WorldWideScience

Sample records for health effects model

  1. COSYMA: Health effects models

    International Nuclear Information System (INIS)

    Ehrhardt, J.

    1995-02-01

    As one of the main objectives of the MARIA project (''Methods for Assessing the Radiological Impact of Accidents'') initiated by the Commission of the European Communities the program package COSYMA (''COde SYstem from MARIA'') for assessing the radiological and economic off-site consequences of accidental releases of radioactive material to the atmosphere has been jointly developed by the Kernforschungszentrum Karlsruhe (KfK), FRG, and the National Radiological Protection Board (NRPB), UK. COSYMA includes models and data for assessing a broad spectrum of accident consequences, and they are implemented in independent modules. The subject of this report are those modules, which incorporate models and data for assessing individual and collective risks for deterministic and stochastic health effects. It describes the models implemented, the mathematical algorithms and the required data. Examples are given and explained for the input and output part of the modules. (orig.)

  2. Revised nonstochastic health effects models

    International Nuclear Information System (INIS)

    Yaniv, S.S.; Scott, B.R.

    1991-01-01

    In 1989, the U.S. Nuclear Regulatory Commission (NRC) published a revision of the 1985 report, Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, NUREG/CR-4214, that included models for early occurring and continuing nonstochastic effects, cancers and thyroid nodules, and genetic effects. This paper discusses specific models for lethality from early occurring and continuing effects. For brevity, hematopoietic-syndrome lethality is called hematopoietic death; pulmonary-syndrome lethality is called pulmonary death; and gastrointestinal syndrome lethality is called gastrointestinal death. Two-parameter Weibull risk functions are recommended for estimating the risk of hematopoietic, pulmonary, or gastrointestinal death. The risks are obtained indirectly by using hazard functions; as a result, this type of approach has been called hazard-function modeling and the models generated are called hazard-function models. In the 1989 NUREG/CR-4214 report, changes were made in the parameter values for a number of effects, and the models used to estimate hematopoietic and pulmonary deaths were substantially revised. Upper and lower estimates of model parameters are provided for all early health effects models. In this paper, we discuss the 1989 models for hematopoietic and pulmonary deaths, highlighting the differences between the 1989 and 1985 models. In addition, we give the reasons for which the 1985 models were modified

  3. The modelling of health effects in COSYMA

    International Nuclear Information System (INIS)

    Ehrhardt, J.; Steinhauer, C.

    1991-01-01

    The presentation gives a brief overview of the types of health effects considered in each of the three subsystems of COSYMA, the way that the corresponding models are implemented and their present default parameter values. The risk of early effects is calculated using hazard functions, as recently recommended by US Nuclear Regulatory Commission and NRPB. The early fatal effects specified in COSYMA comprise those following the irradiation of the bone marrow (hematopoietic syndrome), the lung (pulmonary syndrome), the GI-tract (gastrointestinal syndrome) and skin (skin burns). In addition the mortality of pre-and neonates after exposure in utero is quantified. Of the possible non-fatal effects the only ones included are those which lead to a severe disability of the affected person for the rest of their life or which require medical treatment and/or social care

  4. Health effects models for nuclear power plant accident consequence analysis

    International Nuclear Information System (INIS)

    Abrahamson, S.; Bender, M.A.; Boecker, B.B.; Scott, B.R.

    1993-05-01

    The Nuclear Regulatory Commission (NRC) has sponsored several studies to identify and quantify, through the use of models, the potential health effects of accidental releases of radionuclides from nuclear power plants. The Reactor Safety Study provided the basis for most of the earlier estimates related to these health effects. Subsequent efforts by NRC-supported groups resulted in improved health effects models that were published in the report entitled open-quotes Health Effects Models for Nuclear Power Plant Consequence Analysisclose quotes, NUREG/CR-4214, 1985 and revised further in the 1989 report NUREG/CR-4214, Rev. 1, Part 2. The health effects models presented in the 1989 NUREG/CR-4214 report were developed for exposure to low-linear energy transfer (LET) (beta and gamma) radiation based on the best scientific information available at that time. Since the 1989 report was published, two addenda to that report have been prepared to (1) incorporate other scientific information related to low-LET health effects models and (2) extend the models to consider the possible health consequences of the addition of alpha-emitting radionuclides to the exposure source term. The first addendum report, entitled open-quotes Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, Modifications of Models Resulting from Recent Reports on Health Effects of Ionizing Radiation, Low LET Radiation, Part 2: Scientific Bases for Health Effects Models,close quotes was published in 1991 as NUREG/CR-4214, Rev. 1, Part 2, Addendum 1. This second addendum addresses the possibility that some fraction of the accident source term from an operating nuclear power plant comprises alpha-emitting radionuclides. Consideration of chronic high-LET exposure from alpha radiation as well as acute and chronic exposure to low-LET beta and gamma radiations is a reasonable extension of the health effects model

  5. Review of health effects models for Level 3 PSA

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hee; Kim, Ju Youl [FNC Technology Co., Yongin (Korea, Republic of); Han, Seok Jung [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    Many international organizations have developed health risk models. Especially, as radiation-induced cancer is an important part among health effects, development has been focused on cancer risk model. This paper reviewed the cancer risk models of international agencies; United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), National Academy of Sciences (NAS) and International Commission on Radiological Protection (ICRP). Moreover, as pre-research for improving the health risk model in Korea, this paper analyzed the three methodologies and specific details in modeling. International agencies have developed radiation-induced cancer risk model reflecting the recent A-bomb survivor LSS data. This paper reviewed the recent cancer risk model of UNSCEAR, NAS and ICRP. All three models were based on ERR and EAR model in the form of a multiplication of dose-response model and modification function. Lifetime risk was calculated as a function of exposure age and gender.

  6. Atmospheric characteristics essential for health effects modeling

    International Nuclear Information System (INIS)

    Nelson, N.S.

    1977-01-01

    Factors to be considered in evaluating the possible consequences of exposure of human populations to radioactive aerosols are reviewed. Mathematical models of the mechanisms of radioinduced carcinogenesis, tissue deposition and lung clearance of radioactive aerosols, and meteorological parameters affecting the diffusion of radioactive aerosols in the atmosphere are discussed

  7. A multilevel model of organizational health culture and the effectiveness of health promotion.

    Science.gov (United States)

    Lin, Yea-Wen; Lin, Yueh-Ysen

    2014-01-01

    Organizational health culture is a health-oriented core characteristic of the organization that is shared by all members. It is effective in regulating health-related behavior for employees and could therefore influence the effectiveness of health promotion efforts among organizations and employees. This study applied a multilevel analysis to verify the effects of organizational health culture on the organizational and individual effectiveness of health promotion. At the organizational level, we investigated the effect of organizational health culture on the organizational effectiveness of health promotion. At the individual level, we adopted a cross-level analysis to determine if organizational health culture affects employee effectiveness through the mediating effect of employee health behavior. The study setting consisted of the workplaces of various enterprises. We selected 54 enterprises in Taiwan and surveyed 20 full-time employees from each organization, for a total sample of 1011 employees. We developed the Organizational Health Culture Scale to measure employee perceptions and aggregated the individual data to formulate organization-level data. Organizational effectiveness of health promotion included four dimensions: planning effectiveness, production, outcome, and quality, which were measured by scale or objective indicators. The Health Promotion Lifestyle Scale was adopted for the measurement of health behavior. Employee effectiveness was measured subjectively in three dimensions: self-evaluated performance, altruism, and happiness. Following the calculation of descriptive statistics, hierarchical linear modeling (HLM) was used to test the multilevel hypotheses. Organizational health culture had a significant effect on the planning effectiveness (β = .356, p production (β = .359, p promotion. In addition, results of cross-level moderating effect analysis by HLM demonstrated that the effects of organizational health culture on three dimensions of

  8. Health effects models for nuclear power plant accident consequence analysis

    International Nuclear Information System (INIS)

    Evans, J.S.; Abrahmson, S.; Bender, M.A.; Boecker, B.B.; Scott, B.R.; Gilbert, E.S.

    1993-10-01

    This report is a revision of NUREG/CR-4214, Rev. 1, Part 1 (1990), Health Effects Models for Nuclear Power Plant Accident Consequence Analysis. This revision has been made to incorporate changes to the Health Effects Models recommended in two addenda to the NUREG/CR-4214, Rev. 1, Part 11, 1989 report. The first of these addenda provided recommended changes to the health effects models for low-LET radiations based on recent reports from UNSCEAR, ICRP and NAS/NRC (BEIR V). The second addendum presented changes needed to incorporate alpha-emitting radionuclides into the accident exposure source term. As in the earlier version of this report, models are provided for early and continuing effects, cancers and thyroid nodules, and genetic effects. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes are considered. Linear and linear-quadratic models are recommended for estimating the risks of seven types of cancer in adults - leukemia, bone, lung, breast, gastrointestinal, thyroid, and ''other''. For most cancers, both incidence and mortality are addressed. Five classes of genetic diseases -- dominant, x-linked, aneuploidy, unbalanced translocations, and multifactorial diseases are also considered. Data are provided that should enable analysts to consider the timing and severity of each type of health risk

  9. An Effective Model for Improving Global Health Nursing Competence

    OpenAIRE

    Sunjoo Kang

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The co...

  10. A health hierarchy of effects model: a synthesis of advertising and health hierarchy conceptualizations.

    Science.gov (United States)

    Rouse, R A

    1991-01-01

    Work by both advertising and health researchers has independently yielded hierarchy of effects models which can be used to predict campaign success. Unfortunately, however, previous work has been criticized as "common sense" approaches which are more "assumed" than "proven." This analysis argues that much of the problem is due to the lack of precision often associated with over-simplified "uni-dimensional" models. Instead, this perspective synthesized a "two-dimensional" health hierarchy of effects model and outlines a pragmatic strategy for campaign measurement.

  11. Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models

    Directory of Open Access Journals (Sweden)

    Heather L. White

    2013-03-01

    Full Text Available The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI models to gauge the negative health effects of one social exposure: socioeconomic position (SEP. We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.

  12. Spatial Temporal Modelling of Particulate Matter for Health Effects Studies

    Science.gov (United States)

    Hamm, N. A. S.

    2016-10-01

    Epidemiological studies of the health effects of air pollution require estimation of individual exposure. It is not possible to obtain measurements at all relevant locations so it is necessary to predict at these space-time locations, either on the basis of dispersion from emission sources or by interpolating observations. This study used data obtained from a low-cost sensor network of 32 air quality monitoring stations in the Dutch city of Eindhoven, which make up the ILM (innovative air (quality) measurement system). These stations currently provide PM10 and PM2.5 (particulate matter less than 10 and 2.5 m in diameter), aggregated to hourly means. The data provide an unprecedented level of spatial and temporal detail for a city of this size. Despite these benefits the time series of measurements is characterized by missing values and noisy values. In this paper a space-time analysis is presented that is based on a dynamic model for the temporal component and a Gaussian process geostatistical for the spatial component. Spatial-temporal variability was dominated by the temporal component, although the spatial variability was also substantial. The model delivered accurate predictions for both isolated missing values and 24-hour periods of missing values (RMSE = 1.4 μg m-3 and 1.8 μg m-3 respectively). Outliers could be detected by comparison to the 95% prediction interval. The model shows promise for predicting missing values, outlier detection and for mapping to support health impact studies.

  13. Modeling the mental health effects of victimization among homeless persons

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  14. Modeling the mental health effects of victimization among homeless persons.

    Science.gov (United States)

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  15. Effect of health belief model and health promotion model on breast cancer early diagnosis behavior: a systematic review.

    Science.gov (United States)

    Ersin, Fatma; Bahar, Zuhal

    2011-01-01

    Breast cancer is an important public health problem on the grounds that it is frequently seen and it is a fatal disease. The objective of this systematic analysis is to indicate the effects of interventions performed by nurses by using the Health Belief Model (HBM) and Health Promotion Model (HPM) on the breast cancer early diagnosis behaviors and on the components of the Health Belief Model and Health Promotion Model. The reveiw was created in line with the Centre for Reviews and Dissemination guide dated 2009 (CRD) and developed by York University National Institute of Health Researches. Review was conducted by using PUBMED, OVID, EBSCO and COCHRANE databases. Six hundred seventy eight studies (PUBMED: 236, OVID: 162, EBSCO: 175, COCHRANE:105) were found in total at the end of the review. Abstracts and full texts of these six hundred seventy eight studies were evaluated in terms of inclusion and exclusion criteria and 9 studies were determined to meet the criteria. Samplings of the studies varied between ninety four and one thousand six hundred fifty five. It was detected in the studies that educations provided by taking the theories as basis became effective on the breast cancer early diagnosis behaviors. When the literature is examined, it is observed that the experimental researches which compare the concepts of Health Belief Model (HBM) and Health Promotion Model (HPM) preoperatively and postoperatively and show the effect of these concepts on education and are conducted by nurses are limited in number. Randomized controlled studies which compare HBM and HPM concepts preoperatively and postoperatively and show the efficiency of the interventions can be useful in evaluating the efficiency of the interventions.

