDM) and is second to Rheumatoid Arthritis (RA) in its chronicity. The majority (91%) of patients with UC have a mild to moderate disease course eligible for 5-ASA treatment. Poor adherence in UC is a well known phenomenon, which is associated with a 5-fold increased risk of relapse and increased health care costs. Web-based treatment solution with self-initiated 5-ASA treatment in UC based on the patient's pattern recognition of the disease course had not been published previously. The aims of the thesis were: 1) In a European evidence based consensus to assess the IBD patients' need for Quality of Health Care (QoHC); 2) To validate the influence of a Patient Educational Center (PEC) and a web-based treatment solution program, www.constant-care.dk, on patients' disease self-management, adherence, Quality of Life, and disease course after 1 year of self-initiated 5-ASA treatment. UC patients in a conventional out-patient setting were used as controls; 3) To validate two new quantitative rapid tests (RT scanning and HT photo) for Faecal Calprotectin (FC) measurement, and to assess whether HT photo can be useful as a home test to help the patients deciding on self-initiated treatment. The ECCO Consensus found evidence for optimising QoHC by "information"; "education", "benchmarking", and "psychological analysis", which could help to improve patient compliance, QoL, and to decrease depression and anxiety. UC patients, educated in the PEC, significantly improved the level of disease specific knowledge. Patient education and training on www.constant-care.dk, being validated on first 21 Danish patients and subsequently on 233 Danish and 100 Irish patients, showed that the new web guided approach was feasible, safe, and cost effective for the selected group of the patients included in the trial. Use of the web

  11. Assessing the impact of Cross Compliance measures on nitrogen fluxes from European farmlands with DNDC-EUROPE

    International Nuclear Information System (INIS)

    Follador, Marco; Leip, Adrian; Orlandini, Lorenzo

    2011-01-01

    We investigated the effects of the agricultural Cross Compliance measures for European cultivated lands, focusing on nitrogen (N) fluxes from corn fields. Four scenarios have been designed according to some conservation farming practices, namely no-till, max manure, catch crop and N splitting. Results indicated that (1) in the no-till scenario the N 2 O fluxes are decreased during the first simulated years, with a return to default fluxes in following years; no-till particularly decreased N 2 O emission in the dryer and colder simulation spatial units (HSMUs); (2) the no-till and the N splitting scenarios slightly increased the N surplus because of a decrease in plant uptake; (3) introducing a rotation with alfalfa decreased the N leaching in the corn crops following the catch crops; and (4) the application of fertilizer and manure during the cold and wet seasons led to an increase of N leaching. - Highlights: → Cross Compliance measures reduced the environmental impact of farming activities. → No-tillage decreased N 2 O emissions especially in the dryer and colder regions. → The manure limit amendment decreased the N 2 O emission, N leaching and surplus. → The rotation yield-catch crops decreased the N leaching. → The N input during cold and wet periods significantly augmented the N leaching. - Model simulations suggested that Cross Compliance measures can help reducing the environmental impact of corn cultivation.

  12. When the grace period is over: Assessing the new Member States' compliance with EU requirements for oil stockholding

    International Nuclear Information System (INIS)

    Tosun, Jale

    2011-01-01

    The accumulation of appropriate emergency stocks of crude oil and petroleum products has been at the heart of the European Commission's efforts to increase the security of supply. This study investigates how effectively the 'new' Member States comply with the requirements of Council Directive 2006/67/EC, which imposes the obligation to maintain minimum stocks of crude oil and/or petroleum products. The empirical focus of this analysis is not only motivated by the practical relevance of this issue, but also by the fact that eleven of the twelve new Member States were given grace periods between one and seven years to bring their national stockholding arrangements in line with the European requirements. The granting of extended deadlines raises the question whether this instrument indeed facilitates the transposition process. The empirical findings show that except for Latvia, compliance with the EU stockholding requirements is generally very good. A more detailed analysis of the Latvian case highlights that the transposition delays principally stem from budgetary constraints. More generally, the individual new Member States' capacity to cope with the financial burdens and the degree of adjustment pressure determine the variation in oil stock levels. - Highlights: → Compliance with Council Directive 2006/67/EC is generally very good in the new Member States. → Solely Latvia faces difficulties in developing adequate oil stock levels. → Latvia's insufficient compliance can be attributed to severe budgetary constraints. → Financial capacity and adjustment pressure determine cross-country variation in stock levels.

  13. Assessing the impact of Cross Compliance measures on nitrogen fluxes from European farmlands with DNDC-EUROPE

    Energy Technology Data Exchange (ETDEWEB)

    Follador, Marco, E-mail: marco.follador@jrc.ec.europa.eu [European Commission, DG Joint Research Centre, Institute for Environment and Sustainability, Climate Change Unit, Via E. Fermi 2749, I-21027 Ispra, Varese (Italy); Leip, Adrian [European Commission, DG Joint Research Centre, Institute for Environment and Sustainability, Climate Change Unit, Via E. Fermi 2749, I-21027 Ispra, Varese (Italy); Orlandini, Lorenzo [European Commission, DG Agriculture and Rural Development, L2 Economic Analysis of EU Agriculture, B-1049 Brussels (Belgium)

    2011-11-15

    We investigated the effects of the agricultural Cross Compliance measures for European cultivated lands, focusing on nitrogen (N) fluxes from corn fields. Four scenarios have been designed according to some conservation farming practices, namely no-till, max manure, catch crop and N splitting. Results indicated that (1) in the no-till scenario the N{sub 2}O fluxes are decreased during the first simulated years, with a return to default fluxes in following years; no-till particularly decreased N{sub 2}O emission in the dryer and colder simulation spatial units (HSMUs); (2) the no-till and the N splitting scenarios slightly increased the N surplus because of a decrease in plant uptake; (3) introducing a rotation with alfalfa decreased the N leaching in the corn crops following the catch crops; and (4) the application of fertilizer and manure during the cold and wet seasons led to an increase of N leaching. - Highlights: > Cross Compliance measures reduced the environmental impact of farming activities. > No-tillage decreased N{sub 2}O emissions especially in the dryer and colder regions. > The manure limit amendment decreased the N{sub 2}O emission, N leaching and surplus. > The rotation yield-catch crops decreased the N leaching. > The N input during cold and wet periods significantly augmented the N leaching. - Model simulations suggested that Cross Compliance measures can help reducing the environmental impact of corn cultivation.

  14. An assessment of the compliance with good pharmacy practice in an urban and rural district in Sri Lanka.

    Science.gov (United States)

    Wijesinghe, P R; Jayakody, R L; De A Seneviratne, R

    2007-02-01

    To evaluate the compliance of private pharmacies to good pharmacy practice (GPP) in an urban and rural district in Sri Lanka and identify deficiencies with a view to improving supply of safe and effective drugs to consumers. Lot quality assurance sampling (LQAS) method was used to determine the number of pharmacies that need to be studied and the threshold limit of defective elements. An inspection of 20 pharmacies in the urban and all 18 pharmacies in the rural district was carried out using a structured checklist. Compliance to seven subsystems of GPP was studied. Storage of drugs, maintenance of cold chain, dispensing and documentation were comprehensively substandard in both districts. Individual items of supervision in registration, physical environment and order of the pharmacy were also found to be substandard in both districts. This study shows that the LQAS method can be used to identify inadequate pharmacy services in the community as a whole. There was poor compliance to GPP by the private pharmacies in both districts. There are concerns about the quality of drugs and the safety of private pharmacy services to the community. Some of the deficiencies could be easily corrected by educating the pharmacists and authorised officers, and more effective and streamlined supervision.

  15. 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

  16. Wireless Sensor-Dependent Ecological Momentary Assessment for Pediatric Asthma mHealth Applications.

    Science.gov (United States)

    Buonocore, Chris M; Rocchio, Rosemary A; Roman, Alfonso; King, Christine E; Sarrafzadeh, Majid

    2017-07-01

    Pediatric asthma is a prevalent chronic disease condition that can benefit from wireless health systems through constant symptom management. In this paper, we propose a smart watch based wireless health system that incorporates wireless sensing and ecological momentary assessment (EMA) to determine an individual's asthma symptoms. Since asthma is a multifaceted disease, this approach provides individualized symptom assessments through various physiological and environmental wireless sensor based EMA triggers specific to common asthma exacerbations. Furthermore, the approach described here improves compliance to use of the system through insightful EMA scheduling related to sensor detected environmental and physiological changes, as well as the patient's own schedule. After testing under several real world conditions, it was found that the system is sensitive to both physiological and environmental conditions that would cause asthma symptoms. Furthermore, the EMA questionnaires that were triggered based on these changes were specific to the asthma trigger itself, allowing for invaluable context behind the data to be collected.

  17. 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

  18. 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.

  19. Rocky Flats Compliance Program

    International Nuclear Information System (INIS)

    1994-02-01

    The Department of Energy (DOE) established the Office of Technology Development (EM-50) (OTD) as an element of Environmental Restoration and Waste Management (EM) in November 1989. The primary objective of the Office of Technology Development, Rocky Flats Compliance Program (RFCP), is to develop altemative treatment technologies for mixed low-level waste (wastes containing both hazardous and radioactive components) to use in bringing the Rocky Flats Plant (RFP) into compliance with Federal and state regulations and agreements. Approximately 48,000 cubic feet of untreated low-level mixed waste, for which treatment has not been specified, are stored at the RFP. The cleanup of the Rocky Flats site is driven by agreements between DOE, the Environmental Protection Agency (EPA), and the Colorado Department of Health (CDH). Under these agreements, a Comprehensive Treatment and Management Plan (CTMP) was drafted to outline the mechanisms by which RFP will achieve compliance with the regulations and agreements. This document describes DOE's strategy to treat low-level mixed waste to meet Land Disposal Restrictions and sets specific milestones related to the regulatory aspects of technology development. These milestones detail schedules for the development of technologies to treat all of the mixed wastes at the RFP. Under the Federal Facilities Compliance Act (FFCA), the CTMP has been incorporated into Rocky Flats Plant Conceptual Site Treatment Plan (CSTP). The CSTP will become the Rocky Flats Plant site Treatment Plan in 1995 and will supersede the CTMP

  20. 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.

  1. Longitudinal relations among perceived autonomy support from health care practitioners, motivation, coping strategies and dietary compliance in a sample of adults with type 2 diabetes.

    Science.gov (United States)

    Julien, Etienne; Senécal, Caroline; Guay, Frédéric

    2009-04-01

    The purpose of this study was to test the causal ordering among perceived autonomy support from health care practitioners, motivation, coping strategies and compliance to dietary self-care activities. Using a cross-lagged panel model, we investigate how these variables relate to one another over a one-year period. A total of 365 adults with Type 2 diabetes participated in the study. Results suggest that autonomous motivation and active planning are reciprocally related over time, and that prior autonomous motivation is related to the extent participants subsequently comply with their diet. Results are discussed in light of Self-determination Theory and the coping perspective.

  2. Development of an Information Delivery Manual for Early Stage BIM-based Energy Performance Assessment and Code Compliance as a Part of DGNB Pre-Certification

    DEFF Research Database (Denmark)

    Petrova, Ekaterina Aleksandrova; Romanska, Iva; Stamenov, Martin

    2017-01-01

    for all parties involved. However, the persistent lack of early collaboration and process standardization prevent reaching the full potential of BIM-based performance evaluation. By following buildingSMART’s methodology for development of Information Delivery Manual/Model View Definition, this paper...... presents a framework for BIM-based energy performance assessment and code compliance, as required by the Danish Building Regulations and the DGNB rating system. Standardization of the information exchange would increase efficiency and reduce manual data input, duplication of work and errors due...