  16. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.

  17. An Effective Model for Improving Global Health Nursing Competence

    Directory of Open Access Journals (Sweden)

    Sunjoo Kang

    2016-09-01

    Full Text Available This paper developed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by implementing four programs. All programs were conducted with students majoring nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, most of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre and post-program implementation. We discuss how identifying students’ needs regarding global nursing competence when developing appropriate curricula.

  18. Health effects model for nuclear power plant accident consequence analysis. Part I. Introduction, integration, and summary. Part II. Scientific basis for health effects models

    Energy Technology Data Exchange (ETDEWEB)

    Evans, J.S.; Moeller, D.W.; Cooper, D.W.

    1985-07-01

    Analysis of the radiological health effects of nuclear power plant accidents requires models for predicting early health effects, cancers and benign thyroid nodules, and genetic effects. Since the publication of the Reactor Safety Study, additional information on radiological health effects has become available. This report summarizes the efforts of a program designed to provide revised health effects models for nuclear power plant accident consequence modeling. The new models for early effects address four causes of mortality and nine categories of morbidity. The models for early effects are based upon two parameter Weibull functions. They permit evaluation of the influence of dose protraction and address the issue of variation in radiosensitivity among the population. The piecewise-linear dose-response models used in the Reactor Safety Study to predict cancers and thyroid nodules have been replaced by linear and linear-quadratic models. The new models reflect the most recently reported results of the follow-up of the survivors of the bombings of Hiroshima and Nagasaki and permit analysis of both morbidity and mortality. The new models for genetic effects allow prediction of genetic risks in each of the first five generations after an accident and include information on the relative severity of various classes of genetic effects. The uncertainty in modeloling radiological health risks is addressed by providing central, upper, and lower estimates of risks. An approach is outlined for summarizing the health consequences of nuclear power plant accidents. 298 refs., 9 figs., 49 tabs.

  19. Health effects model for nuclear power plant accident consequence analysis. Part I. Introduction, integration, and summary. Part II. Scientific basis for health effects models

    International Nuclear Information System (INIS)

    Evans, J.S.; Moeller, D.W.; Cooper, D.W.

    1985-07-01

    Analysis of the radiological health effects of nuclear power plant accidents requires models for predicting early health effects, cancers and benign thyroid nodules, and genetic effects. Since the publication of the Reactor Safety Study, additional information on radiological health effects has become available. This report summarizes the efforts of a program designed to provide revised health effects models for nuclear power plant accident consequence modeling. The new models for early effects address four causes of mortality and nine categories of morbidity. The models for early effects are based upon two parameter Weibull functions. They permit evaluation of the influence of dose protraction and address the issue of variation in radiosensitivity among the population. The piecewise-linear dose-response models used in the Reactor Safety Study to predict cancers and thyroid nodules have been replaced by linear and linear-quadratic models. The new models reflect the most recently reported results of the follow-up of the survivors of the bombings of Hiroshima and Nagasaki and permit analysis of both morbidity and mortality. The new models for genetic effects allow prediction of genetic risks in each of the first five generations after an accident and include information on the relative severity of various classes of genetic effects. The uncertainty in modeloling radiological health risks is addressed by providing central, upper, and lower estimates of risks. An approach is outlined for summarizing the health consequences of nuclear power plant accidents. 298 refs., 9 figs., 49 tabs

  20. Mathematical models for radiation effects on human health

    International Nuclear Information System (INIS)

    Negi, U.S.; Petwal, K.C.

    2015-01-01

    In this paper, we are proposing a theoretical approach of basic mathematical models for radiation effect on human health. The largest natural sources of radiation exposure to humans are radon gas. While radon gas has always been in the environment, awareness of its contribution to human radiation exposure has increased in recent years. Radon's primary pathway is through air space in soil and rock. Pressure differences between the soil and the inside of buildings may cause radon gas to move indoors. Radon decays to radon daughters, some of which emit alpha radiation. Alpha-emitting radon daughters are adsorbed on to dust particles which, when inhaled, are trapped in the lungs and may cause gene damage, mutations and finally cancer. Exposure to excess UV radiation increases risk of skin cancer but there is also a dark side. The incidence of all types of skin cancer is related to exposure to UV radiation. Non-melanoma skin cancer, eye melanoma, and lip cancer have also been related to natural UV light

  1. Health effects models for nuclear power plant accident consequence analysis: Modifications of models resulting from recent reports on health effects of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Abrahamson, S. (Wisconsin Univ., Madison, WI (United States)); Bender, M.A. (Brookhaven National Lab., Upton, NY (United States)); Boecker, B.B.; Scott, B.R. (Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States). Inhalation Toxicology Research Inst.); Gilbert, E.S. (Pacific Northwest Lab., Richland, WA (United States))

    1991-08-01

    The Nuclear Regulatory Commission has sponsored several studies to identify and quantify the potential health effects of accidental releases of radionuclides from nuclear power plants. The most recent health effects models resulting from these efforts were published in two reports, NUREG/CR-4214, Rev. 1, Part 1 (1990) and Part 2 (1989). Several major health effects reports have been published recently that may impact the health effects models presented in these reports. This addendum to the Part 2 (1989) report, provides a review of the 1986 and 1988 reports by the United Nations Scientific Committee on the Effects of Atomic Radiation, the National Academy of Sciences/National Research Council BEAR 5 Committee report and Publication 60 of the International Commission on Radiological Protection as they relate to this report. The three main sections of this addendum discuss early occurring and continuing effects, late somatic effects, and genetic effects. The major changes to the NUREG/CR-4214 health effects models recommended in this addendum are for late somatic effects. These changes reflect recent changes in cancer risk factors that have come from longer followup and revised dosimetry in major studies like that on the Japanese A-bomb survivors. The results presented in this addendum should be used with the basic NUREG/CR-4214 reports listed above to obtain the most recent views on the potential health effects of radionuclides released accidentally from nuclear power plants. 48 refs., 4 figs., 24 tabs.

  2. Health effects models for nuclear power plant accident consequence analysis: Modifications of models resulting from recent reports on health effects of ionizing radiation

    International Nuclear Information System (INIS)

    Abrahamson, S.; Bender, M.A.; Boecker, B.B.; Scott, B.R.

    1991-08-01

    The Nuclear Regulatory Commission has sponsored several studies to identify and quantify the potential health effects of accidental releases of radionuclides from nuclear power plants. The most recent health effects models resulting from these efforts were published in two reports, NUREG/CR-4214, Rev. 1, Part 1 (1990) and Part 2 (1989). Several major health effects reports have been published recently that may impact the health effects models presented in these reports. This addendum to the Part 2 (1989) report, provides a review of the 1986 and 1988 reports by the United Nations Scientific Committee on the Effects of Atomic Radiation, the National Academy of Sciences/National Research Council BEAR 5 Committee report and Publication 60 of the International Commission on Radiological Protection as they relate to this report. The three main sections of this addendum discuss early occurring and continuing effects, late somatic effects, and genetic effects. The major changes to the NUREG/CR-4214 health effects models recommended in this addendum are for late somatic effects. These changes reflect recent changes in cancer risk factors that have come from longer followup and revised dosimetry in major studies like that on the Japanese A-bomb survivors. The results presented in this addendum should be used with the basic NUREG/CR-4214 reports listed above to obtain the most recent views on the potential health effects of radionuclides released accidentally from nuclear power plants. 48 refs., 4 figs., 24 tabs

  3. Health effects models for off-site radiological consequence analysis on nuclear reactor accidents (II)

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Toshimitsu [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Takahashi, Tomoyuki [Kyoto Univ., Kumatori, Osaka (Japan). Research Reactor Inst; Yonehara, Hidenori [National Inst. of Radiological Sciences, Chiba (Japan)] [eds.

    2000-12-01

    This report is a revision of JAERI-M 91-005, 'Health Effects Models for Off-Site Radiological Consequence Analysis of Nuclear Reactor Accidents'. This revision provides a review of two revisions of NUREG/CR-4214 reports by the U.S. Nuclear Regulatory Commission which is the basis of the JAERI health effects models and other several recent reports that may impact the health effects models by international organizations. The major changes to the first version of the JAERI health effects models and the recommended parameters in this report are for late somatic effects. These changes reflect recent changes in cancer risk factors that have come from longer followup and revised dosimetry in major studies on the Japanese A-bomb survivors. This report also provides suggestions about future revisions of computational aspects on health effects models. (author)

  4. Health effects models for off-site radiological consequence analysis on nuclear reactor accidents (II)

    International Nuclear Information System (INIS)

    Homma, Toshimitsu

    2000-12-01

    This report is a revision of JAERI-M 91-005, 'Health Effects Models for Off-Site Radiological Consequence Analysis of Nuclear Reactor Accidents'. This revision provides a review of two revisions of NUREG/CR-4214 reports by the U.S. Nuclear Regulatory Commission which is the basis of the JAERI health effects models and other several recent reports that may impact the health effects models by international organizations. The major changes to the first version of the JAERI health effects models and the recommended parameters in this report are for late somatic effects. These changes reflect recent changes in cancer risk factors that have come from longer followup and revised dosimetry in major studies on the Japanese A-bomb survivors. This report also provides suggestions about future revisions of computational aspects on health effects models. (author)

  5. Health effects models for nuclear power plant accident consequence analysis. Modification of models resulting from addition of effects of exposure to alpha-emitting radionuclides: Revision 1, Part 2, Scientific bases for health effects models, Addendum 2

    Energy Technology Data Exchange (ETDEWEB)

    Abrahamson, S. [Wisconsin Univ., Madison, WI (United States); Bender, M.A. [Brookhaven National Lab., Upton, NY (United States); Boecker, B.B.; Scott, B.R. [Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States). Inhalation Toxicology Research Inst.; Gilbert, E.S. [Pacific Northwest Lab., Richland, WA (United States)

    1993-05-01

    The Nuclear Regulatory Commission (NRC) has sponsored several studies to identify and quantify, through the use of models, the potential health effects of accidental releases of radionuclides from nuclear power plants. The Reactor Safety Study provided the basis for most of the earlier estimates related to these health effects. Subsequent efforts by NRC-supported groups resulted in improved health effects models that were published in the report entitled {open_quotes}Health Effects Models for Nuclear Power Plant Consequence Analysis{close_quotes}, NUREG/CR-4214, 1985 and revised further in the 1989 report NUREG/CR-4214, Rev. 1, Part 2. The health effects models presented in the 1989 NUREG/CR-4214 report were developed for exposure to low-linear energy transfer (LET) (beta and gamma) radiation based on the best scientific information available at that time. Since the 1989 report was published, two addenda to that report have been prepared to (1) incorporate other scientific information related to low-LET health effects models and (2) extend the models to consider the possible health consequences of the addition of alpha-emitting radionuclides to the exposure source term. The first addendum report, entitled {open_quotes}Health Effects Models for Nuclear Power Plant Accident Consequence Analysis, Modifications of Models Resulting from Recent Reports on Health Effects of Ionizing Radiation, Low LET Radiation, Part 2: Scientific Bases for Health Effects Models,{close_quotes} was published in 1991 as NUREG/CR-4214, Rev. 1, Part 2, Addendum 1. This second addendum addresses the possibility that some fraction of the accident source term from an operating nuclear power plant comprises alpha-emitting radionuclides. Consideration of chronic high-LET exposure from alpha radiation as well as acute and chronic exposure to low-LET beta and gamma radiations is a reasonable extension of the health effects model.

  6. Health effects models for nuclear power plant accident consequence analysis: Low LET radiation: Part 2, Scientific bases for health effects models

    International Nuclear Information System (INIS)

    Abrahamson, S.; Bender, M.; Book, S.

    1989-05-01

    This report provides dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Two-parameter Weibull hazard functions are recommended for estimating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary and gastrointestinal syndromes -- are considered. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid and ''other''. The category, ''other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also provided. For most cancers, both incidence and mortality are addressed. Linear and linear-quadratic models are also recommended for assessing genetic risks. Five classes of genetic disease -- dominant, x-linked, aneuploidy, unbalanced translocation and multifactorial diseases --are considered. In addition, the impact of radiation-induced genetic damage on the incidence of peri-implantation embryo losses is discussed. The uncertainty in modeling radiological health risks is addressed by providing central, upper, and lower estimates of all model parameters. Data are provided which should enable analysts to consider the timing and severity of each type of health risk. 22 refs., 14 figs., 51 tabs

  7. Health effects models for nuclear power plant accident consequence analysis: Low LET radiation: Part 2, Scientific bases for health effects models

    Energy Technology Data Exchange (ETDEWEB)

    Abrahamson, S.; Bender, M.; Book, S.; Buncher, C.; Denniston, C.; Gilbert, E.; Hahn, F.; Hertzberg, V.; Maxon, H.; Scott, B.

    1989-05-01

    This report provides dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Two-parameter Weibull hazard functions are recommended for estimating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary and gastrointestinal syndromes -- are considered. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid and ''other''. The category, ''other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also provided. For most cancers, both incidence and mortality are addressed. Linear and linear-quadratic models are also recommended for assessing genetic risks. Five classes of genetic disease -- dominant, x-linked, aneuploidy, unbalanced translocation and multifactorial diseases --are considered. In addition, the impact of radiation-induced genetic damage on the incidence of peri-implantation embryo losses is discussed. The uncertainty in modeling radiological health risks is addressed by providing central, upper, and lower estimates of all model parameters. Data are provided which should enable analysts to consider the timing and severity of each type of health risk. 22 refs., 14 figs., 51 tabs.

  8. Modeled PM2.5 removal by trees in ten US cities and associated health effects

    Science.gov (United States)

    David J. Nowak; Satoshi Hirabayashi; Allison Bodine; Robert. Hoehn

    2013-01-01

    Urban particulate air pollution is a serious health issue. Trees within cities can remove fine particles from the atmosphere and consequently improve air quality and human health. Tree effects on PM2.5 concentrations and human health are modeled for 10 U.S. cities. The total amount of PM2.5 removed annually by...

  9. Health effects models for off-site radiological consequence analysis of nuclear reactor accidents

    International Nuclear Information System (INIS)

    Togawa, Orihiko; Homma, Toshimitsu; Matsuzuru, Hideo; Kobayashi, Sadayoshi

    1991-02-01

    A first version of models has been developed for predicting the number of occurrences of health effects induced by radiation exposure in nuclear reactor accidents. The models are based on the health effects models developed originally by Harvard University (NUREG/CR-4214). These models are revised on the basis of the new information on risk estimates by the reassessment of the radiation dosimetry in Hiroshima and Nagasaki. The models deal with the following effects: (1) early effects models for bone marrow, lungs, gastrointestinal tract, central nervous system, thyroid, skin and reproductive organs, using the Weibull function, (2) late somatic effects models including leukemia and cancers of breast, lungs, thyroid, gastrointestinal tract and so forth, on the basis of the information derived from epidemiological studies on the atomic bomb survivors of Hiroshima and Nagasaki, (3) models for late and developmental effects due to exposure in utero. (author)

  10. The application of computer modeling to health effect research

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R.S.H. [Colorado State Univ., Ft. Collins, CO (United States)

    1996-12-31

    In the United States, estimates show that more than 30,000 hazardous waste disposal sites exist, not including military installations, U.S. Department of Energy nuclear facilities, and hundreds and thousands of underground fuel storage tanks; these sites undoubtedly have their own respective hazardous waste chemical problems. When so many sites contain hazardous chemicals, how does one study the health effects of the chemicals at these sites? There could be many different answers, but none would be perfect. For an area as complex and difficult as the study of chemical mixtures associated with hazardous waste disposal sites, there are no perfect approaches and protocols. Human exposure to chemicals, be it environmental or occupational, is rarely, if ever, limited to a single chemical. Therefore, it is essential that we consider multiple chemical effects and interactions in our risk assessment process. Systematic toxicity testing of chemical mixtures in the environment or workplace that uses conventional toxicology methodologies is highly impractical because of the immense numbers of mixtures involved. For example, about 600,000 chemicals are being used in our society. Just considering binary chemical mixtures, this means that there could be 600,000 x 599,999/2 = 359,999,400,000 pairs of chemicals. Assuming that only one in a million of these pairs of chemicals acts synergistically or has other toxicologic interactions, there would still be 359,999 binary chemical mixtures possessing toxicologic interactions. Moreover, toxicologic interactions undoubtedly exist among chemical mixtures with three or more component chemicals; the number of possible combinations for these latter mixtures is almost infinite. These are astronomically large numbers with respect to systematic toxicity testing. 22 refs., 5 figs., 1 tab.

  11. Radiological health effects models for nuclear power plant accident consequence analysis

    International Nuclear Information System (INIS)

    Evans, J.S.; Moeller, D.W.

    1989-01-01

    Improved health effects models have been developed for assessing the early effects, late somatic effects and genetic effects that might result from low-LET radiation exposures to populations following a major accident in a nuclear power plant. All the models have been developed in such a way that the dynamics of population risks can be analyzed. Estimates of life years lost and the duration of illnesses were generated and a framework recommended for summarizing health impacts. Uncertainty is addressed by providing models for upper, central and lower estimates of most effects. The models are believed to be a significant improvement over the models used in the U.S. Nuclear Regulatory Commission's Reactor Safety Study, and they can easily be modified to reflect advances in scientific understanding of the health effects of ionizing radiation

  12. Modeling the cost-effectiveness of health care systems for alcohol use disorders: how implementation of eHealth interventions improves cost-effectiveness

    NARCIS (Netherlands)

    Smit, Filip; Lokkerbol, Joran; Riper, Heleen; Majo, Maria Cristina; Boon, Brigitte; Blankers, Matthijs

    2011-01-01

    Informing policy decisions about the cost-effectiveness of health care systems (ie, packages of clinical interventions) is probably best done using a modeling approach. To this end, an alcohol model (ALCMOD) was developed. The aim of ALCMOD is to estimate the cost-effectiveness of competing health

  13. Multipollutant health effect simulations

    Data.gov (United States)

    U.S. Environmental Protection Agency — Resulting betas (health effects) from a variety of copollutant epidemiologic models used to analyze the impact of exposure measurement error on health effect...

  14. A Bayesian localized conditional autoregressive model for estimating the health effects of air pollution.

    Science.gov (United States)

    Lee, Duncan; Rushworth, Alastair; Sahu, Sujit K

    2014-06-01

    Estimation of the long-term health effects of air pollution is a challenging task, especially when modeling spatial small-area disease incidence data in an ecological study design. The challenge comes from the unobserved underlying spatial autocorrelation structure in these data, which is accounted for using random effects modeled by a globally smooth conditional autoregressive model. These smooth random effects confound the effects of air pollution, which are also globally smooth. To avoid this collinearity a Bayesian localized conditional autoregressive model is developed for the random effects. This localized model is flexible spatially, in the sense that it is not only able to model areas of spatial smoothness, but also it is able to capture step changes in the random effects surface. This methodological development allows us to improve the estimation performance of the covariate effects, compared to using traditional conditional auto-regressive models. These results are established using a simulation study, and are then illustrated with our motivating study on air pollution and respiratory ill health in Greater Glasgow, Scotland in 2011. The model shows substantial health effects of particulate matter air pollution and nitrogen dioxide, whose effects have been consistently attenuated by the currently available globally smooth models. © 2014, The Authors Biometrics published by Wiley Periodicals, Inc. on behalf of International Biometric Society.

  15. The Fixed-Effects Zero-Inflated Poisson Model with an Application to Health Care Utilization

    NARCIS (Netherlands)

    Majo, M.C.; van Soest, A.H.O.

    2011-01-01

    Response variables that are scored as counts and that present a large number of zeros often arise in quantitative health care analysis. We define a zero-in flated Poisson model with fixed-effects in both of its equations to identify respondent and health-related characteristics associated with

  16. Critical review of the reactor-safety study radiological health effects model. Final report

    International Nuclear Information System (INIS)

    Cooper, D.W.; Evans, J.S.; Jacob, N.; Kase, K.R.; Maletskos, C.J.; Robertson, J.B.; Smith, D.G.

    1983-03-01

    This review of the radiological health effects models originally presented in the Reactor Safety Study (RSS) and currently used by the US Nuclear Regulatory Commission (NRC) was undertaken to assist the NRC in determining whether or not to revise the models and to aid in the revision, if undertaken. The models as presented in the RSS and as implemented in the CRAC (Calculations of Reactor Accident Consequences) Code are described and critiqued. The major elements analyzed are those concerning dosimetry, early effects, and late effects. The published comments on the models are summarized, as are the important findings since the publication of the RSS

  17. Critical review of the reactor-safety study radiological health effects model. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, D.W.; Evans, J.S.; Jacob, N.; Kase, K.R.; Maletskos, C.J.; Robertson, J.B.; Smith, D.G.

    1983-03-01

    This review of the radiological health effects models originally presented in the Reactor Safety Study (RSS) and currently used by the US Nuclear Regulatory Commission (NRC) was undertaken to assist the NRC in determining whether or not to revise the models and to aid in the revision, if undertaken. The models as presented in the RSS and as implemented in the CRAC (Calculations of Reactor Accident Consequences) Code are described and critiqued. The major elements analyzed are those concerning dosimetry, early effects, and late effects. The published comments on the models are summarized, as are the important findings since the publication of the RSS.

  18. Estimated effect of alcohol pricing policies on health and health economic outcomes in England: an epidemiological model.

    Science.gov (United States)

    Purshouse, Robin C; Meier, Petra S; Brennan, Alan; Taylor, Karl B; Rafia, Rachid

    2010-04-17

    Although pricing policies for alcohol are known to be effective, little is known about how specific interventions affect health-care costs and health-related quality-of-life outcomes for different types of drinkers. We assessed effects of alcohol pricing and promotion policy options in various population subgroups. We built an epidemiological mathematical model to appraise 18 pricing policies, with English data from the Expenditure and Food Survey and the General Household Survey for average and peak alcohol consumption. We used results from econometric analyses (256 own-price and cross-price elasticity estimates) to estimate effects of policies on alcohol consumption. We applied risk functions from systemic reviews and meta-analyses, or derived from attributable fractions, to model the effect of consumption changes on mortality and disease prevalence for 47 illnesses. General price increases were effective for reduction of consumption, health-care costs, and health-related quality of life losses in all population subgroups. Minimum pricing policies can maintain this level of effectiveness for harmful drinkers while reducing effects on consumer spending for moderate drinkers. Total bans of supermarket and off-license discounting are effective but banning only large discounts has little effect. Young adult drinkers aged 18-24 years are especially affected by policies that raise prices in pubs and bars. Minimum pricing policies and discounting restrictions might warrant further consideration because both strategies are estimated to reduce alcohol consumption, and related health harms and costs, with drinker spending increases targeting those who incur most harm. Policy Research Programme, UK Department of Health. Copyright 2010 Elsevier Ltd. All rights reserved.

  19. Explanatory models concerning the effects of small-area characteristics on individual health.

    Science.gov (United States)

    Voigtländer, Sven; Vogt, Verena; Mielck, Andreas; Razum, Oliver

    2014-06-01

    Material and social living conditions at the small-area level are assumed to have an effect on individual health. We review existing explanatory models concerning the effects of small-area characteristics on health and describe the gaps future research should try to fill. Systematic literature search for, and analysis of, studies that propose an explanatory model of the relationship between small-area characteristics and health. Fourteen studies met our inclusion criteria. Using various theoretical approaches, almost all of the models are based on a three-tier structure linking social inequalities (posited at the macro-level), small-area characteristics (posited at the meso-level) and individual health (micro-level). No study explicitly defines the geographical borders of the small-area context. The health impact of the small-area characteristics is explained by specific pathways involving mediating factors (psychological, behavioural, biological). These pathways tend to be seen as uni-directional; often, causality is implied. They may be modified by individual factors. A number of issues need more attention in research on explanatory models concerning small-area effects on health. Among them are the (geographical) definition of the small-area context; the systematic description of pathways comprising small-area contextual as well as compositional factors; questions of direction of association and causality; and the integration of a time dimension.

  20. Statistical Models to Assess the Health Effects and to Forecast Ground Level Ozone

    Czech Academy of Sciences Publication Activity Database

    Schlink, U.; Herbath, O.; Richter, M.; Dorling, S.; Nunnari, G.; Cawley, G.; Pelikán, Emil

    2006-01-01

    Roč. 21, č. 4 (2006), s. 547-558 ISSN 1364-8152 R&D Projects: GA AV ČR 1ET400300414 Institutional research plan: CEZ:AV0Z10300504 Keywords : statistical models * ground level ozone * health effects * logistic model * forecasting * prediction performance * neural network * generalised additive model * integrated assessment Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.992, year: 2006

  1. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

    International Nuclear Information System (INIS)

    Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed

  2. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume I. Introduction to the SPAHR demographic model for health risk

    Energy Technology Data Exchange (ETDEWEB)

    Collins, J.J.; Lundy, R.T.; Grahn, D.; Ginevan, M.E.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. The first volume presents the theory behind the SPAHR health risk projection model and several applications of the model to actual pollution episodes. The elements required for an effective health risk projection model are specified, and the models that have been used to date in health risk projections are outlined. These are compared with the demographic model, whose formulation is described in detail. Examples of the application of air pollution and radiation dose-response functions are included in order to demonstrate the estimation of future mortality and morbidity levels and the range of variation in excess deaths that occurs when populations structure is changed.