  3. 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.

  4. Health impacts related to urban and transport planning: A burden of disease assessment.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-10-01

    Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866-61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36-24.83) annually. Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial

  5. Improved compliance with the World Health Organization Surgical Safety Checklist is associated with reduced surgical specimen labelling errors.

    Science.gov (United States)

    Martis, Walston R; Hannam, Jacqueline A; Lee, Tracey; Merry, Alan F; Mitchell, Simon J

    2016-09-09

    A new approach to administering the surgical safety checklist (SSC) at our institution using wall-mounted charts for each SSC domain coupled with migrated leadership among operating room (OR) sub-teams, led to improved compliance with the Sign Out domain. Since surgical specimens are reviewed at Sign Out, we aimed to quantify any related change in surgical specimen labelling errors. Prospectively maintained error logs for surgical specimens sent to pathology were examined for the six months before and after introduction of the new SSC administration paradigm. We recorded errors made in the labelling or completion of the specimen pot and on the specimen laboratory request form. Total error rates were calculated from the number of errors divided by total number of specimens. Rates from the two periods were compared using a chi square test. There were 19 errors in 4,760 specimens (rate 3.99/1,000) and eight errors in 5,065 specimens (rate 1.58/1,000) before and after the change in SSC administration paradigm (P=0.0225). Improved compliance with administering the Sign Out domain of the SSC can reduce surgical specimen errors. This finding provides further evidence that OR teams should optimise compliance with the SSC.

  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. 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

  8. 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.

  9. THE ASSESSMENT OF COMPLIANCE TO THE USE OF NEW ORAL ANTICOAGULANTS IN PATIENTS WITH ATRIAL FIBRILLATION ACCORDING TO THE PROFILE REGISTER

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2014-01-01

    Full Text Available Aim. To study in the PROFILE register the rate of new oral anticoagulants (NOAC taking in patients with atrial fibrillation (AF and to identify the factors influencing it.Material and methods. Patients with AF who applied to the Cardiology Center in 2013-2014 (n=111 were included into the study. The oral anticoagulants (OAC were recommended to patients at the reference visit (n=97. Inquiry in questionnaire format was performed to assess the compliance to recommended therapy at the follow-up visit. Patients were divided into two groups according to taking/not-taking NOAC. Analysis of the facts that influence the compliance to NOAC therapy was performed.Results. At the reference visit 70 patients desired to receive NOAC. At the follow-up visit 29 (41.4% patients refused to take NOAC. Leading causes of NOAC refusal were satisfactory with warfarin (32.6%, the high price of these drugs (23.9%, the description of adverse reactions in the patient information leaflet for medicines (15.2%, and withdrawal by physician in outpatient clinic/hospital (8.7%. Preferential provision of medicines and warfarin therapy at the time of reference visit had a negative impact on the taking of NOAC. Patients taking NOAC were more aware of the possible outcomes of their illness, the possible side effects of OAC and were more familiar with patient information leaflet for medicines.Conclusion. The study assessed NOAC taking rate and the factors influencing patients' compliance to NOAC therapy.

  10. Compliance with the annual NO 2 air quality standard in Athens. Required NO x levels and expected health implications

    Science.gov (United States)

    Chaloulakou, A.; Mavroidis, I.; Gavriil, I.

    Recent risk assessment studies have shown that high outdoor NO 2 levels observed in residential areas contribute to increased respiratory and cardiovascular diseases and mortality. Detailed information on present NO 2 levels as well as predictions of NO 2 concentrations corresponding to reduced NO x levels in urban areas are very useful to decision and policy makers in order to protect the public health. In the present paper, monitoring stations of the Athens network are initially classified into two main groups, traffic affected and urban background, using effectively a criterion based on the ratio of annual mean NO:NO 2 concentrations. Two empirical methodologies are then considered and compared for assessing the effect of different NO x levels on the attainment of the annual NO 2 air quality standard at urban-background locations in the Athens area. An interesting finding is that these two methodologies, one more general and one both year and site dependent, give similar results for the specific study area and can be applied alternatively based on the length of available concentration time series. The results show that in order to meet the EU annual mean NO 2 objective at all the urban-background locations of the Athens area, annual NO x concentrations should be reduced to approximately 60 μg m -3, requiring NO x emission reductions of up to 30%. An analysis of the health implications of the currently observed NO 2 levels is conducted, based on a dose-response relationship, and is coupled with available health-related data for the Athens area. This analysis suggests that if NO 2 concentrations were reduced to the levels of the annual EU air quality standard, then a decrease of hospital admissions of up to 2.6% would be observed, depending on the levels of NO 2 measured at different monitoring sites of the Athens conurbation.

  11. 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

  12. Health and Safety Assessment in Lakhra Coal Mines and Its Mitigation Measures

    Directory of Open Access Journals (Sweden)

    Sallahuddin Panhwar

    2017-04-01

    Full Text Available The coal mine excavation, transportation and coal cutting process are involved in hazards and risks that can result in fatalities, injuries and diseases, if these are not properly managed. This study has been undertaken for assessment of the safety and health issues amongst the mines workers. Convenience sampling technique was exercised upon 97 mine workers and interviewed with the help of set questionnaire. Personnel protection to workplace environment was monitored by using physical observation and scientific analysis. All parameters were measured against national and international protocols pertaining to labor law at coal mines. It has been determined that very high risk was persisting while mine excavation, coal cutting and transportation processes. Previous record of last five years was suggesting that 04 deaths happened due to roof fall, 03 fatalities occurred through suffocation by inhaling toxic gases, one causality happened via rope haulage pulley, and also one death due to stone fall down from mine shaft. 121 workers injured in different kinds of accidents within five years. It has been learnt from in-depth analysis that maximum of health risk and subsequent health damages are triggering due to lack of awareness, non-compliance of labor as well as mines laws. Thus, it is recommended that government should not allow coal mining contractors and companies, those which are failing in compliance with the suggested standards.

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

    DEFF Research Database (Denmark)

    Larsen, Torben

    2002-01-01

    -actualisation; (3) Independence of stimulantia including tobacco and alcohol; (4) Cardiologic health. RESULTS: This health promotion is explained by a cybernetic model based on 'The Limbic System'. A sample of records collected by the Internet shows significant compliance between the self-reports of TM......-practitioners and controls without specific health promotion. The TM-group has a relative high level of education. TM is organized as a private, standardised dissemination of the original, Indoeuropean mantrameditation. This standardisation creates economies-of-scale 1) using local instructors with a short education, 2...

  14. 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.

  15. Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

    Science.gov (United States)

    Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

    1999-01-01

    The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

  16. 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 ...

  17. 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

  18. 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.

  19. 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…

  20. Monitoring the hand hygiene compliance of health care workers in a general intensive care unit: Use of continuous closed circle television versus overt observation.

    Science.gov (United States)

    Brotfain, Evgeni; Livshiz-Riven, Ilana; Gushansky, Alexander; Erblat, Alexander; Koyfman, Leonid; Ziv, Tomer; Saidel-Odes, Lisa; Klein, Moti; Borer, Abraham

    2017-08-01

    A variety of hand hygiene monitoring programs (HHMPs) have come into use in hospitals throughout the world. In the present study, we compare continuous closed circle television (CCTV) with overt observation for monitoring the hand hygiene compliance of health care workers (HCWs) in a general intensive care unit (GICU). This is a cross-sectional and comparative study. In this study, we use a novel hand hygiene CCTV monitoring system for hand hygiene performance monitoring. The study population incorporated all the GICU HCWs, including registered nurses, staff physicians, and auxiliary workers. All HCWs of our GICU were observed, including ICU registered nurses, ICU staff physicians, and auxiliary workers participated in the present study. Overall, each observer team did 50 sessions in each arm of the study. Total number of hand hygiene opportunities was approaching 500 opportunities. The compliance rates when only overt observations were performed was higher than when only covert observations were performed with a delta of approximately 10% (209 out of 590 [35.43%] vs 130 out of 533 [24.39%]; P hand hygiene. However, there is no clear basis for incorporating a CCTV observation modality into a health care system that already operates an overt observation program. We have shown that CCTV methodology records a different distribution of opportunities for performing hand hygiene and of actual performances of hand hygiene compared with overt observation. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Environmental Compliance Mechanisms

    NARCIS (Netherlands)

    Merkouris, Panagiotis; Fitzmaurice, Malgosia

    2017-01-01

    Compliance mechanisms can be found in treaties regulating such diverse issues as human rights, disarmament law, and environmental law. In this bibliography, the focus will be on compliance mechanisms of multilateral environmental agreements (MEAs). Compliance with norms of international

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

    International Nuclear Information System (INIS)

    1993-08-01

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

  3. A Tool for Assessment of Animal Health Laboratory Safety and Biosecurity: The Safety Module of the Food and Agriculture Organization’s Laboratory Mapping Tool

    Directory of Open Access Journals (Sweden)

    Beatrice Mouillé

    2018-03-01

    Full Text Available The Laboratory Management Tool (LMT is a standardized spreadsheet-based assessment tool developed to help support national, regional, and global efforts to maintain an effective network of animal health and veterinary public health laboratories. The safety and biosecurity module of the LMT (LMT-S includes 98 measures covering administrative, operational, engineering, and personal protective equipment practices used to provide laboratory safety and biosecurity. Performance aspects of laboratory infrastructure and technical compliance considered fundamental for ensuring that a laboratory is able to appropriately function in a safe and biosecure manner are systematically queried and scored for compliance on a four-point scale providing for a semi-quantitative assessment. Data collected is used to generate graphs and tables mapping levels of compliance with international standards and good practices, as well as for documenting progress over time. The LMT-S was employed by trained auditors in 34 laboratories located in 19 countries between 2015 and 2017. The tool is intended to help standardize animal health laboratory assessments, document compliance with recognized laboratory safety and biosecurity measures, serve as a self-help and training tool, and assist global laboratory development efforts by providing an accurate measurement of laboratory safety and biosecurity at local, national, and regional levels.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. Commentary: Compliance education and training: a need for new responses in clinical research.

    Science.gov (United States)

    Steinberg, Mindy J; Rubin, Elaine R

    2010-03-01

    Increasing regulatory mandates, heightened concerns about compliance, accountability, and liability, as well as a movement toward organizational integration are prompting assessment and transformation in education and training programs at academic health centers, particularly with regard to clinical research compliance. Whereas education and training have become a major link between all research and compliance functions, the infrastructure to support and sustain these activities has not been examined in any systematic, comprehensive fashion, leaving many critical interrelated issues unaddressed. Through a series of informal interviews in late 2008 with chief compliance officers and other senior leadership at 10 academic health centers, the authors studied the organization, management, and administration of clinical research compliance education and training programs. The interviews revealed that while clinical research compliance education and training are undergoing growth and expansion to accommodate a rapidly changing regulatory environment and research paradigm, there are no strategies or models for development. The decentralization of education and training is having serious consequences for leadership, resources, and effectiveness. The authors recommend that leaders of academic health centers conduct a comprehensive analysis of clinical research compliance education and training as clinical trials administration undergoes change, focusing on strategic planning, communication, collaboration across the institution, and program evaluation.