  3. Health effects models for nuclear power plant accident consequence analysis: Low LET radiation

    International Nuclear Information System (INIS)

    Evans, J.S.

    1990-01-01

    This report describes dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes -- are considered. In addition, models are included for assessing the risks of several nonlethal early and continuing effects -- including prodromal vomiting and diarrhea, hypothyroidism and radiation thyroiditis, skin burns, reproductive effects, and pregnancy losses. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid, and ''other.'' The category, ''other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also developed. For most cancers, both incidence and mortality are addressed. The models of cancer risk are derived largely from information summarized in BEIR III -- with some adjustment to reflect more recent studies. 64 refs., 18 figs., 46 tabs

  4. Health effects models for nuclear power plant accident consequence analysis: Low LET radiation

    Energy Technology Data Exchange (ETDEWEB)

    Evans, J.S. (Harvard Univ., Boston, MA (USA). School of Public Health)

    1990-01-01

    This report describes dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes -- are considered. In addition, models are included for assessing the risks of several nonlethal early and continuing effects -- including prodromal vomiting and diarrhea, hypothyroidism and radiation thyroiditis, skin burns, reproductive effects, and pregnancy losses. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid, and other.'' The category, other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also developed. For most cancers, both incidence and mortality are addressed. The models of cancer risk are derived largely from information summarized in BEIR III -- with some adjustment to reflect more recent studies. 64 refs., 18 figs., 46 tabs.

  5. The Effect of Occupational Stress on Health and Illness: A Model.

    Science.gov (United States)

    Taylor, William L.; Cangemi, Joseph P.

    1988-01-01

    Examines brief history of stress research and concludes that psychological factors can affect job satisfaction, work adjustment, work attitudes, and overall well-being in the work environment. Establishes relationship between mental and physiological functioning disturbances. Presents model relating effect of stress on health and illness. (Author)

  6. Health effects

    Energy Technology Data Exchange (ETDEWEB)

    Mahieu, L

    1998-07-01

    The main objectives of research in the field of health effects at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study; (4) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phases of its development; (5) to assess the genetic risks of material exposure to ionizing radiation; (6) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (7) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas for 1997 are reported.

  7. Health effects

    International Nuclear Information System (INIS)

    Mahieu, L.

    1998-01-01

    The main objectives of research in the field of health effects at the Belgian Nuclear Research Centre SCK-CEN are: (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study; (4) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phases of its development; (5) to assess the genetic risks of material exposure to ionizing radiation; (6) to elucidate the cellular mechanisms leading to brain damage after prenatal irradiation; (7) to advise authorities and to provide the general population with adequate information concerning the health risk arising from radiation exposure. Progress and major achievements in these topical areas for 1997 are reported

  8. Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.

    Science.gov (United States)

    Baggaley, Rebecca F; Irvine, Michael A; Leber, Werner; Cambiano, Valentina; Figueroa, Jose; McMullen, Heather; Anderson, Jane; Santos, Andreia C; Terris-Prestholt, Fern; Miners, Alec; Hollingsworth, T Déirdre; Griffiths, Chris J

    2017-10-01

    Early HIV diagnosis reduces morbidity, mortality, the probability of onward transmission, and their associated costs, but might increase cost because of earlier initiation of antiretroviral treatment (ART). We investigated this trade-off by estimating the cost-effectiveness of HIV screening in primary care. We modelled the effect of the four-times higher diagnosis rate observed in the intervention arm of the RHIVA2 randomised controlled trial done in Hackney, London (UK), a borough with high HIV prevalence (≥0·2% adult prevalence). We constructed a dynamic, compartmental model representing incidence of infection and the effect of screening for HIV in general practices in Hackney. We assessed cost-effectiveness of the RHIVA2 trial by fitting model diagnosis rates to the trial data, parameterising with epidemiological and behavioural data from the literature when required, using trial testing costs and projecting future costs of treatment. Over a 40 year time horizon, incremental cost-effectiveness ratios were £22 201 (95% credible interval 12 662-132 452) per quality-adjusted life-year (QALY) gained, £372 207 (268 162-1 903 385) per death averted, and £628 874 (434 902-4 740 724) per HIV transmission averted. Under this model scenario, with UK cost data, RHIVA2 would reach the upper National Institute for Health and Care Excellence cost-effectiveness threshold (about £30 000 per QALY gained) after 33 years. Scenarios using cost data from Canada (which indicate prolonged and even higher health-care costs for patients diagnosed late) suggest this threshold could be reached in as little as 13 years. Screening for HIV in primary care has important public health benefits as well as clinical benefits. We predict it to be cost-effective in the UK in the medium term. However, this intervention might be cost-effective far sooner, and even cost-saving, in settings where long-term health-care costs of late-diagnosed patients in high

  9. How robust are the estimated effects of air pollution on health? Accounting for model uncertainty using Bayesian model averaging.

    Science.gov (United States)

    Pannullo, Francesca; Lee, Duncan; Waclawski, Eugene; Leyland, Alastair H

    2016-08-01

    The long-term impact of air pollution on human health can be estimated from small-area ecological studies in which the health outcome is regressed against air pollution concentrations and other covariates, such as socio-economic deprivation. Socio-economic deprivation is multi-factorial and difficult to measure, and includes aspects of income, education, and housing as well as others. However, these variables are potentially highly correlated, meaning one can either create an overall deprivation index, or use the individual characteristics, which can result in a variety of pollution-health effects. Other aspects of model choice may affect the pollution-health estimate, such as the estimation of pollution, and spatial autocorrelation model. Therefore, we propose a Bayesian model averaging approach to combine the results from multiple statistical models to produce a more robust representation of the overall pollution-health effect. We investigate the relationship between nitrogen dioxide concentrations and cardio-respiratory mortality in West Central Scotland between 2006 and 2012. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. A relational model of sexual minority mental and physical health: The negative effects of shame on relationships, loneliness, and health.

    Science.gov (United States)

    Mereish, Ethan H; Poteat, V Paul

    2015-07-01

    Sexual minorities (e.g., lesbians, gay men, bisexual individuals) are at an increased risk for poorer mental and physical health outcomes than heterosexuals, and some of these health disparities relate to minority stressors such as discrimination. Yet, there is little research elucidating pathways that predict health or that promote resiliency among sexual minorities. Building on the minority stress model, the present study utilized relational cultural theory to situate sexual minority health within a relational framework. Specifically, the study tested mediators of the relationships between distal (i.e., discrimination, rejection, victimization) and proximal stressors (i.e., internalized homophobia, sexual orientation concealment) and psychological and physical distress for sexual minorities. Among 719 sexual minority adults, structural equation modeling analyses were used to test 4 models reflecting the mediating effects of shame, poorer relationships with a close peer and the lesbian/gay/bisexual/transgender (LGBT) community, and loneliness on the associations between minority stressors and psychological distress (i.e., depression and anxiety) and physical distress (i.e., distressing physical symptoms). As hypothesized, the associations between distal and proximal minority stressors and distress were mediated by shame, poorer relationships with a close peer and the LGBT community, and loneliness. Findings underscore the possible relational and interpersonal mechanisms by which sexual minority stressors lead to psychological and physical distress. (c) 2015 APA, all rights reserved).

  11. Effect of Education by Text Messaging Based on Health Belief Model on Food Handling Behaviors in Health Volunteers\\' Yazd City

    Directory of Open Access Journals (Sweden)

    MA Morowatisharifabad

    2016-05-01

    Full Text Available Introduction: The text message can be presented as a way to change patterns of behavior-based prevention programs, such as the theory of planned behavior and health belief model to be used., And as an alternative approach to the individual and group training programs should be considered. The present study examined the effectiveness of this new method in promoting food handling behavior of a team of health volunteers on health belief model was based. Methods: This study was an evaluation of an intervention in which 16 health centers, 200 health volunteers who were actively involved Yazd city who were randomly divided into two groups. After the initial test, chi-square test, t test were analyzed. The intervention group received an educational package on the SMS regarding  food handling behavior on health Belief Model was designed for codification; wantonly within a month and a half a day and after 8 weeks of the last SMS sent from any intervention and control groups was performed in a secondary assessment. Tool for data gathering questionnaire consisting of structures of health belief model including demographic variables, respectively. Data were using 18spss and employing applied, statistical tests of non-parametric Wilcoxon, Mann-Whitney and Kruskal-Wallis, Chi-square and correlation coefficient the analysis was. Results: The overall food handling behavior, after training significantly increased in the intervention group (p =0/01, while the control group was not significant (p=0/21. Cooling behavior after training in the experimental group and the control group was significantly increased (p =0/00. Cooking behavior, after training in the intervention group (p =0/11 and control group( p =0/17 was not significantly increased. Individual health behavior, after training in the intervention group (p =0/13 and control group (p =0/07 was not significantly increased. Separation behavior after training has not significantly increased in the

  12. An effective model for store and retrieve big health data in cloud computing.

    Science.gov (United States)

    Goli-Malekabadi, Zohreh; Sargolzaei-Javan, Morteza; Akbari, Mohammad Kazem

    2016-08-01

    The volume of healthcare data including different and variable text types, sounds, and images is increasing day to day. Therefore, the storage and processing of these data is a necessary and challenging issue. Generally, relational databases are used for storing health data which are not able to handle the massive and diverse nature of them. This study aimed at presenting the model based on NoSQL databases for the storage of healthcare data. Despite different types of NoSQL databases, document-based DBs were selected by a survey on the nature of health data. The presented model was implemented in the Cloud environment for accessing to the distribution properties. Then, the data were distributed on the database by applying the Shard property. The efficiency of the model was evaluated in comparison with the previous data model, Relational Database, considering query time, data preparation, flexibility, and extensibility parameters. The results showed that the presented model approximately performed the same as SQL Server for "read" query while it acted more efficiently than SQL Server for "write" query. Also, the performance of the presented model was better than SQL Server in the case of flexibility, data preparation and extensibility. Based on these observations, the proposed model was more effective than Relational Databases for handling health data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Aligning health information technologies with effective service delivery models to improve chronic disease care.

    Science.gov (United States)

    Bauer, Amy M; Thielke, Stephen M; Katon, Wayne; Unützer, Jürgen; Areán, Patricia

    2014-09-01

    Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care, have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored. We use the evidence-based collaborative care model as an example, with attention to health literacy improvement for supporting patient engagement in care. A review of the literature was conducted to identify how HIT and collaborative care, an evidence-based model of chronic disease care, support each other. Five key principles of effective collaborative care are outlined: care is patient-centered, evidence-based, measurement-based, population-based, and accountable. The potential role of HIT in implementing each principle is discussed. Key features of the mobile health paradigm are described, including how they can extend evidence-based treatment beyond traditional clinical settings. HIT, and particularly mobile health, can enhance collaborative care interventions, and thus improve the health of individuals and populations when deployed in integrated delivery systems. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Prediction of health effects of cross-border atmospheric pollutants using an aerosol forecast model.