  9. Environmental assessment in health care organizations.

    Science.gov (United States)

    Romero, Isabel; Carnero, María Carmen

    2017-12-22

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

  10. Agent Architectures for Compliance

    Science.gov (United States)

    Burgemeestre, Brigitte; Hulstijn, Joris; Tan, Yao-Hua

    A Normative Multi-Agent System consists of autonomous agents who must comply with social norms. Different kinds of norms make different assumptions about the cognitive architecture of the agents. For example, a principle-based norm assumes that agents can reflect upon the consequences of their actions; a rule-based formulation only assumes that agents can avoid violations. In this paper we present several cognitive agent architectures for self-monitoring and compliance. We show how different assumptions about the cognitive architecture lead to different information needs when assessing compliance. The approach is validated with a case study of horizontal monitoring, an approach to corporate tax auditing recently introduced by the Dutch Customs and Tax Authority.

  11. The Cost of Compliance: A CGE Assessment of Canada's Policy Options under the Kyoto Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Boehringer, Christoph (Univ. of Oldenburg, Dept. of Economics, D-26111 Oldenburg (Germany)); Rutherford, Thomas F. (ETH Zuerich, Center for Energy Policy and Economy, CH-8032 Zuerich (Switzerland))

    2008-07-01

    Canada is committed under the Kyoto Protocol to reduce greenhouse gas emissions between 2008 and 2012 to a level six percent below the 1990 reference value. To date, however, Canada's greenhouse gas emissions remain far above 1990 levels. Stringent short-term policy measures are needed if Canada is to meet this legally binding commitment. This paper uses a multi-region, multi-commodity static general equilibrium model to quantify the economic impacts of alternative compliance strategies for Canada in the context of climate policies undertaken by other Kyoto Parties. The numerical results confirm fears among Canadian policy makers of larger economic adjustment cost should Canada fulfill its Kyoto commitment solely through domestic action. Comprehensive use of flexible mechanisms - in particular the Clean Development Mechanism - could allow Canada to live up with its international climate policy commitment at a substantially lower economic cost

  12. 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

  13. An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene.

    Science.gov (United States)

    McCalla, Saungi; Reilly, Maggie; Thomas, Rowena; McSpedon-Rai, Dawn

    2017-05-01

    Consistent hand hygiene is key to reducing health care-associated infections (HAIs) and assessing compliance with hand hygiene protocols is vital for hospital infection control staff. A new automated hand hygiene compliance system (HHCS) was trialed as an alternative to human observers in an intensive care unit and an intensive care stepdown unit at a hospital facility in the northeastern United States. Using a retrospective cohort design, researchers investigated whether implementation of the HHCS resulted in improved hand hygiene compliance and a reduction in common HAI rates. Pearson χ 2 tests were used to assess changes in compliance, and incidence rate ratios were used to test for significant differences in infection rates. During the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences. Human hand hygiene observers may not report accurate measures of compliance. The HHCS is a promising new tool for fine-grained assessment of hand hygiene compliance. Further study is needed to examine the association between the HHCS and HAI rate reduction. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Compliance with removable orthodontic appliances.

    Science.gov (United States)

    Shah, Nirmal

    2017-12-22

    Data sourcesMedline via OVID, PubMed, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, LILACS and BBO databases. Unpublished clinical trials accessed using ClinicalTrials.gov, National Research Register, ProQuest Dissertation and Thesis database.Study selectionTwo authors searched studies from inception until May 2016 without language restrictions. Quantitative and qualitative studies incorporating objective data on compliance with removable appliances, barriers to appliance wear compliance, and interventions to improve compliance were included.Data extraction and synthesisQuality of research was assessed using the Cochrane Collaboration's risk of bias tool, the risk of bias in non-randomised studies of interventions (ROBINS-I), and the mixed methods appraisal tool. Statistical heterogeneity was investigated by examining a graphic display of the estimated compliance levels in conjunction with 95% confidence intervals and quantified using the I-squared statistic. A weighted estimate of objective compliance levels for different appliances in relation to stipulated wear and self-reported levels was also calculated. Risk of publication bias was assessed using funnel plots. Meta-regression was undertaken to assess the relative effects of appliance type on compliance levels.ResultsTwenty-four studies met the inclusion criteria. Of these, 11 were included in the quantitative synthesis. The mean duration of objectively measured wear was considerably lower than stipulated wear time amongst all appliances. Headgear had the greatest discrepancy (5.81 hours, 95% confidence interval, 4.98, 6.64). Self-reported wear time was consistently higher than objectively measured wear time amongst all appliances. Headgear had the greatest discrepancy (5.02 hours, 95% confidence interval, 3.64, 6.40). Two studies found an increase in compliance with headgear and Hawley retainers when patients were aware of monitoring. Five studies found younger age groups to

  15. Compliance with OSHA record-keeping requirements.

    Science.gov (United States)

    Seligman, P J; Sieber, W K; Pedersen, D H; Sundin, D S; Frazier, T M

    1988-01-01

    The Occupational Safety and Health Act of 1970 requires employers to maintain records of workplace injuries and illnesses. To assess compliance with the law, data from the National Occupational Exposure Survey (NOES) were examined. Of the 4,185 companies with 11 or more employees, 75 per cent maintained OSHA Form 200 designed for recording illnesses and injuries. The number of employees and the presence of a union were positive determinants in the record maintenance. Of companies with 500 or more employees, 95 per cent kept records compared with 60 per cent of companies with between 11 and 99 employees. PMID:3407825

  16. A care study exploring a patient's non-compliance to haemodialysis.

    Science.gov (United States)

    Murphy, Fiona

    This care study is based on the nursing assessment of a 26-year-old man (MT) who attends a local haemodialysis unit for treatment using Gordon's (1994) functional health patterns. There will be a discussion of this framework and the methods used to assess this patient including an exploration of one of the problem areas identified--that of non-compliance.

  17. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: Council on Education for Public Health

    Science.gov (United States)

    US Department of Education, 2010

    2010-01-01

    Between 1945-1973, the American Public Health Association (APHA), a membership organization for public professionals, accredited graduate programs in public health. In 1974, the APHA and the Association of Schools of Public Health (ASPH), a national association representing deans, faculty, and students of accredited schools of public health,…

  18. Low compliance with iron-folate supplementation among postpartum mothers of Nepal: an analysis of Nepal Demographic and Health Survey 2011.

    Science.gov (United States)

    Khanal, Vishnu; Adhikari, Mandira; Karkee, Rajendra

    2014-06-01

    One in five maternal deaths are directly attributable to anaemia in the world. The World Health Organization recommends iron supplementation from the second trimester of pregnancy to 45 days after delivery. The aim of this study was to determine the compliance rate of iron-folate consumption and the factors associated with iron-folate consumption among post-natal mothers in Nepal. This study utilised the data of Nepal Demographic and Health Survey (NDHS) 2011. The NDHS 2011 is a cross sectional and nationally representative survey. Of the 4,148 respondents, only 20.7% consumed iron throughout the post-natal period for 45 days. Mothers who had higher and secondary education [adjusted Odd ratio (aOR) 3.101; 95% CI (2.268-4.240)]; had attended four or more antenatal care visits [aOR 9.406; 95% CI (5.552-15.938)]; lived in Far-western development region [aOR 1.822; 95% CI (1.387-2.395)]; delivered in health facility [aOR 1.335; 95% CI (1.057-1.687)]; and attended postnatal care [aOR 2.348; 95% CI (1.859-2.965)] were more likely to take iron for 45 days of postpartum. Intervention to increase the compliance with the postpartum iron-folate supplementation are required to avoid adverse pregnancy outcomes associated with poor iron status with especial focus on the mothers who delivered at homes and did not attend post-natal check up.

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

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

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

  20. 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

  1. Structure health assessment and warning system (SHAWS)

    Science.gov (United States)

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

    2008-03-01

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

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

    National Research Council Canada - National Science Library

    2002-01-01

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

  3. Caregivers' compliance with referral advice

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2018-01-01

    BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance...... in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18......,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings

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

    African Journals Online (AJOL)

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

  5. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI

    Directory of Open Access Journals (Sweden)

    Yan Shan

    2016-01-01

    Full Text Available Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2 patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8±7.5 years were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV, flow-mediated dilation (FMD of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73±2.00 m/s and FMD was 16.67±9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14–3.2; P<0.05 and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71–0.95; P<0.05. Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease.

  6. The Development and Piloting of a Mobile Data Collection Protocol to Assess Compliance With a National Tobacco Advertising, Promotion, and Product Display Ban at Retail Venues in the Russian Federation.

    Science.gov (United States)

    Grant, Ashley S; Kennedy, Ryan D; Spires, Mark H; Cohen, Joanna E

    2016-08-31

    Tobacco control policies that lead to a significant reduction in tobacco industry marketing can improve public health by reducing consumption of tobacco and preventing initiation of tobacco use. Laws that ban or restrict advertising and promotion in point-of-sale (POS) environments, in the moment when consumers decide whether or not to purchase a tobacco product, must be correctly implemented to achieve the desired public health benefits. POS policy compliance assessments can support implementation; however, there are challenges to conducting evaluations that are rigorous, cost-effective, and timely. Data collection must be discreet, accurate, and systematic, and ideally collected both before and after policies take effect. The use of mobile phones and other mobile technology provide opportunities to efficiently collect data and support effective tobacco control policies. The Russian Federation (Russia) passed a comprehensive national tobacco control law that included a ban on most forms of tobacco advertising and promotion, effective November 15, 2013. The legislation further prohibited the display of tobacco products at retail trade sites and eliminated kiosks as a legal trade site, effective June 1, 2014. The objective of the study was to develop and test a mobile data collection protocol including: (1) retailer sampling, (2) adaptation of survey instruments for mobile phones, and (3) data management protocols. Two waves of observations were conducted; wave 1 took place during April-May 2014, after the advertising and promotion bans were effective, and again in August-September 2014, after the product display ban and elimination of tobacco sales in kiosks came into effect. Sampling took place in 5 Russian cities: Moscow, St. Petersburg, Novosibirsk, Yekaterinburg, and Kazan. Lack of access to a comprehensive list of licensed tobacco retailers necessitated a sampling approach that included the development of a walking protocol to identify tobacco retailers to

  7. Assessment of implementation of the health management ...

    African Journals Online (AJOL)

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

  8. Challenges and perspectives of compliance with pediatric antiretroviral therapy in Sub-Saharan Africa.

    Science.gov (United States)

    Dahourou, D L; Leroy, V

    2017-12-01

    More than 3 million children aged less than 15years are infected with HIV worldwide, mainly in Sub-Saharan Africa. The survival of HIV-infected children depends on their access to antiretroviral therapy whose success mainly depends on a good life-long compliance with antiretroviral therapy. Given its complexity and specificity, assessment and monitoring of pediatric compliance with antiretroviral therapy is a major challenge. There is no consensus on a gold standard for monitoring compliance with antiretroviral therapy. Compliance is also influenced by many factors related to the child, the caregiver, the healthcare staff, the healthcare system, and antiretroviral drugs. This review aimed to assess scientific knowledge on pediatric compliance with antiretroviral therapy in Sub-Saharan Africa, and to identify areas for future interventions to improve compliance. Good compliance is essential to achieve the "90% coverage of children on antiretroviral therapy" gold standard of the World Health Organization, and to eliminate HIV infection by 2030. Copyright © 2017. Published by Elsevier SAS.