    Science.gov (United States)

    Onishi, Kazunari; Sekiyama, Tsuyoshi Thomas; Nojima, Masanori; Kurosaki, Yasunori; Fujitani, Yusuke; Otani, Shinji; Maki, Takashi; Shinoda, Masato; Kurozawa, Youichi; Yamagata, Zentaro

    2018-08-01

    Health effects of cross-border air pollutants and Asian dust are of significant concern in Japan. Currently, models predicting the arrival of aerosols have not investigated the association between arrival predictions and health effects. We investigated the association between subjective health symptoms and unreleased aerosol data from the Model of Aerosol Species in the Global Atmosphere (MASINGAR) acquired from the Japan Meteorological Agency, with the objective of ascertaining if these data could be applied to predicting health effects. Subjective symptom scores were collected via self-administered questionnaires and, along with modeled surface aerosol concentration data, were used to conduct a risk evaluation using generalized estimating equations between October and November 2011. Altogether, 29 individuals provided 1670 responses. Spearman's correlation coefficients were determined for the relationship between the proportion of the participants reporting the maximum score of two or more for each symptom and the surface concentrations for each considered aerosol species calculated using MASINGAR; the coefficients showed significant intermediate correlations between surface sulfate aerosol concentration and respiratory, throat, and fever symptoms (R = 0.557, 0.454, and 0.470, respectively; p < 0.01). In the general estimation equation (logit link) analyses, a significant linear association of surface sulfate aerosol concentration, with an endpoint determined by reported respiratory symptom scores of two or more, was observed (P trend = 0.001, odds ratio [OR] of the highest quartile [Q4] vs. the lowest [Q1] = 5.31, 95% CI = 2.18 to 12.96), with adjustment for potential confounding. The surface sulfate aerosol concentration was also associated with throat and fever symptoms. In conclusion, our findings suggest that modeled data are potentially useful for predicting health risks of cross-border aerosol arrivals. Copyright © 2018 Elsevier Ltd

  15. Financial Effect of a Drug Distribution Model Change on a Health System.

    Science.gov (United States)

    Turingan, Erin M; Mekoba, Bijan C; Eberwein, Samuel M; Roberts, Patricia A; Pappas, Ashley L; Cruz, Jennifer L; Amerine, Lindsey B

    2017-06-01

    Background: Drug manufacturers change distribution models based on patient safety and product integrity needs. These model changes can limit health-system access to medications, and the financial impact on health systems can be significant. Objective: The primary aim of this study was to determine the health-system financial impact of a manufacturer's change from open to limited distribution for bevacizumab (Avastin), rituximab (Rituxan), and trastuzumab (Herceptin). The secondary aim was to identify opportunities to shift administration to outpatient settings to support formulary change. Methods: To assess the financial impact on the health system, the cost minus discount was applied to total drug expenditure during a 1-year period after the distribution model change. The opportunity analysis was conducted for three institutions within the health system through chart review of each inpatient administration. Opportunity cost was the sum of the inpatient administration cost and outpatient administration margin. Results: The total drug expenditure for the study period was $26 427 263. By applying the cost minus discount, the financial effect of the distribution model change was $1 393 606. A total of 387 administrations were determined to be opportunities to be shifted to the outpatient setting. During the study period, the total opportunity cost was $1 766 049. Conclusion: Drug expenditure increased for the health system due to the drug distribution model change and loss of cost minus discount. The opportunity cost of shifting inpatient administrations could offset the increase in expenditure. It is recommended to restrict bevacizumab, rituximab, and trastuzumab through Pharmacy & Therapeutics Committees to outpatient use where clinically appropriate.

  16. A Relational Model of Sexual Minority Mental and Physical Health: The Negative Effects of Shame on Relationships, Loneliness, and Health

    Science.gov (United States)

    Mereish, Ethan H.; Poteat, V. Paul

    2015-01-01

    Sexual minorities (e.g., lesbians, gay men, bisexual individuals) are at higher risk for mental and physical health disparities than heterosexuals, and some of these disparities relate to minority stressors such as discrimination. Yet, there is little research elucidating pathways that predict health or that promote resiliency among sexual minorities. Building on the minority stress model, the present study utilized relational cultural theory to situate sexual minority health within a relational framework. Specifically, the study tested mediators of the relationships between distal (i.e., discrimination, rejection, victimization) and proximal stressors (i.e., internalized homophobia, sexual orientation concealment) and psychological and physical distress for sexual minorities. Among 719 sexual minority adults, structural equation modeling analyses were used to test four models reflecting the mediating effects of shame, poorer relationships with a close peer and the LGBT community, and loneliness on the associations between minority stressors and psychological distress (i.e., depression and anxiety) and physical distress (i.e., distressing physical symptoms). As hypothesized, the associations between distal and proximal minority stressors and distress were mediated by shame, poorer relationships with a close peer and the LGBT community, and loneliness. Findings underscore the possible relational and interpersonal mechanisms by which sexual minority stressors lead to psychological and physical distress. PMID:26010289

  17. Assessment of the effect of visual impairment on mortality through multiple health pathways: structural equation modeling.

    Science.gov (United States)

    Christ, Sharon L; Lee, David J; Lam, Byron L; Zheng, D Diane; Arheart, Kristopher L

    2008-08-01

    To estimate the direct effects of self-reported visual impairment (VI) on health, disability, and mortality and to estimate the indirect effects of VI on mortality through health and disability mediators. The National Health Interview Survey (NHIS) is a population-based annual survey designed to be representative of the U.S. civilian noninstitutionalized population. The National Death Index of 135,581 NHIS adult participants, 18 years of age and older, from 1986 to 1996 provided the mortality linkage through 2002. A generalized linear structural equation model (GSEM) with latent variable was used to estimate the results of a system of equations with various outcomes. Standard errors and test statistics were corrected for weighting, clustering, and stratification. VI affects mortality, when direct adjustment was made for the covariates. Severe VI increases the hazard rate by a factor of 1.28 (95% CI: 1.07-1.53) compared with no VI, and some VI increases the hazard by a factor of 1.13 (95% CI: 1.07-1.20). VI also affects mortality indirectly through self-rated health and disability. The total effects (direct effects plus mediated effects) on the hazard of mortality of severe VI and some VI relative to no VI are hazard ratio (HR) 1.54 (95% CI: 1.28-1.86) and HR 1.23 (95% CI: 1.16-1.31), respectively. In addition to the direct link between VI and mortality, the effects of VI on general health and disability contribute to an increased risk of death. Ignoring the latter may lead to an underestimation of the substantive impact of VI on mortality.

  18. Effect of Preconception Care Education by Health Volunteers on Knowledge and Attitudes of Women: Application of the Health Belief Model

    Directory of Open Access Journals (Sweden)

    Nasrin Fazeli

    2018-04-01

    Full Text Available Preconception care identifies and modifies the risk factors for pregnancy and childbirth. The present study aimed to determine the effects a preconception care education program, which was based on the Health Belief Model (HBM and implemented by health volunteers, on knowledge and attitudes of women. A semi-experimental study was conducted using 22 health volunteers and 110 women aged 15-49 years selected from two comprehensive health centers of Mashhad, Iran, in 2016. The convenience sampling method was employed for selecting the volunteers and the regular random sampling method for choosing the women. For data collection, we applied a researcher-made tool with verified validity and reliability. HBM-based education was implemented by the volunteers during three sessions. Data analysis was performed in SPSS using Mann-Whitney test, Friedman, and Spearman's rank correlation coefficient; repeated measures data analysis was carried out at the significance level of 0.05. The mean age of the women was 30.6±6.6 years in the intervention group and 31.6±6.5 years in the control group. The mean levels of knowledge and attitude increased significantly after the intervention (P

  19. Spatial modelling of arsenic distribution and human health effects in Lake Victoria basin, Tanzania

    Science.gov (United States)

    Ijumulana, Julian; Mtalo, Felix; Bhattacharya, Prosun

    2016-04-01

    Increasing incidences of naturally occurring geogenic pollutants in drinking water sources and associated human health risks are the two major challenges requiring detailed knowledge to support decision making process at various levels. The presence, location and extent of environmental contamination is needed towards developing mitigation measures to achieve required standards. In this study we are developing a GIS-based model to detect and predict drinking water pollutants at the identified hotspots and monitor its variation in space. In addition, the mobility of pollutants within the affected region needs to be evaluated using topographic and hydrogeological data. Based on these geospatial data on contaminant distribution, spatial relationship of As and F contamination and reported human health effects such as dental caries, dental fluorosis, skeletal fluorosis and bone crippling, skin and other cancers etc. can be modeled for potential interventions for safe drinking water supplies.

  20. Construction of a case for expert judgement of uncertainty in early health effects models

    International Nuclear Information System (INIS)

    Grupa, J.

    1997-11-01

    The contribution of ECN to a joint study of the European Commission (EC) and the US Nuclear Regulatory Commission (NRC), in which the uncertainty in risks and consequences of severe accidents at nuclear power plants are evaluated, is described. The procedure used to obtain these uncertainties is called expert judgement. In a formal expert judgement procedure a panel of experts has provided quantitative information about the uncertainty in given observables: a quantity that describes an observation concerning the phenomenon of interest, in this paper the relation between dose and health effects, without information or assumptions about any model describing this phenomenon. The observables are defined in a case structure, a questionnaire provided to all experts. ECN has contributed to the selection of the experts for the early health effects panel, and provided assistance for drafting the case structure for this panel. This paper describes the radiological information provided by ECN and the analyses necessary for constructing the case structure. The deliverables of the expert elicitation are uncertainty distributions of the observables requested in the case structure. The results are intended to be unbiased, i.e. it should be applicable to any model describing the relation between dose and health effects. They will be published by the project team in a joint publication of the NRC and the EC. In this way the resulting uncertainty distributions are available for further work in the joint project and available to a more general public. 2 figs., 4 refs

  1. Letter to the Editor: Applications Air Q Model on Estimate Health Effects Exposure to Air Pollutants

    Directory of Open Access Journals (Sweden)

    Gholamreza Goudarzi

    2016-02-01

    Full Text Available Epidemiologic studies in worldwide have measured increases in mortality and morbidity associated with air pollution (1-3. Quantifying the effects of air pollution on the human health in urban area causes an increasingly critical component in policy discussion (4-6. Air Q model was proved to be a valid and reliable tool to predicts health effects related to criteria  pollutants (particulate matter (PM, ozone (O3, nitrogen dioxide (NO2, sulfur dioxide (SO2, and carbon monoxide (CO, determinate  the  potential short term effects of air pollution  and allows the examination of various scenarios in which emission rates of pollutants are varied (7,8. Air Q software provided by the WHO European Centre for Environment and Health (ECEH (9. Air Q model is based on cohort studies and used to estimates of both attributable average reductions in life-span and numbers of mortality and morbidity associated with exposure to air pollution (10,11. Applications

  2. Developing a model for effects of climate change on human health and health-environment interactions: Heat stress in Austin, Texas presentation

    Science.gov (United States)

    Background/Question/Methods In December, 2010, a consortium of EPA, Centers for Disease Control, and state and local health officials convened in Austin, Texas for a “participatory modeling workshop” on climate change effects on human health and health-environment int...

  3. Developing a model for effects of climate change on human health and health-environment interactions: Heat stress in Austin, Texas

    Science.gov (United States)

    Background/Question/Methods In December, 2010, a consortium of EPA, Centers for Disease Control, and state and local health officials convened in Austin, Texas for a “participatory modeling workshop” on climate change effects on human health and health-environment interactions. ...

  4. The Effect of Health Beliefs, Media Perceptions, and Communicative Behaviors on Health Behavioral Intention: An Integrated Health Campaign Model on Social Media.

    Science.gov (United States)

    Yoo, Sun-Wook; Kim, Jarim; Lee, Yeunjae

    2018-01-01

    Social media have recently gained attention as a potential health campaign tool. This study examines this line of expectation concerning the role social media may play in health campaigns by testing an integrated health campaign model that combines insights from research on social media-specific perceptions and communicative behaviors in order to predict health behaviors. Specifically, this study aims to (a) develop a more holistic social media campaign model for predicting health behaviors in the social media context, (b) investigate how social media channel-related perceptions affect preventive health behaviors, and (c) investigate how communicative behaviors mediate perceptions and behavioral intention. The study conducted an online survey of 498 females who followed the Purple Ribbon Twitter campaign (@pprb), a cervical cancer prevention campaign. The results indicated that information acquisition mediated perceived risk's effect on intention. Information acquisition also mediated the relationships between intention and information selection and information transmission. On the other hand, social media-related perceptions indirectly impacted behavioral intention through communicative behaviors. The findings' theoretical and practical implications are discussed.

  5. Description of the CEEH health effect model. CEEH scientific report no. 7a

    Energy Technology Data Exchange (ETDEWEB)

    Boenloekke, J.H.; Sigsgaard, T. (Aarhus Univ. Dept. of of Public Health, AArhus (Denmark)); Brandt, J.; Frohn, L.M. (Aarhus Univ. National Environmental Research Institute, Dept. of Atmospheric Environment, Roskilde (Denmark)); Flachs, E.M.; Broennum-Hansen, H. (Univ. of Southern Denmark. National Institute of Public Health, Copenhagen (Denmark)); Siggaard-Andersen4, M.-L. (Univ. of Copenhagen. Niels Bohr Institute, Copenhagen (Denmark))

    2011-11-15

    This report is based on a number of up-to-date reviews of the existing literature on health effects from air pollution at the population level and conclude with recommendations for CEEH. The pollutants in the CEEH models have been selected based on the following criteria: 1) They stem from combustion sources either directly or via chemical transformations. This may include evaporation or dust from the energy sources themselves (i.e. from wear and tear). Other pollution derived from energy production but not liberated to the air is not included (e.g. heavy metals in soil deposits). However, heavy metals, dioxins and possibly PAHs that are emitted to the air, deposit on soil or in water and end up by being ingested should ideally be covered by CEEH. 2) Be possible to model in the CEEH settings both in terms of emissions, chemical transformations and transport. 3) Be sufficiently investigated in terms of documented health effects and in terms of the costs associated with these health effects. Combustion sources and accordingly combustion products are highly diverse and widespread. In practice, therefore, not all sources that contribute to health effects in humans can be included in the CEEH models. Other sources than combustion contribute some of the pollutants and as a result a brief discussion of the relevance and effect of such non-combustion derived air pollutants is included in this report. For a more comprehensive discussion of secondary pollutants from e.g. agricultural activities the reader is referred to CEEH report no. 3. The EVA model was based on existing European models such as EcoSense 4.0 from ExternE and used the same air pollution products as these in the versions available in 2003-4. With time EVA has changed independently from its predecessors. A more recent version of the ExternE methods is now available (ExternE, 2005). The pollutants ontained by ExternE are provided in table 1. Pollutants originally included in EVA are the following: SO2, O3, PM2

  6. The Brazilian Unified National Health System: Proposal of a Cost-effectiveness Evaluation Model

    Directory of Open Access Journals (Sweden)

    Lilian Ribeiro de Oliveira

    2016-04-01

    Full Text Available The Brazilian Unified National Health System (Sistema Único de Saúde [SUS] is in a prominent position compared to the existing social policies. One of the new tools used by SUS is known as Performance Index of the Unified Health System (Índice de Desempenho do Sistema Único de Saúde [IDSUS], which is intended to measure the performance of each municipality. Therefore, the aim of this study was to propose a model of cost-effectiveness to compare IDSUS performance against total revenues achieved in Homogeneous Group 2, consisting of 94 municipalities and analysed using data from IDSUS and the System Information of the Public Budget for Health Care (Sistema de Informação do Orçamento Público em Saúde [SIOPS] for the year 2011. After structuring this data, we carried out descriptive statistical and cluster analysis in order to group similar municipalities in accordance with established variables: IDSUS performance, population and total revenue in health per capita. Even with the division of municipalities into homogeneous groups and after using variables such as population and revenue to regroup them, the results showed there are municipalities with heterogeneous characteristics. Another finding is in the use and intersection of two distinct databases (IDSUS and SIOPS, which allowed for visualizing the impact of health care revenue on the municipalities performance.

  7. Modeling the acute health effects of astronauts from exposure to large solar particle events.

    Science.gov (United States)

    Hu, Shaowen; Kim, Myung-Hee Y; McClellan, Gene E; Cucinotta, Francis A

    2009-04-01

    Radiation exposure from Solar Particle Events (SPE) presents a significant health concern for astronauts for exploration missions outside the protection of the Earth's magnetic field, which could impair their performance and result in the possibility of failure of the mission. Assessing the potential for early radiation effects under such adverse conditions is of prime importance. Here we apply a biologically based mathematical model that describes the dose- and time-dependent early human responses that constitute the prodromal syndromes to consider acute risks from SPEs. We examine the possible early effects on crews from exposure to some historically large solar events on lunar and/or Mars missions. The doses and dose rates of specific organs were calculated using the Baryon radiation transport (BRYNTRN) code and a computerized anatomical man model, while the hazard of the early radiation effects and performance reduction were calculated using the Radiation-Induced Performance Decrement (RIPD) code. Based on model assumptions we show that exposure to these historical events would cause moderate early health effects to crew members inside a typical spacecraft or during extra-vehicular activities, if effective shielding and medical countermeasure tactics were not provided. We also calculate possible even worse cases (double intensity, multiple occurrences in a short period of time, etc.) to estimate the severity, onset and duration of various types of early illness. Uncertainties in the calculation due to limited data on relative biological effectiveness and dose-rate modifying factors for protons and secondary radiation, and the identification of sensitive sites in critical organs are discussed.

  8. Quantification of health effects of breastfeeding - Review of the literature and model simulation

    NARCIS (Netherlands)

    Rossum CTM van; Buchner FL; Hoekstra J; CVG

    2006-01-01

    Breastfeeding has positive health effects, with the largest health gain realized through policy that focuses on encouraging all mothers to start breastfeeding. A literature review shows that breastfeeding has beneficial health effects in both the short and the longer term. There is convincing

  9. Rat Models of Cardiometabolic Diseases: Baseline Clinical Chemistries, and Rationale for their Use in Examining Air Pollution Health Effects

    Science.gov (United States)

    This is the first of a series of 8 papers examining susceptibility of various rodent cardiometabolic disease models to ozone induced health effects. Individuals with cardiovascular and metabolic diseases (CVD) are shown to be more susceptible to adverse health effects o...

  10. Noise effects on the health status in a dynamic failure model for living organisms

    Science.gov (United States)

    Kang, H.; Jo, J.; Choi, M. Y.; Choi, J.; Yoon, B.-G.

    2007-03-01

    We study internal and external noise effects on the healthy-unhealthy transition and related phenomena in a dynamic failure model for living organisms. It is found that internal noise makes the system weaker, leading to breakdown under smaller stress. The discontinuous healthy-unhealthy transition in a system with global load sharing below a critical point is naturally explained in terms of the bistability for the health status. External noise present in constant stress gives similar results; further, it induces resonance in response to periodic stress, regardless of load transfer. In the case of local load sharing, such periodic stress is revealed more hazardous than the constant stress.

  11. The health effects of fetal microchimerism can be modeled in companion dogs.

    Science.gov (United States)

    Kumar, Senthil R; Hansen, Sarah A; Axiak-Bechtel, Sandra M; Bryan, Jeffrey N

    2013-01-01

    Fetal microchimerism (FMC) has been described to have a range of effects on health and disease. Y-chromosomal DNA has been detected in Golden Retrievers suggesting persistent FMC. In that report, nine dogs had evidence of microchimerism without prior pregnancy. To further understand this finding, a dam with prior male live births giving birth to her fourth litter of puppies, all females, was evaluated for FMC along with two of her daughters. All three female dogs had evidence of Y-chromosomal DNA in their blood. This suggests that male cells carried by the dam from previous pregnancy trafficked to her daughters to establish microchimerism in younger siblings. Companion dogs share many of the same cancers as humans, have out-bred genetics, and share the human environment, making them optimal models of human disease. Understanding the impact of FMC on health and disease of dogs could elucidate mechanisms useful for clinical interventions in humans.

  12. A simplified model for calculating atmospheric radionuclide transport and early health effects from nuclear reactor accidents

    International Nuclear Information System (INIS)

    Madni, I.K.; Cazzoli, E.G.; Khatib-Rahbar, M.

    1995-01-01

    During certain hypothetical severe accidents in a nuclear power plant, radionuclides could be released to the environment as a plume. Prediction of the atmospheric dispersion and transport of these radionuclides is important for assessment of the risk to the public from such accidents. A simplified PC-based model was developed that predicts time-integrated air concentration of each radionuclide at any location from release as a function of time integrated source strength using the Gaussian plume model. The solution procedure involves direct analytic integration of air concentration equations over time and position, using simplified meteorology. The formulation allows for dry and wet deposition, radioactive decay and daughter buildup, reactor building wake effects, the inversion lid effect, plume rise due to buoyancy or momentum, release duration, and grass height. Based on air and ground concentrations of the radionuclides, the early dose to an individual is calculated via cloudshine, groundshine, and inhalation. The model also calculates early health effects based on the doses. This paper presents aspects of the model that would be of interest to the prediction of environmental flows and their public consequences

  13. Global and regional health effects of future food production under climate change: a modelling study.

    Science.gov (United States)

    Springmann, Marco; Mason-D'Croz, Daniel; Robinson, Sherman; Garnett, Tara; Godfray, H Charles J; Gollin, Douglas; Rayner, Mike; Ballon, Paola; Scarborough, Peter

    2016-05-07

    One of the most important consequences of climate change could be its effects on agriculture. Although much research has focused on questions of food security, less has been devoted to assessing the wider health impacts of future changes in agricultural production. In this modelling study, we estimate excess mortality attributable to agriculturally mediated changes in dietary and weight-related risk factors by cause of death for 155 world regions in the year 2050. For this modelling study, we linked a detailed agricultural modelling framework, the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT), to a comparative risk assessment of changes in fruit and vegetable consumption, red meat consumption, and bodyweight for deaths from coronary heart disease, stroke, cancer, and an aggregate of other causes. We calculated the change in the number of deaths attributable to climate-related changes in weight and diets for the combination of four emissions pathways (a high emissions pathway, two medium emissions pathways, and a low emissions pathway) and three socioeconomic pathways (sustainable development, middle of the road, and more fragmented development), which each included six scenarios with variable climatic inputs. The model projects that by 2050, climate change will lead to per-person reductions of 3·2% (SD 0·4%) in global food availability, 4·0% (0·7%) in fruit and vegetable consumption, and 0·7% (0·1%) in red meat consumption. These changes will be associated with 529,000 climate-related deaths worldwide (95% CI 314,000-736,000), representing a 28% (95% CI 26-33) reduction in the number of deaths that would be avoided because of changes in dietary and weight-related risk factors between 2010 and 2050. Twice as many climate-related deaths were associated with reductions in fruit and vegetable consumption than with climate-related increases in the prevalence of underweight, and most climate-related deaths were projected to

  14. Modeling energy efficiency to improve air quality and health effects of China’s cement industry

    International Nuclear Information System (INIS)

    Zhang, Shaohui; Worrell, Ernst; Crijns-Graus, Wina; Krol, Maarten; Bruine, Marco de; Geng, Guangpo; Wagner, Fabian; Cofala, Janusz

    2016-01-01

    Highlights: • An integrated model was used to model the co-benefits for China’s cement industry. • PM_2_._5 would decrease by 2–4% by 2030 through improved energy efficiency. • 10,000 premature deaths would be avoided per year relative to the baseline scenario. • Total benefits are about two times higher than the energy efficiency costs. - Abstract: Actions to reduce the combustion of fossil fuels often decrease GHG emissions as well as air pollutants and bring multiple benefits for improvement of energy efficiency, climate change, and air quality associated with human health benefits. The China’s cement industry is the second largest energy consumer and key emitter of CO_2 and air pollutants, which accounts for 7% of China’s total energy consumption, 15% of CO_2, and 14% of PM_2_._5, respectively. In this study, a state-of-the art modeling framework is developed that comprises a number of different methods and tools within the same platform (i.e. provincial energy conservation supply curves, the Greenhouse Gases and Air Pollution Interactions and Synergies, ArcGIS, the global chemistry Transport Model, version 5, and Health Impact Assessment) to assess the potential for energy savings and emission mitigation of CO_2 and PM_2_._5, as well as the health impacts of pollution arising from China’s cement industry. The results show significant heterogeneity across provinces in terms of the potential for PM_2_._5 emission reduction and PM_2_._5 concentration, as well as health impacts caused by PM_2_._5. Implementation of selected energy efficiency measures would decrease total PM_2_._5 emissions by 2% (range: 1–4%) in 2020 and 4% (range: 2–8%) by 2030, compared to the baseline scenario. The reduction potential of provincial annual PM_2_._5 concentrations range from 0.03% to 2.21% by 2030 respectively, when compared to the baseline scenario. 10,000 premature deaths are avoided by 2020 and 2030 respectively relative to baseline scenario. The

  15. The Effect of Puberty Health Education based on Health Belief Model on Health Behaviors and Preventive among Teen Boys in Marivan, North West of Iran

    Directory of Open Access Journals (Sweden)

    Rohollah Valizade

    2016-08-01

    Full Text Available Background Maturity and its related sexual and mental changes are one of the most important events in the life of every individual. The purpose of this study was to determine the effect of puberty health education based on Health Belief Model on health behaviors and preventive among students boy first secondary school in Marivan city in 2015. Materials and Methods This research is an experimental intervention study that was conducted in 2015. The study participants were 64 male students of second year of first secondary school boys who were selected randomly with cluster sampling from two schools among 12 schools in first grade of high school in the Marivan city. Totally 32 students were selected randomly in the intervention group in the one of the schools and 32 students in the control group in the other school. The data collection instrument was a questionnaire developed by the researchers based on the health belief model. The validity and reliability of questionnaire was confirmed. Statistical analysis was carried out using SPSS version 17, Chi square, descriptive statistics and independent t-tests. Results Results showed significance differences after educational intervention in the mean scores of awareness, perceived susceptibility, perceived severity, perceived benefits, cues to action and performance in the intervention group (p

  16. Hails from the crypt: a terror management health model investigation of the effectiveness of health-oriented versus celebrity-oriented endorsements.

    Science.gov (United States)

    McCabe, Simon; Vail, Kenneth E; Arndt, Jamie; Goldenberg, Jamie L

    2014-03-01

    Interfacing the terror management health model with the meaning transfer model, we offer novel hypotheses concerning the effectiveness of celebrity and medical endorsements for consumer products and health behavior decisions. Studies 1 and 2 revealed that, compared with control topic primes, death thoughts in focal attention increased the effectiveness of health-oriented (doctor) endorsers but not culture-oriented (celebrity) endorsers, whereas death thoughts outside of focal attention increased the effectiveness of culture-oriented endorsers but not health-oriented endorsers. Studies 3 and 4 then focus more specifically on the valence and specificity of culture-oriented endorsements, revealing that death thoughts outside focal attention increase the effectiveness of culture-oriented endorsers only on the behaviors specifically endorsed and only when the endorser is characterized as possessing cultural value. Discussion focuses on everyday management of existential concerns and implications for persuasive communications in the health domain.