  9. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  10. DEVELOPMENT OF THE QUESTIONNAIRE ON COMPLIANCE TO MEDICAL NUTRITION THERAPY FOR TYPE 2 DIABETIC PATIENTS AND ASSESSMENT OF ITS POTENTIAL USE

    Directory of Open Access Journals (Sweden)

    E. G. Starostina

    2016-01-01

    Full Text Available Background: А  specific questionnaire is necessary to perform quantitative assessment of compliance to medical nutrition therapy in patients with type 2 diabetes mellitus (DM.Aim: Тo develop a questionnaire to assess how type 2 diabetic patients adhere with the principles of medical nutrition therapy and to identify factors associated with good dietary compliance.Materials and methods: We proposed a questionnaire "Dietary adherence test" (DAT and validated it in 300 inand out-patients with type 2 DM. DAT was validated against the diabetes-related behavior score, diabetes-related knowledge score, and HbA1c level; the internal consistency coefficient (Cronbach's alfa was also calculated.Results: Cronbach's alfa for primary raw and standardized data were 0.7444 and 0.7413, respectively, thus meeting the required range of 0.7–0.8. The score on DAT item 1 (the title item and total score (the sum of scores of item 2 to 10 correlated with the diabetes-related behavior score (r=0.21, р=0.0006 and r=0.34, р<0.0001, respectively. Patients with poor dietary compliance (average DAT score≤2 had a significantly lower score on the subscale "Nutrition" of the diabetes knowledge test, than those with good dietary compliance (average DAT score≥2 (44.9±15.6 vs 60.2±16.2, р<0.0001. Patients who perceived their diet as the most burdensome element of life with diabetes, had lower total DAT score (24.1±4.6 than those who did not see their diet as a problem (25.9±5.1, р=0.001. There was a  significant difference in average DAT score between patients on insulin therapy and patients on oral treatment (2.8±0.6 vs 2.9±0.6, respectively, р=0.019. Patients with poor and good dietary adherence, according to DAT, differed in their duration of diabetes, social status and diabetes-related behavior score. There was a  weak correlation between the DAT score and duration of diabetes (r=0.16, р=0.009, and weak inverse correlation between the DAT score and

  11. A multifaceted hospital-wide intervention increases hand hygiene compliance.

    Science.gov (United States)

    Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W

    2016-03-07

    Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

  12. Compliance with HIPAA security standards in U.S. Hospitals.

    Science.gov (United States)

    Davis, Diane; Having, Karen

    2006-01-01

    With the widespread use of computer networks, the amount of information stored electronically has grown exponentially, resulting in increased concern for privacy and security of information. The healthcare industry has been put to the test with the federally mandated Health Insurance Portability and Accountability Act (HIPAA) of 1996. To assess the compliance status of HIPAA security standards, a random sample of 1,000 U.S. hospitals was surveyed in January 2004, yielding a return rate of 29 percent. One year later, a follow-up survey was sent to all previous respondents, with 50 percent replying. HIPAA officers'perceptions of security compliance in 2004 and 2005 are compared in this article. The security standards achieving the highest level of compliance in both 2004 and 2005 were obtaining required business associate agreements and physical safeguards to limit access to electronic information systems. Respondents indicated least compliance both years in performing periodic evaluation of security practices governed by the Security Rule. Roadblocks, threats, problems and solutions regarding HIPAA compliance are discussed. This information may be applied to current and future strategies toward maintaining security of information systems throughout the healthcare industry.

  13. Methods to Quantify Uncertainty in Human Health Risk Assessment

    National Research Council Canada - National Science Library

    Aurelius, Lea

    1998-01-01

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

  14. 30 CFR 90.207 - Compliance sampling.

    Science.gov (United States)

    2010-07-01

    ... MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.207 Compliance sampling. (a) The operator shall take five valid respirable dust samples for... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance sampling. 90.207 Section 90.207...

  15. Prioritising action on occupational carcinogens in Europe: a socioeconomic and health impact assessment.

    Science.gov (United States)

    Cherrie, J W; Hutchings, S; Gorman Ng, M; Mistry, R; Corden, C; Lamb, J; Sánchez Jiménez, A; Shafrir, A; Sobey, M; van Tongeren, M; Rushton, L

    2017-07-11

    Work-related cancer is an important public health issue with a large financial impact on society. The key European legislative instrument is the Carcinogens and Mutagens Directive (2004/37/EC). In preparation for updating the Directive, the European Commission commissioned a study to provide a socioeconomic, health and environmental impact assessment. The evaluation was undertaken for 25 preselected hazardous substances or mixtures. Estimates were made of the number of cases of cancer attributable to workplace exposure, both currently and in the future, with and without any regulatory interventions, and these data were used to estimate the financial health costs and benefits. It was estimated that if no action is taken there will be >700 000 attributable cancer deaths over the next 60 years for the substances assessed. However, there are only seven substances where the data suggest a clear benefit in terms of avoided cancer cases from introducing a binding limit at the levels considered. Overall, the costs of the proposed interventions were very high (up to [euro ]34 000 million) and the associated monetised health benefits were mostly less than the compliance costs. The strongest cases for the introduction of a limit value are for: respirable crystalline silica, hexavalent chromium, and hardwood dust.

  16. An integrated framework for health and ecological risk assessment

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  17. Human Health Toxicity Values in Superfund Risk Assessments

    Science.gov (United States)

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

  18. The Update of the Mexican Health Care Formulary and Supply Catalog in the Context of the Health Technology Assessment.

    Science.gov (United States)

    Ríos, Pedro Rizo; Rivera, Aurora González; Oropeza, Itzel Rivas; Ramírez, Odette Campos

    2014-12-01

    until December 2012. During the analysis period, 394 submissions were received. After confirming compliance with the requirements, 59.9% of the submissions passed to the next stage of the process, technology assessment. In the third stage, the committee approved 44.9% of the submissions evaluated. The improvements established in the country in terms of health technology assessment allowed choosing the technologies that give more value for money in a context of public health institutions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. 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...

  1. 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.

  2. 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

  3. Revisiting Health System Performance Assessment in Africa

    NARCIS (Netherlands)

    Achoki, Tom

    2016-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  6. Patterns of objectively assessed physical activity and sedentary time: Are Nigerian health professional students complying with public health guidelines?

    Directory of Open Access Journals (Sweden)

    Adewale L Oyeyemi

    Full Text Available Understanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria.A cross-sectional study was conducted among 102 health professional students (age = 19-34 years old, 43.1% women of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics.The students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time. Sedentary time was higher among older than younger students (P<0.038 and among medical laboratory science students than physiotherapy and nursing students (P = 0.046. Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041. Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity.Prevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health professional students in Nigeria

  7. Environmental Assessment for the construction and operation of the Health Physics Site Support Facility on the Savannah River Site

    International Nuclear Information System (INIS)

    1995-07-01

    DOE has prepared an environmental assessment for the proposed construction and operation of the Health Physics Site Support Facility on the Savannah River Site. This (new) facility would meet requirements of the site radiological protection program and would ensure site compliance with regulations. It was determined that the proposed action is not a major Federal action significantly affecting the quality of the environment within the meaning of NEPA. Therefore, a finding of no significant impact is made, and no environmental impact statement is needed

  8. [Compliance with antismoking laws in official institutions].

    Science.gov (United States)

    Cordovilla, R; Barrueco, M; González Ruiz, J M; Hernández, M A; de Castro, J; Gómez, F

    1997-01-01

    The prevention of nicotine addiction involves a wide range of measures, including writing laws to preserve public health by protecting nonsmokers from smoke and discouraging smokers from consumption. Also important are campaigns to educate both parties (smokers and nonsmokers) about the negative effects of tobacco. The main antismoking law in Spain is the Health and Consumer Ministry's Royal Decree 192/1988 limiting the sale and use of tobacco with the aim of protecting public health. Other regulations have since been enacted by public administrations to complement that law. Research finding published in recent years have been the basis for major legal changes leading in two directions; toward standardizing laws existing in different countries and toward increasing restrictions on the advertising and sale of tobacco. Various scientific and social groups have demanded that current laws be made stricter. Little has been done, however, to assess the degree of vigilance and compliance, and consequently the efficacy, of current legislation. The aim of this study was to determine the level of compliance with the law in governmental institutions in Salamanca. We visited 30 centers and saw that while notices prohibiting smoking were visible in 80%, the number of smokers was high: 43% among workers (none of whom was in educational or medical centers) and 37% among the public. No posters warning of the dangers of tobacco were seen in any of the centers visited. It appears necessary to further restrict the sale and use of tobacco in public places, to enforce compliance with existing regulations and to increase the amount of information on the toxic effects of tobacco in order to gain the cooperation of both smokers and nonsmokers toward achieving smoke-free environments.

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

    Science.gov (United States)

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

    2017-11-06

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

  12. The Development of a Secondary School Health Assessment Model

    Science.gov (United States)

    Sriring, Srinual; Erawan, Prawit; Sriwarom, Monoon

    2015-01-01

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

  13. Lifestyle Assessment: Helping Patients Change Health Behaviors

    OpenAIRE

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

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

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

    Science.gov (United States)

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

    2018-02-07

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

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

    Science.gov (United States)

    Krozy, R E; McCarthy, N C

    1999-01-01

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

  16. 42 CFR 3.304 - Principles for achieving compliance.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Principles for achieving compliance. 3.304 Section 3.304 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... Principles for achieving compliance. (a) Cooperation. The Secretary will, to the extent practicable, seek the...

  17. Computational assessment of pregnant woman models exposed to uniform ELF-magnetic fields: compliance with the European current exposure regulations for the general public and occupational exposures at 50 Hz

    International Nuclear Information System (INIS)

    Liorni, Ilaria; Parazzini, Marta; Fiocchi, Serena; Ravazzani, Paolo; Douglas, Mark; Capstick, Myles; Kuster, Niels

    2016-01-01

    The Recommendation 1999/529/EU and the Directive 2013/35/EU suggest limits for both general public and occupational exposures to extremely low-frequency magnetic fields, but without special limits for pregnant women. This study aimed to assess the compliance of pregnant women to the current regulations, when exposed to uniform MF at 50 Hz (100 μT for EU Recommendation and 1 and 6 mT for EU Directive). For general public, exposure of pregnant women and fetus always resulted in compliance with EU Recommendation. For occupational exposures, (1) Electric fields in pregnant women were in compliance with the Directive, with exposure variations due to fetal posture of 40 % in head tissues, (3) Electric fields in fetal CNS tissues of head are above the ICNIRP 2010 limits for general public at 1 mT (in 7 and 9 months gestational age) and at 6 mT (in all gestational ages). (authors)

  18. Soil microbiology and soil health assessment

    Science.gov (United States)

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

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

    OpenAIRE

    Smith, Jody

    2006-01-01

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

  20. A Retrospective Longitudinal Database Study of Persistence and Compliance with Treatment of Osteoporosis in Hungary.

    Science.gov (United States)

    Lakatos, Péter; Takács, István; Marton, István; Tóth, Emese; Zoltan, Cina; Lang, Zsolt; Psachoulia, Emi; Intorcia, Michele

    2016-03-01

    This study assessed persistence and compliance with anti-osteoporosis therapies, and associations between compliance and clinical outcomes (fracture, fracture-related hospitalization and death), in Hungarian women with postmenopausal osteoporosis. The study used the Hungarian National Health Insurance Fund Administration database and included women with PMO aged at least 50 years, for whom a prescription for anti-osteoporosis medication had been filled between 1 January 2004 and 31 December 2013 (index event). Persistence (prescription refilled within 8 weeks of the end of the previous supply) was evaluated over 2 years; good compliance (medication possession ratio ≥ 80 %) was evaluated at 1 year. Associations between compliance and clinical outcomes (data collected for up to 6 years) were assessed with adjustment for baseline covariates. A total of 296,300 women met the inclusion criteria (524,798 index events). Persistence and compliance were higher for less frequent and parenteral therapies (1- and 2-year persistence: half-yearly [parenteral] vs. daily/weekly/monthly [oral and parenteral], 81 and 38 % vs. 21-34 and 10-18 %, respectively; parenteral vs. oral, 75 and 36 % vs. 32 and 16 %; good compliance: half-yearly vs. daily/weekly/monthly, 70 vs. 24-39 %; parenteral vs. oral 78 vs. 36 %). Good compliance significantly reduced the risks of fracture, fracture-related hospitalization and death (relative risk vs. non-compliance [95 % confidence interval]: 0.77 [0.70-0.84], 0.72 [0.62-0.85] and 0.57 [0.51-0.64], respectively; P < 0.01). Improving compliance through long-interval parenteral therapies may result in clinical benefits for patients.