  17. From intermediate to final behavioral endpoints : Modeling cognitions in (cost-)effectiveness analyses in health promotion

    NARCIS (Netherlands)

    Prenger, Hendrikje Cornelia

    2012-01-01

    Cost-effectiveness analyses (CEAs) are considered an increasingly important tool in health promotion and psychology. In health promotion adequate effectiveness data of innovative interventions are often lacking. In case of many promising interventions the available data are inadequate for CEAs due

  18. A Global Model for Effective Use and Evaluation of e-Learning in Health

    Science.gov (United States)

    Farrington, Conor; Brayne, Carol

    2013-01-01

    Abstract Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of “information overload” have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and “digital literacy” and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning. PMID:23472702

  19. A global model for effective use and evaluation of e-learning in health.

    Science.gov (United States)

    Ruggeri, Kai; Farrington, Conor; Brayne, Carol

    2013-04-01

    Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

  20. Job Stress, Employee Health, and Organizational Effectiveness: A Facet Analysis, Model, and Literature Review.

    Science.gov (United States)

    Beehr, Terry A.; Newman, John E.

    1978-01-01

    The empirical research on job stress and employee health is reviewed within the context of six facets (environmental, personal, process, human consequences, organizational consequences, and time) of a seven facet conceptualization of the job stress-employee health research domain. Models are proposed for tying the facets together. (Author/SJL)

  1. Health effects models for nuclear power plant accident consequence analysis. Part 1, Introduction, integration, and summary: Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Evans, J.S. [Harvard School of Public Health, Boston, MA (United States); Abrahmson, S. [Wisconsin Univ., Madison, WI (United States); Bender, M.A. [Brookhaven National Lab., Upton, NY (United States); Boecker, B.B.; Scott, B.R. [Inhalation Toxicology Research Inst., Albuquerque, NM (United States); Gilbert, E.S. [Battelle Pacific Northwest Lab., Richland, WA (United States)

    1993-10-01

    This report is a revision of NUREG/CR-4214, Rev. 1, Part 1 (1990), Health Effects Models for Nuclear Power Plant Accident Consequence Analysis. This revision has been made to incorporate changes to the Health Effects Models recommended in two addenda to the NUREG/CR-4214, Rev. 1, Part 11, 1989 report. The first of these addenda provided recommended changes to the health effects models for low-LET radiations based on recent reports from UNSCEAR, ICRP and NAS/NRC (BEIR V). The second addendum presented changes needed to incorporate alpha-emitting radionuclides into the accident exposure source term. As in the earlier version of this report, models are provided for early and continuing effects, cancers and thyroid nodules, and genetic effects. Weibull dose-response functions are recommended for evaluating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary, and gastrointestinal syndromes are considered. Linear and linear-quadratic models are recommended for estimating the risks of seven types of cancer in adults - leukemia, bone, lung, breast, gastrointestinal, thyroid, and ``other``. For most cancers, both incidence and mortality are addressed. Five classes of genetic diseases -- dominant, x-linked, aneuploidy, unbalanced translocations, and multifactorial diseases are also considered. Data are provided that should enable analysts to consider the timing and severity of each type of health risk.

  2. Health effects of home energy efficiency interventions in England: a modelling study

    Science.gov (United States)

    Milner, James; Chalabi, Zaid; Das, Payel; Jones, Benjamin; Shrubsole, Clive; Davies, Mike; Wilkinson, Paul

    2015-01-01

    Objective To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. Design Health impact modelling study. Setting England. Participants English household population. Intervention Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. Main outcome Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. Results The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10 000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM2.5). Scenario (2) resulted in a negative impact of −728 (95% CI −864 to −592) QALYs per 10 000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in −539 (95% CI −678 to -399) QALYs per 10 000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants. Conclusions If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful

  3. Health effects

    International Nuclear Information System (INIS)

    Mahieu, L.

    1998-01-01

    The objectives of the research in the field of epidemiology , performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study. For radiobiology, the main objectives are: (1) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phase of its development, (2) to assess the genetic risks of maternal exposure to ionizing radiation, (3) to elucidate the mechanisms by which damage to the brain and mental retardation are caused in man after prenatal irradiation. The main achievements in these domains for 1997 are presented

  4. A simple model for discounting radiation health effects risks with time

    International Nuclear Information System (INIS)

    Sandquist, G.M.; Rogers, V.C.

    1988-01-01

    In estimating human health effects resulting from ionizing radiation exposures, it is often assumed that the age of the person at the time of exposure and the latency period for the appearance of any associated health effects are values that maximize the consequences of the exposure. Such assumptions are obviously conservative, but they can result in distortions and errors when nondiscounted radiation-related health effects arising from nonradiation-related risks. Human life expectancy obviously decreases with age, and the latency period for radiation-related health effects can range from a few years to several decades. For example, if a man is 45 yr old at the time of exposure and this exposure results in a lethal health effect 20 yr after exposure, then the expected number of years of life loss is ∼5 yr and not 70 yr, as is commonly assumed in radiation risk assessment studies. If one full-health effect is equivalent to 70 person-yr, then this example exposure results in only 0.07 full-health effects

  5. Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study.

    Directory of Open Access Journals (Sweden)

    Petra S Meier

    2016-02-01

    Full Text Available While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO "best buy" intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities.An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol; and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on mortality rates are as

  6. Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study

    Science.gov (United States)

    Meier, Petra S.; Holmes, John; Angus, Colin; Ally, Abdallah K.; Meng, Yang; Brennan, Alan

    2016-01-01

    Introduction While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO “best buy” intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities. Methods and Findings An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol); and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA) and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on

  7. Estimated Effects of Different Alcohol Taxation and Price Policies on Health Inequalities: A Mathematical Modelling Study.

    Science.gov (United States)

    Meier, Petra S; Holmes, John; Angus, Colin; Ally, Abdallah K; Meng, Yang; Brennan, Alan

    2016-02-01

    While evidence that alcohol pricing policies reduce alcohol-related health harm is robust, and alcohol taxation increases are a WHO "best buy" intervention, there is a lack of research comparing the scale and distribution across society of health impacts arising from alternative tax and price policy options. The aim of this study is to test whether four common alcohol taxation and pricing strategies differ in their impact on health inequalities. An econometric epidemiological model was built with England 2014/2015 as the setting. Four pricing strategies implemented on top of the current tax were equalised to give the same 4.3% population-wide reduction in total alcohol-related mortality: current tax increase, a 13.4% all-product duty increase under the current UK system; a value-based tax, a 4.0% ad valorem tax based on product price; a strength-based tax, a volumetric tax of £0.22 per UK alcohol unit (= 8 g of ethanol); and minimum unit pricing, a minimum price threshold of £0.50 per unit, below which alcohol cannot be sold. Model inputs were calculated by combining data from representative household surveys on alcohol purchasing and consumption, administrative and healthcare data on 43 alcohol-attributable diseases, and published price elasticities and relative risk functions. Outcomes were annual per capita consumption, consumer spending, and alcohol-related deaths. Uncertainty was assessed via partial probabilistic sensitivity analysis (PSA) and scenario analysis. The pricing strategies differ as to how effects are distributed across the population, and, from a public health perspective, heavy drinkers in routine/manual occupations are a key group as they are at greatest risk of health harm from their drinking. Strength-based taxation and minimum unit pricing would have greater effects on mortality among drinkers in routine/manual occupations (particularly for heavy drinkers, where the estimated policy effects on mortality rates are as follows: current tax

  8. Health Professionals' Explanations of Suicidal Behaviour: Effects of Professional Group, Theoretical Intervention Model, and Patient Suicide Experience.

    Science.gov (United States)

    Rothes, Inês Areal; Henriques, Margarida Rangel

    2017-12-01

    In a help relation with a suicidal person, the theoretical models of suicidality can be essential to guide the health professional's comprehension of the client/patient. The objectives of this study were to identify health professionals' explanations of suicidal behaviors and to study the effects of professional group, theoretical intervention models, and patient suicide experience in professionals' representations. Two hundred and forty-two health professionals filled out a self-report questionnaire. Exploratory principal components analysis was used. Five explanatory models were identified: psychological suffering, affective cognitive, sociocommunicational, adverse life events, and psychopathological. Results indicated that the psychological suffering and psychopathological models were the most valued by the professionals, while the sociocommunicational was seen as the least likely to explain suicidal behavior. Differences between professional groups were found. We concluded that training and reflection on theoretical models in general and in communicative issues in particular are needed in the education of health professionals.

  9. Modeling the effects of LID practices on streams health at watershed scale

    Science.gov (United States)

    Shannak, S.; Jaber, F. H.

    2013-12-01

    Increasing impervious covers due to urbanization will lead to an increase in runoff volumes, and eventually increase flooding. Stream channels adjust by widening and eroding stream bank which would impact downstream property negatively (Chin and Gregory, 2001). Also, urban runoff drains in sediment bank areas in what's known as riparian zones and constricts stream channels (Walsh, 2009). Both physical and chemical factors associated with urbanization such as high peak flows and low water quality further stress aquatic life and contribute to overall biological condition of urban streams (Maxted et al., 1995). While LID practices have been mentioned and studied in literature for stormwater management, they have not been studied in respect to reducing potential impact on stream health. To evaluate the performance and the effectiveness of LID practices at a watershed scale, sustainable detention pond, bioretention, and permeable pavement will be modeled at watershed scale. These measures affect the storm peak flows and base flow patterns over long periods, and there is a need to characterize their effect on stream bank and bed erosion, and aquatic life. These measures will create a linkage between urban watershed development and stream conditions specifically biological health. The first phase of this study is to design and construct LID practices at the Texas A&M AgriLife Research and Extension Center-Dallas, TX to collect field data about the performance of these practices on a smaller scale. The second phase consists of simulating the performance of LID practices on a watershed scale. This simulation presents a long term model (23 years) using SWAT to evaluate the potential impacts of these practices on; potential stream bank and bed erosion, and potential impact on aquatic life in the Blunn Watershed located in Austin, TX. Sub-daily time step model simulations will be developed to simulate the effectiveness of the three LID practices with respect to reducing

  10. Alternate Models of Sibling Status Effects on Health in Later Life

    Science.gov (United States)

    Falbo, Toni; Kim, Sunghun; Chen, Kuan-yi

    2009-01-01

    Although siblings are thought to be influential in child development, little is known about the influence of sibling status on the health of older adults. Using structural equation modeling, the authors created and tested a series of models with data from a sample (N = 3,968) of 1957 high school graduates from the Wisconsin Longitudinal Study. The…

  11. Effects of organically and conventionally produced feed on biomarkers of health in a chicken model

    NARCIS (Netherlands)

    Huber, M.; Vijver, L.P.L. van de; Parmentier, H.; Savelkoul, H.; Coulier, L.; Wopereis, S.; Verheij, E.; Greef, J. van der; Nierop, D.; Hoogenboom, R.A.P.

    2010-01-01

    Consumers expect organic products to be healthier. However, limited research has been performed to study the effect of organic food on health. The present study aimed to identify biomarkers of health to enable future studies in human subjects. A feeding experiment was performed in two generations of

  12. The effectiveness of nutritional education on the knowledge of diabetic patients using the health belief model

    Directory of Open Access Journals (Sweden)

    Gholamreza Sharifirad

    2009-02-01

    Full Text Available

    • BACKGROUND: Patients have a major role in the control and treatment of type 2 diabetes. So, knowledge of different aspects of this disease especially diet therapy is very important for these patients. This study was conducted to determine the effectiveness of the Health Belief Model (HBM on nutrition education in type 2 diabetic patients.
    • METHOD: Eighty eight type 2 diabetic patients attending Iranian Diabetes Association seminars were randomly selected to participate in the study (44 in intervention group and 44 in control group. The intervention was consisted of two educational sessions each one for 80 minutes. Data were collected by a validated and reliable questionnaire (58 questions before intervention and one month after intervention.
    • RESULTS: After intervention, knowledge scores increased in the intervention group compared to the control group (Mean differences in the intervention and test group: 22.68 ± 15.90 vs - 2.27 ± 17.30, P < 0.001. Perceived susceptibility increased significantly in the intervention group compared to the control group (27.5 ± 18.5 vs 3.9 ± 17.2, P < 0.001. The result was the same for perceived severity, perceived threatened and perceived benefits (P < 0.001. In contrast perceived barriers reduced in the intervention group compared to the control diet (-14.7 ± 13.3 vs 0.9 ± 13.9, P < 0.001. In the intervention group, behavior grades increased more than control group (34.61 ± 14.93 vs -0.23 ± 8.52, P < 0.001.
    • CONCLUSION: The efficacy of the health belief model in nutritional education to the diabetic patients was confirmed in the present study.