  1. Comparison of chest radiography and static respiratory compliance in the assessment of the severity of pulmonary diseases in newborns with respiratory distress

    International Nuclear Information System (INIS)

    Lischka, A.; Coradello, H.; Simbruner, G.; Popow, C.

    1984-01-01

    In 55 newborn infants with respiratory distress syndrome (RDS) we compared chest radiographs and static respiratory compliance to see which of the two methods would best characterize the severity of pulmonary disease. There was a significant correlation between radiological score and compliance (rsub(s)=-0.5776, n=55, p=0.001). Healthy newborns, newborns with RDS who did not need artificial ventilation and those newborns who needed respirator treatment had significantly different values of radiological score and compliance. RDS may be differentiated into groups of diagnoses. New-borns with HMD could be separated from those with wet lung syndrome or aspiration pneumonia by analyzing the radiogram or measuring the compliance. When survivors are compared with those newborns who died, the static respiratory compliance alone could predict the final outcome. (orig.)

  2. 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.

  3. Deadline Compliance Status Reports

    Data.gov (United States)

    Department of Housing and Urban Development — These monthly Deadline Compliance Status Reports assist Participating Jurisdictions and HUD Field Offices in monitoring compliance with the 2-year commitment and...

  4. Measuring User Compliance and Cost Effectiveness of Safe Drinking Water Programs: A Cluster-Randomized Study of Household Ultraviolet Disinfection in Rural Mexico.

    Science.gov (United States)

    Reygadas, Fermín; Gruber, Joshua S; Dreizler, Lindsay; Nelson, Kara L; Ray, Isha

    2018-03-01

    Low adoption and compliance levels for household water treatment and safe storage (HWTS) technologies have made it challenging for these systems to achieve measurable health benefits in the developing world. User compliance remains an inconsistently defined and poorly understood feature of HWTS programs. In this article, we develop a comprehensive approach to understanding HWTS compliance. First, our Safe Drinking Water Compliance Framework disaggregates and measures the components of compliance from initial adoption of the HWTS to exclusive consumption of treated water. We apply this framework to an ultraviolet (UV)-based safe water system in a cluster-randomized controlled trial in rural Mexico. Second, we evaluate a no-frills (or "Basic") variant of the program as well as an improved (or "Enhanced") variant, to test if subtle changes in the user interface of HWTS programs could improve compliance. Finally, we perform a full-cost analysis of both variants to assess their cost effectiveness (CE) in achieving compliance. We define "compliance" strictly as the habit of consuming safe water. We find that compliance was significantly higher in the groups where the UV program variants were rolled out than in the control groups. The Enhanced variant performed better immediately postintervention than the Basic, but compliance (and thus CE) degraded with time such that no effective difference remained between the two versions of the program.

  5. Radiological environmental dose assessment methods and compliance dose results for 2015 operations at the Savannah River Site

    International Nuclear Information System (INIS)

    Jannik, G. T.; Dixon, K. L.

    2016-01-01

    This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2015 Savannah River Site (SRS) atmospheric and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios - such as the consumption of deer meat, fish, and goat milk.

  6. Radiological environmental dose assessment methods and compliance dose results for 2015 operations at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Jannik, G. T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Dixon, K. L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-09-01

    This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2015 Savannah River Site (SRS) atmospheric and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios - such as the consumption of deer meat, fish, and goat milk.

  7. Application of the MERIT survey in the multi-criteria quality assessment of occupational health and safety management.

    Science.gov (United States)

    Korban, Zygmunt

    2015-01-01

    Occupational health and safety management systems apply audit examinations as an integral element of these systems. The examinations are used to verify whether the undertaken actions are in compliance with the accepted regulations, whether they are implemented in a suitable way and whether they are effective. One of the earliest solutions of that type applied in the mining industry in Poland involved the application of audit research based on the MERIT survey (Management Evaluation Regarding Itemized Tendencies). A mathematical model applied in the survey facilitates the determination of assessment indexes WOPi for each of the assessed problem areas, which, among other things, can be used to set up problem area rankings and to determine an aggregate (synthetic) assessment. In the paper presented here, the assessment indexes WOPi were used to calculate a development measure, and the calculation process itself was supplemented with sensitivity analysis.

  8. Water for human and livestock consumption in rural settings of Ethiopia: assessments of quality and health aspects.

    Science.gov (United States)

    Amenu, Kebede; Markemann, André; Valle Zárate, Anne

    2013-11-01

    The study aimed to assess the quality and health aspects of water intended for human and livestock consumption in two rural districts of the Rift Valley of Ethiopia. The study involved two parts: the first consisted of a questionnaire survey and farmers' group discussions, complemented by secondary health data, and the second part determined the chemical (total dissolved solids, pH, manganese, hexa-valent chromium, fluoride) and microbiological quality of different water sources during dry and wet seasons. The result showed a lack of sustainable access to safe water in the communities. Industrial pollution and mismanagement of water sources by human and livestock was found to be a source of potential health risk. Potentially linked human health problems like malaria, diarrhoea and gastrointestinal parasites were common in the districts. Overall, 76% of the assessed water sources (n = 25) failed to comply with World Health Organization guidelines for human drinking water, for at least one assessed parameter, mostly irrespective of the season. The non-compliance was mainly attributed to Escherichia coli contamination and/or high fluoride concentration. At least 20% of the water samples were also found to be unfit for livestock consumption based on assessed chemical parameters in both dry and wet seasons. To minimize the health risk associated with mismanagement and poor quality of water sources in the area, targeted action in the protection of surface water sources should be given priority.

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

    Science.gov (United States)

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

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

  10. 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.

  11. STANDARD PRECAUTIONS: AN ASSESSMENT OF AWARENESS AMONG HEALTH CARE PERSONNEL IN A TEACHING HOSPITAL, SOUTH INDIA.

    Directory of Open Access Journals (Sweden)

    Sangeetha

    2015-02-01

    Full Text Available BACKGROUND : Standard precautions ar e crucial in the prevention and transmission of Healthcare associated infections ( HAI and transmission of blood - borne pathogens like Hepatitis B, Human Immunodeficiency Virus & Hepatitis C. They are not well u nderstood or implemented by health care practitioners. Hence this study was taken up to determine and compare knowledge, attitude of standard precautions among health care personnel at a teaching hospital, Bangalore. OBJECTIVE : To assess knowledge, attitud e, practices and compliance of Standard precautions among health care workers at a teaching hospital. METHODOLOGY : One hundred and fifty seven health care personnel participated in this study. A pretest and post test was administered to the study group. A pre - structured questionnaire on standard precautions was prepared which included knowledge, attitude and practices. RESULTS : 116 ( 73.88% nurses had knowledge about hand hygiene, but only 82 ( 52.2% nurses practiced hand hygiene before and after patient care. Knowledge about PPE measures like gloves, face mask & goggles, gowns were known to 101(64.33%, 56 ( 35.66% & 69 ( 43.94% nurses respectively. 117 ( 74.52% nurses discarded needles & sharps in correct puncture proof containers, but their correct knowled ge regarding colour coding of hospital waste segregation was comparatively less i.e. 104 ( 66.24%. 119 ( 75.79% of the nurses had practice of recapping the needles after use. CONCLUSION : There was significant improvement in the knowledge and practice of stan dard precautions in the present study after incorporating good training practices

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  13. Tiger Team assessment of the Pinellas Plant

    Energy Technology Data Exchange (ETDEWEB)

    1990-05-01

    This Document contains findings identified during the Tiger Team Compliance Assessment of the Department of Energy's (DOE's) Pinellas Plant, Pinellas County, Florida. The assessment wa directed by the Department's Office of Environment, Safety, and Health (ES H) from January 15 to February 2, 1990. The Pinellas Tiger Team Compliance Assessment is comprehensive in scope. It covers the Environment Safety and Health, and Management areas and determines the plant's compliance with applicable Federal (including DOE), State, and local regulations and requirements.

  14. Low-Cost Air Quality Monitoring Methods to Assess Compliance With Smoke-Free Regulations: A Multi-Center Study in Six Low- and Middle-Income Countries.

    Science.gov (United States)

    Jackson-Morris, Angela; Bleymann, Kayleigh; Lyall, Elaine; Aslam, Fouad; Bam, Tara Singh; Chowdhury, Ishrat; Daouda, Elhadj Adam; Espinosa, Mariana; Romo, Jonathan; Singh, Rana J; Semple, Sean

    2016-05-01

    Many low- and middle-income countries (LMICs) have enacted legislation banning smoking in public places, yet enforcement remains challenging. The aim of this study was to assess the feasibility of using a validated low-cost methodology (the Dylos DC1700) to provide objective evidence of smoke-free (SF) law compliance in hospitality venues in urban LMIC settings, where outdoor air pollution levels are generally high. Teams measured indoor fine particulate matter (PM2.5) concentrations and systematically observed smoking behavior and SF signage in a convenience sample of hospitality venues (bars, restaurants, cafes, and hotels) covered by existing SF legislation in Mexico, Pakistan, Indonesia, Chad, Bangladesh, and India. Outdoor air PM2.5 was also measured on each sampling day. Data were collected from 626 venues. Smoking was observed during almost one-third of visits with substantial differences between countries-from 5% in India to 72% in Chad. After excluding venues where other combustion sources were observed, secondhand smoke (SHS) derived PM2.5 was calculated by subtracting outdoor ambient PM2.5 concentrations from indoor measurements and was, on average, 34 µg/m(3) in venues with observed smoking-compared to an average value of 0 µg/m(3) in venues where smoking was not observed (P hospitality venues in LMICs. Air quality monitoring can provide objective scientific data on SHS and air quality levels in venues to assess the effectiveness of SF laws and identify required improvements. Equipment costs and high outdoor air pollution levels have hitherto limited application in LMICs. This study tested the feasibility of using a validated low-cost methodology in hospitality venues in six LMIC urban settings and suggests this is a viable method for improving knowledge about SHS exposure and can provide indicative data on compliance with SF legislation. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and

  15. 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...

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

    National Research Council Canada - National Science Library

    2002-01-01

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

  17. Keep Kids in School: A Collaborative Community Effort to Increase Compliance with State-Mandated Health Requirements

    Science.gov (United States)

    Rogers, Valerie; Salzeider, Christine; Holzum, Laura; Milbrandt, Tracy; Zahnd, Whitney; Puczynski, Mark

    2016-01-01

    Background: It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. Methods: A collaborative relationship in Illinois involving an academic…

  18. Health workers' compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Kabaghe, Alinune N.; Visser, Benjamin J.; Spijker, Rene; Phiri, Kamija S.; Grobusch, Martin P.; van Vugt, Michèle

    2016-01-01

    The World Health Organization recommends malaria to be confirmed by either microscopy or a rapid diagnostic test (RDT) before treatment. The correct use of RDTs in resource-limited settings facilitates basing treatment onto a confirmed diagnosis; contributes to speeding up considering a correct

  19. ASSESSMENT OF PRACTICE AT RETAIL PHARMACIES IN PAKISTAN: EXTENT OF COMPLIANCE WITH THE PREVAILING DRUG LAW OF PAKISTAN.

    Science.gov (United States)

    Ullah, Hanif; Zada, Wahid; Khan, Muhammad Sona; Iqbal, Muhammad; Chohan, Osaam; Raza, Naeem; Khawaja, Naeem Raza; Abid, Syed Mobasher Ali; Murtazai, Ghulam

    2016-01-01

    The main objective of this study was to assess the practice at retail pharmacies in Pakistan and to compare the same in rural and urban areas. The maintenance of pharmacy and drug inspectors' visit was also assessed. This cross sectional study was conducted in Abbottabad, Pakistan during October-November, 2012. A sample of 215 drug sellers or drug stores was selected by employing convenient sampling method. With a response rate of 91.6%, 197 drug sellers participated in this study. All the drug sellers were male. Overall, 35% (n = 197) of the drug sellers did not have any professional qualification. A majority of the drug sellers were involved in various malpractices like selling of medicines without prescription (80.7%), prescribing practice (60.9%), prescription intervention (62.4%) and selling of controlled substances (66%) without a license for selling it. These malpractices were significantly higher in rural area than that in urban area.

  20. A comparison of independently conducted dose assessments to determine compliance and resettlement options for the people of Rongelap Atoll

    International Nuclear Information System (INIS)

    Simon, S.L.; Robison, W.L.; Thorne, M.C.

    1997-01-01

    Rongelap Island was the home of Marshallese people numbering less than 120 in 1954; 67 were on the island and severely exposed to radioactive fallout from an atomic weapons test in March of that year. Those resident on Rongelap were evacuated 50 h after the test, returned 3 y later, then voluntarily left their home island in 1985 due to their ongoing fear of radiation exposure from residual radioactive contamination. Following international negotiations in 1991, a Memorandum of Understanding (NIOU) was signed in early 1992 between the Republic of the Marshall Islands Government, the Rongelap Atoll Local Government, the U.S. Department of Energy, and the U.S. Department of the Interior. In this MOU it was agreed that the Republic of the Marshall Islands, with the aid of the U.S. Department of Energy, would carry out independent dose assessments for the purpose of assisting and advising the Rongelap community on radiological issues related to a safe resettlement of Rongelap. In 1994, four independent assessments were reported, including one from each of the following entities: Marshall Islands Nationwide Radiological Study; Lawrence Livermore National Laboratory; an independent advisor from the United Kingdom (MCT); and a committee of the National Research Council. All four assessments concluded that possibly more than 25% of the adult population could exceed the 1 mSv y -1 dose level based on strict utilization of a local food diet. The purpose of this report is to summarize the methodology, assumptions, and findings from each of four assessments; to summarize the recommendations related to mitigation and resettlement options; to discuss unique programmatic aspects of the study; and to consider the implications of the findings to the future of the Rongelap people. 63 refs., 5 figs., 3 tabs

  1. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-01-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance. PMID:20502612

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  3. Molecular assessment of muscle health and function

    NARCIS (Netherlands)

    Hangelbroek, Roland W.J.

    2017-01-01

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

  4. Assessment of Health Knowledge in College Women.

    Science.gov (United States)

    Richmond, Gail; And Others

    1991-01-01

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

  5. Assessing mobile health applications with twitter analytics.

    Science.gov (United States)

    Pai, Rajesh R; Alathur, Sreejith

    2018-05-01

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

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

    DEFF Research Database (Denmark)

    Borup, Ina K.

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2012-10-16

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

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

    International Nuclear Information System (INIS)

    Pennock, Michael; Ura, Karma

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    1979-01-01

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

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

    Science.gov (United States)

    Banta, David; Jonsson, Egon; Childs, Paul

    2009-07-01

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

  12. Health Technology Assessment of Integrated Home Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

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

  13. Assessment of health physics manpower needs

    International Nuclear Information System (INIS)

    Moeller, D.W.; Eliassen, R.

    1976-01-01

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

  14. Assessing Community Quality of Health Care.

    Science.gov (United States)

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

    2016-02-01

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

  15. [Online information supplied by Italian Hospitals and Local Healthcare Units: a descriptive research on their compliance with the guidelines issued by the Italian Ministry of Health].

    Science.gov (United States)

    Vanzetta, M; Vellone, E; De Marinis, M G; Cavicchi, I; Alvaro, R

    2012-01-01

    In most countries where Internet is widely used the number of people surfing the web for healthcare information equals (and in some countries is more than) the number of people looking for healthcare assistance. More and more often, all over the world, Internet is integrated by advanced healthcare systems as a cornerstone of their e-health infrastructure, to meet citizens' needs for health information. Therefore, information plays a key role in the relationship between healthcare providers and citizenship. In 2010 the Italian Ministry of Health has worked out a set of guidelines to improve online communication, within the framework of health promotion. To analyze if the web sites of the Italian public hospitals (PH) and the local healthcare units (LHU) comply with the guidelines of the Italian Ministry of Health (IMH) on the improvement of online communication within the framework of healthcare promotion. All Italian PH and LHU web sites have been analyzed using the self evaluation tool of the IMH. The total number of web sites analyzed was 245. Their compliance with the IMH guidelines was low. Web sites linking to other professional sites, such as the College of Physicians, the College of Pharmacists, or the College of Nurses, were 32 (13%). One hundred and forty-two (58%) were the sites that did not offer any kind of health information, such as pathophysiology of diseases, the most relevant pathologic conditions, risky behaviors, primary and secondary prevention's interventions. A web navigation menu organized according to the most relevant life events or according to categories of users (I am ... /dedicated to...) was available only in 53 web sites (22%). The IMH's guidelines on online communication -- with reference to the aspects here analyzed -- have been in some ways disregarded and the criteria suggested by them have not been fully adopted by PHs and LHUs. Overall, communication is globally meant (and directed) "towards" citizenship and not "together with

  16. Patient compliance with exercise: different theoretical approaches to short-term and long-term compliance.

    NARCIS (Netherlands)

    Sluijs, E.M.; Knibbe, J.J.

    1991-01-01

    Compliance with exercise regimens is difficult to obtain as is compliance with other medical regimens. In analyzing noncompliance, two problems exist: (I) current theories only partly explain patients’ noncompliance; (2) health care providers seldom act according to the recommendations derived from

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

    Science.gov (United States)

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

    2003-08-01

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

  18. A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model.

    Science.gov (United States)

    Horton, Rachael Jane; Minniti, Antoinette; Mireylees, Stewart; McEntegart, Damian

    2008-11-01

    Non-compliance in clinical studies is a significant issue, but causes remain unclear. Utilizing the Elaboration Likelihood Model of persuasion, this study assessed the psychophysical peripheral cue 'Interactive Voice Response System (IVRS) call frequency' on compliance. 71 participants were randomized to once daily (OD), twice daily (BID) or three times daily (TID) call schedules over two weeks. Participants completed 30-item cognitive function tests at each call. Compliance was defined as proportion of expected calls within a narrow window (+/- 30 min around scheduled time), and within a relaxed window (-30 min to +4 h). Data were analyzed by ANOVA and pairwise comparisons adjusted by the Bonferroni correction. There was a relationship between call frequency and compliance. Bonferroni adjusted pairwise comparisons showed significantly higher compliance (p=0.03) for the BID (51.0%) than TID (30.3%) for the narrow window; for the extended window, compliance was higher (p=0.04) with OD (59.5%), than TID (38.4%). The IVRS psychophysical peripheral cue call frequency supported the ELM as a route to persuasion. The results also support OD strategy for optimal compliance. Models suggest specific indicators to enhance compliance with medication dosing and electronic patient diaries to improve health outcomes and data integrity respectively.

  19. Progressing quality control in environmental impact assessment beyond legislative compliance: An evaluation of the IEMA EIA Quality Mark certification scheme

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia (United Kingdom); Research Unit for Environmental Sciences and Management, North-West University (South Africa); Fischer, Thomas B, E-mail: fischer@liverpool.ac.uk [School of Environmental Sciences, University of Liverpool (United Kingdom); Fothergill, Josh, E-mail: j.fothergill@iema.net [Institute of Environmental Management and Assessment, Lincoln (United Kingdom)

    2017-03-15

    The effectiveness of Environmental Impact Assessment (EIA) systems is contingent on a number of control mechanisms: procedural; judicial; evaluative; public and government agency; professional; and development aid agency. If we assume that procedural and judicial controls are guaranteed in developed EIA systems, then progressing effectiveness towards an acceptable level depends on improving the performance of other control mechanisms over time. These other control mechanisms are either absent, or are typically centrally controlled, requiring public finances; this we argue is an unpopular model in times of greater Government austerity. Here we evaluate a market-based mechanism for improving the performance of evaluative and professional control mechanisms, the UK Institute of Environmental Management and Assessments' EIA Quality Mark. We do this by defining dimensions of effectiveness for the purposes of our evaluation, and by identifying international examples of the approaches taken to delivering the other control measures to validate the approach taken in the EIA Quality Mark. We then evaluate the EIA Quality Mark, when used in combination with legal procedures and an active judiciary, against the effectiveness dimensions and use time-series analysis of registrant data to examine its ability to progress practice. We conclude that the EIA Quality Mark has merit as a model for a market-based mechanism, and may prove a more financially palatable approach for delivering effective EIA in mature systems in countries that lack centralised agency oversight. It may, therefore, be of particular interest to some Member States of the European Union for ensuring forthcoming certification requirements stemming from recent amendments to the EIA Directive. - Highlights: • Quality control mechanisms in EIA are identified. • Effectiveness of EIA is conceptualised for evaluation purposes. • The UK IEMA EIA Quality Mark is introduced as a market-based mechanism. • The

  20. Progressing quality control in environmental impact assessment beyond legislative compliance: An evaluation of the IEMA EIA Quality Mark certification scheme

    International Nuclear Information System (INIS)

    Bond, Alan; Fischer, Thomas B; Fothergill, Josh

    2017-01-01

    The effectiveness of Environmental Impact Assessment (EIA) systems is contingent on a number of control mechanisms: procedural; judicial; evaluative; public and government agency; professional; and development aid agency. If we assume that procedural and judicial controls are guaranteed in developed EIA systems, then progressing effectiveness towards an acceptable level depends on improving the performance of other control mechanisms over time. These other control mechanisms are either absent, or are typically centrally controlled, requiring public finances; this we argue is an unpopular model in times of greater Government austerity. Here we evaluate a market-based mechanism for improving the performance of evaluative and professional control mechanisms, the UK Institute of Environmental Management and Assessments' EIA Quality Mark. We do this by defining dimensions of effectiveness for the purposes of our evaluation, and by identifying international examples of the approaches taken to delivering the other control measures to validate the approach taken in the EIA Quality Mark. We then evaluate the EIA Quality Mark, when used in combination with legal procedures and an active judiciary, against the effectiveness dimensions and use time-series analysis of registrant data to examine its ability to progress practice. We conclude that the EIA Quality Mark has merit as a model for a market-based mechanism, and may prove a more financially palatable approach for delivering effective EIA in mature systems in countries that lack centralised agency oversight. It may, therefore, be of particular interest to some Member States of the European Union for ensuring forthcoming certification requirements stemming from recent amendments to the EIA Directive. - Highlights: • Quality control mechanisms in EIA are identified. • Effectiveness of EIA is conceptualised for evaluation purposes. • The UK IEMA EIA Quality Mark is introduced as a market-based mechanism. • The

  1. SNF project's MCO compliance assessment with DOE ''general design criteria,'' order 6430.1A and ''SNF project MCO additional NRC requirements,'' HNF-SD-SNF-DB-005

    International Nuclear Information System (INIS)

    GOLDMANN, L.H.

    1999-01-01

    This document is presented to demonstrate the MCOs compliance to the major design criteria invoked on the MCO. This document is broken down into a section for the MCO's evaluation against DOE Order 6430.1A General Design Criteria sixteen divisions and then the evaluation of the MCO against HNF-SD-SNF-DB-005 ''Spent Nuclear Fuel Project Multi-Canister Overpack Additional NRC Requirements.'' The compliance assessment is presented as a matrix in tabular form. The MCO is the primary container for the K-basin's spent nuclear fuel as it leaves the basin pools and through to the 40 year interim storage at the Canister Storage Building (CSB). The MCO and its components interface with; the K basins, shipping cask and transportation system, Cold Vacuum Drying facility individual process bays and equipment, and CSB facility including the MCO handling machine (MHM), the storage tubes, and the MCO work stations where sampling, welding, and inspection of the MCO is performed. As the MCO is the primary boundary for handling, process, and storage, its main goals are to minimize the spread of its radiological contents to the outside of the MCO and provide for nuclear criticality control. The MCO contains personnel radiation shielding only on its upper end, in the form of a shield plug, where the process interfaces are located. Shielding beyond the shield plug is the responsibility of the using facilities. The design of the MCO and its components is depicted in drawings H-2-828040 through H-2-828075. Not every drawing number in the sequence is used. The first drawing number, H-2-828040, is the drawing index for the MCO. The design performance specification for the MCO is HW-S-0426, and was reviewed and approved by the interfacing design authorities, the safety, regulatory, and operations groups, and the local DOE office. The current revision for the design performance specification is revision 5. The designs of the MCO have been reviewed and approved in a similar way and the reports

  2. Watershed health assessment to monitor land degradation

    Science.gov (United States)

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

    2017-04-01

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

  3. Healthcare information privacy and security regulatory compliance and data security in the age of electronic health records

    CERN Document Server

    Robichau, Bernard Peter

    2014-01-01

    Healthcare is a huge market--20% of yearly GDP in the U.S. It employs tens of thousands of computer programmers and IT administrators Regulations mandate electronic health records by 2015 (for anyone dealing with Medicare/Medicaid), which means new concerns for privacy and security Many medical organizations lagging, putting them at risk for government fines and private lawsuits when a breach in security occurs. Healthcare IT is the growth industry right now, and the need for guidance in regard to privacy and security is huge.

  4. 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

  5. Assessing the value of structural health monitoring

    DEFF Research Database (Denmark)

    Thöns, S.; Faber, Michael Havbro

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

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

  8. 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.

  9. 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.

  10. Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-01-01

    By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M

  11. How health risk from radiation is assessed

    International Nuclear Information System (INIS)

    Rahm-Crites, L.

    1994-07-01

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

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

    Science.gov (United States)

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

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

  13. 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.

  14. 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

  15. Whole effluent assessment of industrial wastewater for determination of BAT compliance. Part 2: metal surface treatment industry.

    Science.gov (United States)

    Gartiser, Stefan; Hafner, Christoph; Hercher, Christoph; Kronenberger-Schäfer, Kerstin; Paschke, Albrecht

    2010-06-01

    Toxicity testing has become a suitable tool for wastewater evaluation included in several reference documents on best available techniques of the Integrated Pollution Prevention and Control (IPPC) Directive. The IPPC Directive requires that for direct dischargers as well as for indirect dischargers, the same best available techniques should be applied. Within the study, the whole effluent assessment approach of OSPAR has been applied for determining persistent toxicity of indirectly discharged wastewater from the metal surface treatment industry. Twenty wastewater samples from the printed circuit board and electroplating industries which indirectly discharged their wastewater to municipal wastewater treatment plants (WWTP) have been considered in the study. In all factories, the wastewater partial flows were separated in collecting tanks and physicochemically treated in-house. For assessing the behaviour of the wastewater samples in WWTPs, all samples were biologically pretreated for 7 days in the Zahn-Wellens test before ecotoxicity testing. Thus, persistent toxicity could be discriminated from non-persistent toxicity caused, e.g. by ammonium or readily biodegradable compounds. The fish egg test with Danio rerio, the Daphnia magna acute toxicity test, the algae test with Desmodesmus subspicatus, the Vibrio fischeri assay and the plant growth test with Lemna minor have been applied. All tests have been carried out according to well-established DIN or ISO standards and the lowest ineffective dilution (LID) concept. Additionally, genotoxicity was tested in the umu assay. The potential bioaccumulating substances (PBS) were determined by solid-phase micro-extraction and referred to the reference compound 2,3-dimethylnaphthalene. The chemical oxygen demand (COD) and total organic carbon (TOC) values of the effluents were in the range of 30-2,850 mg L(-1) (COD) and 2-614 mg L(-1) (TOC). With respect to the metal concentrations, all samples were not heavily polluted. The

  16. 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.

  17. 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 ...

  18. 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.

  19. 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 ...

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

    African Journals Online (AJOL)

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

  1. 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 ...

  2. Methodology of constructive technology assessment in health care

    NARCIS (Netherlands)

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

    2007-01-01

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

  3. Methodology of constructive technology assessment in health care

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

    Borup, Ina K.

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

  5. Assessment of hand hygiene techniques using the World Health Organization's six steps.

    Science.gov (United States)

    Arias, Ariadna V; Garcell, Humberto G; Ochoa, Yagdeline R; Arias, Katiana F; Miranda, Fernando R

    2016-01-01

    The quality of hand hygiene was evaluated via direct observation for compliance with the six recommended World Health Organization steps. A total of 2497 HH opportunities, of which 1573 (63.0%) were hand rubs, were monitored over a five month period. Compliance was higher in nurses compared with physicians and auxiliaries and in steps 1 and 2 for hand rubs as well as the first three steps of hand washing, with lower rates after these steps. Rubbing of the thumbs and fingertips achieved the lowest rates of compliance in both HH types. A combination of the five recommended moments and six steps and staff education is recommended to improve the quality of hand hygiene. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-03-10

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

  8. Editorial: Lead Risk Assessment and Health Effects

    Directory of Open Access Journals (Sweden)

    Howard W. Mielke

    2016-06-01

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

  9. mHealth Assessment: Conceptualization of a Global Framework.

    Science.gov (United States)

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

    2017-05-02

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

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

    Directory of Open Access Journals (Sweden)

    Daniel Apolinario

    2012-08-01

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

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

    Science.gov (United States)

    Hooper, J I

    1996-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Šćepanović Aleksandar

    2017-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  16. 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.

  17. 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

  18. 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,…

  19. Assessment of pharmaceutical services in HIV/AIDS health units in the city of Niterói, Brazil

    Directory of Open Access Journals (Sweden)

    Nilo Jorge Piccoli

    2017-06-01

    Full Text Available ABSTRACT This study aimed to conduct an assessment of pharmaceutical services in HIV/AIDS in the city of Niteroi, Brazil, with emphasis on management. It was done a descriptive cross-sectional study, and the approach used was a normative assessment focused on quality. The indicators used were analyzed individually or grouped according to the components of pharmaceutical services. The assessment identified some good points, especially regarding the good availability of ARVs, and good guide patients in the use of these drugs, and also some problems such as low levels of compliance in relation to good dispensing practices criteria and storage and a high time for the distribution of medicines. The result was a degree of 50.3% compliance with the quality criteria, considered only regular in accordance with trial made. Proposals were suggested for actions and interventions, especially in relation to the improvement of structural conditions of pharmacies of health facilities in the city, and increased training of professionals involved in the services.

  20. Narratives of empowerment and compliance

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2013-01-01

    Purpose: New technologies enable new forms of patient participation in health care. Thearticle discusses whether communication in online patient support groups is a source ofindividual as well as collective empowerment or to be understood within the tradition ofcompliance. The discussion is based...... of empowerment and compliance in patient care. On a collective level, the site isempowering the individual users to comply with ‘doctor’s recommendations’ as a group....

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

    Science.gov (United States)

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

    2014-01-01

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

  2. 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.

  3. 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.

  4. Unaddressed privacy risks in accredited health and wellness apps: a cross-sectional systematic assessment.

    Science.gov (United States)

    Huckvale, Kit; Prieto, José Tomás; Tilney, Myra; Benghozi, Pierre-Jean; Car, Josip

    2015-09-07

    Poor information privacy practices have been identified in health apps. Medical app accreditation programs offer a mechanism for assuring the quality of apps; however, little is known about their ability to control information privacy risks. We aimed to assess the extent to which already-certified apps complied with data protection principles mandated by the largest national accreditation program. Cross-sectional, systematic, 6-month assessment of 79 apps certified as clinically safe and trustworthy by the UK NHS Health Apps Library. Protocol-based testing was used to characterize personal information collection, local-device storage and information transmission. Observed information handling practices were compared against privacy policy commitments. The study revealed that 89% (n = 70/79) of apps transmitted information to online services. No app encrypted personal information stored locally. Furthermore, 66% (23/35) of apps sending identifying information over the Internet did not use encryption and 20% (7/35) did not have a privacy policy. Overall, 67% (53/79) of apps had some form of privacy policy. No app collected or transmitted information that a policy explicitly stated it would not; however, 78% (38/49) of information-transmitting apps with a policy did not describe the nature of personal information included in transmissions. Four apps sent both identifying and health information without encryption. Although the study was not designed to examine data handling after transmission to online services, security problems appeared to place users at risk of data theft in two cases. Systematic gaps in compliance with data protection principles in accredited health apps question whether certification programs relying substantially on developer disclosures can provide a trusted resource for patients and clinicians. Accreditation programs should, as a minimum, provide consistent and reliable warnings about possible threats and, ideally, require publishers to

  5. Mapping Tax Compliance

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... compliance is constructed, challenges the explanatory reaches of today's social science approaches, arguing that an alternative approach to understanding tax compliance is worthwhile exploring. This other choice of approach, inspired by actor–network theory (ANT), adopts a more practice-oriented focus...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

  6. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

  7. 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

  8. Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts.

    Science.gov (United States)

    Rajpura, Jigar R; Nayak, Rajesh

    2014-02-01

    Poor compliance with antihypertensive medications is one possible reason why its success in clinical trials has not been translated into everyday practice. In addition, medication noncompliance in elderly leads to increased hospitalizations, physician visits, and higher health care costs. The study assessed influence of illness perceptions and medications beliefs on medication compliance of elderly hypertensive cohorts. A cross-sectional survey research design, utilizing self-administered health surveys, was adapted to address key study objectives. Conceptualized associations among the study variables were explored to assess their individual as well as their collective impact on the medication compliance. A total of 78 (66%) study samples were found to be noncompliant with their medications. Analysis revealed that perceptions about illness and beliefs about medication jointly played a significant role in the prediction of medication compliance (F = 5.966, P compliance building in elderly populations having hypertension by incorporating the value and importance of patient perceptions of illness and medications in order to achieve desired patient outcomes.

  9. The Environmental Compliance Assessment Management Program (ECAMP) Air National Guard Supplement for The Environmental Assessment and Management (TEAM) Guide. Volume 2. (Revised)

    National Research Council Canada - National Science Library

    Krooks, David

    1997-01-01

    ... (The Environmental Assessment and Management (TEAM) Guide), the ECAMP-ANG supplement was developed to examine Air Force Instructions, Air Force Manuals, and Air Force Policies in conjunction with the TEAM Guide...

  10. 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.

  11. Training and technical assistance for compliance with beverage and physical activity components of New York City's regulations for early child care centers.

    Science.gov (United States)

    Kakietek, Jakub; Dunn, Lillian; O'Dell, Sarah Abood; Jernigan, Jan; Kettel Khan, Laura

    2014-10-16

    In 2006, the New York City Department of Health and Mental Hygiene (DOHMH) passed regulations for child care centers that established standards for beverages provided to children and set a minimum amount of time for daily physical activity. DOHMH offered several types of training and technical assistance to support compliance with the regulations. This article analyzes the association between training and technical assistance provided and compliance with the regulations in a sample of 174 group child care centers. Compliance was measured by using a site inventory of beverages stored on premises and a survey of centers' teachers regarding the amount of physical activity provided. Training and technical assistance measures were based on the DOHMH records of training and technical assistance provided to the centers in the sample and on a survey of center directors. Ordinal logistic regression was used to assess the association between training and technical assistance measures and compliance with the regulations. Measures of training related to physical activity the center received: the number of staff members who participated in Sport, Play and Active Recreation for Kids (SPARK) and other training programs in which a center participated were associated with better compliance with the physical activity regulations. Neither training nor technical assistance were associated with compliance with the regulations related to beverages. Increased compliance with regulations pertaining to physical activity was not related to compliance with beverage regulations. Future trainings should be targeted to the specific regulation requirements to increase compliance.

  12. 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.

  13. Interventions to improve hand hygiene compliance in patient care.

    Science.gov (United States)

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

    2010-09-08

    Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the

  14. 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.

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

    International Nuclear Information System (INIS)

    Repacholi, M.H.

    2003-01-01

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

  16. NASA Occupational Health Program FY98 Self-Assessment

    Science.gov (United States)

    Brisbin, Steven G.

    1999-01-01

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

  17. The Development and Piloting of a Mobile Data Collection Protocol to Assess Compliance With a National Tobacco Advertising, Promotion, and Product Display Ban at Retail Venues in the Russian Federation

    Science.gov (United States)

    Grant, Ashley S; Spires, Mark H; Cohen, Joanna E

    2016-01-01

    Background Tobacco control policies that lead to a significant reduction in tobacco industry marketing can improve public health by reducing consumption of tobacco and preventing initiation of tobacco use. Laws that ban or restrict advertising and promotion in point-of-sale (POS) environments, in the moment when consumers decide whether or not to purchase a tobacco product, must be correctly implemented to achieve the desired public health benefits. POS policy compliance assessments can support implementation; however, there are challenges to conducting evaluations that are rigorous, cost-effective, and timely. Data collection must be discreet, accurate, and systematic, and ideally collected both before and after policies take effect. The use of mobile phones and other mobile technology provide opportunities to efficiently collect data and support effective tobacco control policies. The Russian Federation (Russia) passed a comprehensive national tobacco control law that included a ban on most forms of tobacco advertising and promotion, effective November 15, 2013. The legislation further prohibited the display of tobacco products at retail trade sites and eliminated kiosks as a legal trade site, effective June 1, 2014. Objective The objective of the study was to develop and test a mobile data collection protocol including: (1) retailer sampling, (2) adaptation of survey instruments for mobile phones, and (3) data management protocols. Methods Two waves of observations were conducted; wave 1 took place during April-May 2014, after the advertising and promotion bans were effective, and again in August-September 2014, after the product display ban and elimination of tobacco sales in kiosks came into effect. Sampling took place in 5 Russian cities: Moscow, St. Petersburg, Novosibirsk, Yekaterinburg, and Kazan. Lack of access to a comprehensive list of licensed tobacco retailers necessitated a sampling approach that included the development of a walking protocol to

  18. Compliance with school nutrition policies in Ontario and Alberta: An assessment of secondary school vending machine data from the COMPASS study.

    Science.gov (United States)

    Vine, Michelle M; Harrington, Daniel W; Butler, Alexandra; Patte, Karen; Godin, Katelyn; Leatherdale, Scott T

    2017-04-20

    We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta. Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years. Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.

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

    Directory of Open Access Journals (Sweden)

    Joana Christina Carvalho

    2012-01-01

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

  20. 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.

  1. 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.

  2. Environmental Compliance Assessment System (ECAS).

    Science.gov (United States)

    1993-03-01

    shopping malls, schools, hospitals. reli- gious buildings, factories. workshops, or tourism sites are found within 200 meters (in) of the border of the... Smm (EM&S) (14) W"Wewrm Tmooem Pl~m Svpmwvow (GAM) (16) Ekldbal adl Ca Dýu.oe (DEH) (22) Stdf Jhdle Mvomf 132) Dwoon- of R.scusv. MaUt ut (DRM

  3. Environmental Compliance Assessment System (ECAS)

    Science.gov (United States)

    1994-02-01

    a 1 h average - at ground level, 10 mg/in for an 8 h average. Verify that the concentration of ozone does not exceed 0.12 part per mil- lion ’ppm...research. "* Pest - any imect, rodent, nematode , fungus, or weed; or any other form of terestrial or aquatic plant or animal life or virus, bacterium...524-344 JUDGE 524-314-9779 STALL 524-314-34704 PARTNER 524-403 MOONEY CHEMICALS M-GARD W320 279-3014-9630 . NAUTICAL COATINGS SEA HAWK BIOCOP 44891-6 9

  4. Environmental Compliance Assessment System (ECAS)

    Science.gov (United States)

    1993-09-01

    generators -open burning/open detonation -peak shaving generators -landfills -turbines -surface impoundments -landfarw r- bioremediation Petroleum Product...greater. Methidathion All formu- All uses Restricted Residue effects lations. except on avian species. stock, safflower, and sunflower . All formu...Nursery Unclassified lations. stock. safflower, and sunflower Methomyl As sole Nondomestic Restricted. Residue effects active in- outdoor on mammalian

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

    Science.gov (United States)

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

    2012-09-01

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

  6. Prevalence of MERS-CoV nasal carriage and compliance with the Saudi health recommendations among pilgrims attending the 2013 Hajj.

    Science.gov (United States)

    Memish, Ziad A; Assiri, Abdullah; Almasri, Malak; Alhakeem, Rafat F; Turkestani, Abdulhafeez; Al Rabeeah, Abdullah A; Al-Tawfiq, Jaffar A; Alzahrani, Abdullah; Azhar, Essam; Makhdoom, Hatem Q; Hajomar, Waleed H; Al-Shangiti, Ali M; Yezli, Saber

    2014-10-01

    Annually, Saudi Arabia is the host of the Hajj mass gathering. We aimed to determine the Middle East respiratory syndrome coronavirus (MERS-CoV) nasal carriage rate among pilgrims performing the 2013 Hajj and to describe the compliance with the Saudi Ministry of Health vaccine recommendations. Nasopharyngeal samples were collected from 5235 adult pilgrims from 22 countries and screened for MERS-CoV using reverse transcriptase-polymerase chain reaction. Information regarding the participants' age, gender, country of origin, medical conditions, and vaccination history were obtained. The mean age of the screened population was 51.8 years (range, 18-93 years) with a male/female ratio of 1.17:1. MERS-CoV was not detected in any of the samples tested (3210 pre-Hajj and 2025 post-Hajj screening). According to the vaccination documents, all participants had received meningococcal vaccination and the majority of those from at-risk countries were vaccinated against yellow fever and polio. Only 22% of the pilgrims (17.5% of those ≥65 years and 36.3% of diabetics) had flu vaccination, and 4.4% had pneumococcal vaccination. There was no evidence of MERS-CoV nasal carriage among Hajj pilgrims. While rates of compulsory vaccinations uptake were high, uptake of pneumococcal and flu seasonal vaccinations were low, including among the high-risk population. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Health risk assessment of exposure to ionizing radiation

    International Nuclear Information System (INIS)

    Ogata, Hiromitsu

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dandan Xu

    2015-01-01

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

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

    Science.gov (United States)

    Xu, Dandan; Guo, Xulin

    2015-01-29

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

  11. Compliance Verification Paths for Residential and Commercial Energy Codes

    Energy Technology Data Exchange (ETDEWEB)

    Conover, David R.; Makela, Eric J.; Fannin, Jerica D.; Sullivan, Robin S.

    2011-10-10

    This report looks at different ways to verify energy code compliance and to ensure that the energy efficiency goals of an adopted document are achieved. Conformity assessment is the body of work that ensures compliance, including activities that can ensure residential and commercial buildings satisfy energy codes and standards. This report identifies and discusses conformity-assessment activities and provides guidance for conducting assessments.

  12. Marketing of breast-milk substitutes in Zambia: evaluation of compliance to the international regulatory code.

    Science.gov (United States)

    Funduluka, P; Bosomprah, S; Chilengi, R; Mugode, R H; Bwembya, P A; Mudenda, B

    2018-03-01

    We sought to assess the level of non-compliance with the International Code of Marketing breast-milk substitutes (BMS) and/or Statutory Instrument (SI) Number 48 of 2006 of the Laws of Zambia in two suburbs, Kalingalinga and Chelstone, in Zambia. This was a cross sectional survey. Shop owners (80), health workers (8) and mothers (214) were interviewed. BMS labels and advertisements (62) were observed. The primary outcome was mean non-compliance defined as the number of article violations divided by the total 'obtainable' violations. The score ranges from 0 to 1 with 0 representing no violations in all the articles and one representing violations in all the articles. A total of 62 BMS were assessed. The mean non-compliance score by manufacturers in terms of violations in labelling of BMS was 0.33 (SD = 0.28; 95% CI: 0.26, 0.40). These violations were mainly due to labels containing pictures or graphics representing an infant. 80 shops were also assessed with mean non-compliance score in respect of violations in tie-in-sales, special display, and contact with mothers at the shop estimated as 0.14 (SD = 0.14; 95% CI: 0.11, 0.18). Non-compliance with the Code and/or the local SI is high after 10 years of domesticating the Code.

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

    Science.gov (United States)

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

    2010-12-01

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

  14. Oil Mist Compliance

    International Nuclear Information System (INIS)

    Lazarus, Lloyd

    2009-01-01

    This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that 'Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace', and subsection 9 contains the following applicable standard: 'American Congress of Governmental Industrial Hygienists (ACGIH), 'Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,' (2005) (incorporated by reference, see (section)851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910'. In the 2005 ACGIH Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified

  15. Oil Mist Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Lazarus, Lloyd

    2009-02-02

    This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that “Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace”, and subsection 9 contains the following applicable standard: “American Congress of Governmental Industrial Hygienists (ACGIH), ‘Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,’ (2005) (incorporated by reference, see §851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910.” In the 2005 ACGIH – Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified.

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  17. Occupational health policies on risk assessment in Japan.

    Science.gov (United States)

    Horie, Seichi

    2010-09-01

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

  18. 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.

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

    OpenAIRE

    Wright, John; Parry, Jayne; Scully, Edward

    2005-01-01

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

  20. A Decision Support System for Drinking Water Production Integrating Health Risks Assessment

    Science.gov (United States)

    Delpla, Ianis; Monteith, Donald T.; Freeman, Chris; Haftka, Joris; Hermens, Joop; Jones, Timothy G.; Baurès, Estelle; Jung, Aude-Valérie; Thomas, Olivier

    2014-01-01

    The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD). Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS) named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes) to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109). Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation. PMID:25046634