  13. The Effectiveness of Education Based on BASNEF Model Program in Promotion of Preventive Behavior of Leishmaniasis among Health Workers and Families under Health Centers Coverage

    Directory of Open Access Journals (Sweden)

    Ali Khani Jeihooni

    2012-06-01

    Full Text Available Background & Objective: Intervention of educational training in order to prevent the leishmaniasis in endemic areas seems necessary. This study was implemented with the aim of assessing the effectiveness of education based on BASNEF Model program in promotion of preventive behavior of leishmaniasis among Health workers and families under the coverage of Health centers. Materials & Methods: An intervention study was carried out in rural health centers during 2009. Questionnaires were completed by 20 health- workers of two rural health centers. Also 20 families under the coverage of this health centers were randomly selected to complete the questionnaire. Then four training sessions for health workers and 2 training sessions for the influential individuals were conducted to increase the enabling factors and solving their problems, weekly meetings was held with health workers representatives. After three months of health workers training the data were collected again and analyzed via Chi- Square, T Independent, T pair, Regression and Mann- Whitney statistics. Results: The mean score for to knowledge, attitude, behavior intension, enabling factors and health workers behaviors significantly increased after educational intervention in experimental group and influential individuals. The mean scores for knowledge, attitude, behavior intension, enabling factors and the behavior of attendant families under coverage also increased significantly. Conclusion: Educational program of BASNEF Model, leads to behavior change of health workers and eventually their training behavior leads to preventive actions in families under coverage.

  14. Modeling The Effects of Mother’s Age at First Birth on Child Health at Birth

    OpenAIRE

    Mbu Daniel Tambi

    2014-01-01

    This study models the impact of mother’s age at first birth on child health at birth in Cameroon. The objectives are: (1) investigate the implication of mother’s age at first birth on child health at birth; (2) examine the impact of mother’s age groups on birth weight, and (3) suggest economic policies to ameliorate the mother’s age – child health relationship. We make used of the control function approach to determine the relationship between mother’s age at first birth and birth...

  15. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes

    DEFF Research Database (Denmark)

    Smed, Sinne; Scarborough, P.; Rayner, M.

    2016-01-01

    Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. Results: The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled......Background/Objective: The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective...... reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Conclusions: Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark....

  16. Climate Effects on Health

    Science.gov (United States)

    ... Guidance and Trainings Webinars Data and Tools Publications Climate Effects on Health Recommend on Facebook Tweet Share ... effects has been excerpted from the Third National Climate Assessment’s Health Chapter . Additional information regarding the health ...

  17. The effect of an educational program based on health belief model on preventing osteoporosis in women

    Directory of Open Access Journals (Sweden)

    Ali Khani Jeihooni

    2015-01-01

    Full Text Available Background: Osteoporosis is the most common metabolic bone disease. The study′s objective is to investigate the effect of an educational program based on Health Belief Model (HBM on preventing osteoporosis in women. Methods: In this quasi-experimental study, 120 patients (60 experimental and 60 control who were registered under the health centers in Fasa City, Fars Province, Iran, were selected in 2014. A questionnaire consisting of demographic information, HBM constructs was used to measure nutrition and walking performance for the prevention of osteoporosis before, immediately after intervention, and 6 months later. Bone mineral density (BMD was recorded at the lumbar spine and femur before and 6 months after intervention. Results: The mean age of women participated in the study was 41.75 ± 5.4 years for the experimental group, and 41.77 ± 5.43 years for the control group. The mean body mass index was 22.44 ± 3.30 for the experimental group and 22.27 ± 3.05 for the control group. The average number of women deliveries for the experimental group was 2.57 ± 1.47 and 2.50 ± 1.19 for the control group. There is no significant difference between the two groups in education level (P = 0.771, marital status (P = 0.880, occupation (P = 0.673, breastfeeding (P = 0.769, smoking (P = 0.315, history of osteoporosis in the family (P = 0.378, history of special diseases (P = 0.769, and records of bone densitometry (P = 0.543. Immediately and 6 months after intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, internal cues to action, nutrition, and walking performance compared to the control group. Six months after intervention, the value of lumbar spine BMD T-score in the experimental group increased to 0.127, while in the control group it reduced to −0.043. The value of the hip BMD T-score in the intervention group

  18. MODELS SELECTED FOR CALCULATION OF DOSES, HEALTH EFFECTS AND ECONOMIC COSTS DUE TO ACCIDENTAL RADIONUCLIDE RELEASES FROM NUCLEAR POWER PLANTS

    Energy Technology Data Exchange (ETDEWEB)

    Strenge, D L; Baker, D A; Droppo, J G; McPherson, R B; Napier, B A; Nieves, L A; Soldat, J K

    1980-05-01

    Models are described for use in site-specific environmental consequence analysis of nuclear reactor accidents of Classes 3 through 9. The models presented relate radioactivity released to resulting doses, health effects, and costs of remedial actions. Specific models are presented for the major exposure pathways of airborne releases, waterborne releases and direct irradiation from activity within the facility buildings, such as the containment. Time-dependent atmospheric dispersion parameters, crop production parameters and other variable parameters are used in the models. The environmental effects are analyzed for several accident start times during the year.

  19. Modeling the effects of influenza vaccination of health care workers in hospital departments

    NARCIS (Netherlands)

    van den Dool, C.; Bonten, M. J. M.; Hak, E.; Wallinga, J.

    2009-01-01

    Nowadays health care worker (HCW) vaccination is widely recommended. Although the benefits of this strategy have been demonstrated in long-term care settings, no studies have been performed in regular hospital departments. We adapt a previously developed model of influenza transmission in a

  20. Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study.

    Science.gov (United States)

    Cobiac, Linda J; Tam, King; Veerman, Lennert; Blakely, Tony

    2017-02-01

    An increasing number of countries are implementing taxes on unhealthy foods and drinks to address the growing burden of dietary-related disease, but the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods is not well understood. Using a population model of dietary-related diseases and health care costs and food price elasticities, we simulated the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables, over the lifetime of the Australian population. The sizes of the taxes and subsidy were set such that, when combined as a package, there would be a negligible effect on average weekly expenditure on food (beverage tax (12,000 [95% UI: 2,100 to 21,000] DALYs). The fruit and vegetable subsidy (-13,000 [95% UI: -44,000 to 18,000] DALYs) was a cost-effective addition to the package of taxes. However, it did not necessarily lead to a net health benefit for the population when modelled as an intervention on its own, because of the possible adverse cross-price elasticity effects on consumption of other foods (e.g., foods high in saturated fat and salt). The study suggests that taxes and subsidies on foods and beverages can potentially be combined to achieve substantial improvements in population health and cost-savings to the health sector. However, the magnitude of health benefits is sensitive to measures of price elasticity, and further work is needed to incorporate potential benefits or harms associated with changes in other foods and nutrients that are not currently modelled, such as red and processed meats and fibre. With potentially large health benefits for the Australian population and large benefits in reducing health sector spending on the treatment of non-communicable diseases, the formulation of a tax and subsidy package should be given a more prominent role in Australia's public health nutrition strategy.

  1. Health economic modeling of the potential cost saving effects of Neurally Adjusted Ventilator Assist.

    Science.gov (United States)

    Hjelmgren, Jonas; Bruce Wirta, Sara; Huetson, Pernilla; Myrén, Karl-Johan; Göthberg, Sylvia

    2016-02-01

    Asynchrony between patient and ventilator breaths is associated with increased duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) controls MV through an esophageal reading of diaphragm electrical activity via a nasogastric tube mounted with electrode rings. NAVA has been shown to decrease asynchrony in comparison to pressure support ventilation (PSV). The objective of this study was to conduct a health economic evaluation of NAVA compared with PSV. We developed a model based on an indirect link between improved synchrony with NAVA versus PSV and fewer days spent on MV in synchronous patients. Unit costs for MV were obtained from the Swedish intensive care unit register, and used in the model along with NAVA-specific costs. The importance of each parameter (proportion of asynchronous patients, costs, and average MV duration) for the overall results was evaluated through sensitivity analyses. Base case results showed that 21% of patients ventilated with NAVA were asynchronous versus 52% of patients receiving PSV. This equals an absolute difference of 31% and an average of 1.7 days less on MV and a total cost saving of US$7886 (including NAVA catheter costs). A breakeven analysis suggested that NAVA was cost effective compared with PSV given an absolute difference in the proportion of asynchronous patients greater than 2.5% (49.5% versus 52% asynchronous patients with NAVA and PSV, respectively). The base case results were stable to changes in parameters, such as difference in asynchrony, duration of ventilation and daily intensive care unit costs. This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV. © The Author(s), 2015.

  2. Modelling the effect of hydrological change on estuarine health: An Australian Perspective. (Invited)

    Science.gov (United States)

    Bruce, L. C.; Adiyanti, S.; Ruibal, A. L.; Hipsey, M. R.

    2013-12-01

    Estuaries provide an important role in the filtering and transformation of carbon and nutrients from coastal catchments into the marine environment. Global trends including climate change, increased population, industrialization and agriculture have led to the rapid deterioration of estuarine ecosystems across the world. Within the Australian context, a particular concern is how changes to hydrological regimes, due to both water diversions and climate variability, are contributing to increased stress and consequent decline in estuarine health. In this study we report the modeling output of five Australian estuaries, each with different hydrological regimes and alternative management issues relating to altered hydrology: 1) The Yarra River estuary is a highly urbanized system, also receiving agriculturally derived nutrients, where the concern is the role of periodic hypoxia in reducing the assimilation capacity of nitrogen and thus increased risk of algal blooms forming in the coastal environment; 2) The upper Swan River estuary in Western Australia, which experiences persistent anoxia and hypoxia brought about by reduced flows has led to the commissioning of several oxygenation plants to alleviate stress on biodiversity and overall estuarine health; 3) The health of the Caboolture estuary in Queensland has deteriorated in the past decade with the aim of model development to quantify the various sources of surface and groundwater derived nutrients; 4) The construction of an additional channel to increase flushing in the Peel Harvey estuary in Western Australia was designed to control persistent harmful algal blooms; and 5) The Lower River Murray estuary experienced a prolonged drought that led to the development of acid sulfate soils and acid drainage deteriorating water quality. For these applications we applied 3-D hydrodynamic-biogeochemical models to determine underlying relationships between altered flow regimes, increased temperatures and the response of

  3. The effect of a rehabilitation nursing intervention model on improving the comprehensive health status of patients with hand burns.

    Science.gov (United States)

    Li, Lin; Dai, Jia-Xi; Xu, Le; Huang, Zhen-Xia; Pan, Qiong; Zhang, Xi; Jiang, Mei-Yun; Chen, Zhao-Hong

    2017-06-01

    To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns. Most studies of hand-burn patients have focused on functional recovery. There have been no studies involving a biological-psychological-social rehabilitation model of hand-burn patients. A randomized controlled design was used. Patients with hand burns were recruited to the study, and sixty patients participated. Participants were separated into two groups: (1) The rehabilitation intervention model group (n=30) completed the rehabilitation intervention model, which included the following measures: enhanced social support, intensive health education, comprehensive psychological intervention, and graded exercise. (2) The control group (n=30) completed routine treatment. Intervention lasted 5 weeks. Analysis of variance (ANOVA) and Student's t test were conducted. The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health. The differences between the index scores of the two groups were statistically significant. The rehabilitation intervention improved the comprehensive health status of patients with hand burns and has favorable clinical application. The comprehensive rehabilitation intervention model used here provides scientific guidance for medical staff aiming to improve the integrated health status of hand-burn patients and accelerate their recovery. What does this paper contribute to the wider global clinical community? Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. The application of the health effects models to the severe accident consequence analysis of nuclear power plants

    International Nuclear Information System (INIS)

    Yang Ling; Yeung, M.R.

    1998-01-01

    Health Effect Model (HEM) is an important model used in the analysis of severe accidents consequence of the Nuclear Power Plants (NPP). The accuracy of HEM affects the reliability of the assessment for the accidents consequences, and furthermore, the effectiveness of the emergency countermeasures taken for the health protection of the public around the NPPs. Based on the NUREG/CR4214 series reports, the paper sets appropriate parameters for HEM by studying both early and late HEMs used for domestic NPP accident consequence analysis. In the study, the Guangdong Daya Bay NPP is chosen as an example study to calculate the health risk of the Hong Kong population caused by Daya Bay NPP

  5. Modeled PM2.5 removal by trees in ten U.S. cities and associated health effects

    International Nuclear Information System (INIS)

    Nowak, David J.; Hirabayashi, Satoshi; Bodine, Allison; Hoehn, Robert

    2013-01-01

    Urban particulate air pollution is a serious health issue. Trees within cities can remove fine particles from the atmosphere and consequently improve air quality and human health. Tree effects on PM 2.5 concentrations and human health are modeled for 10 U.S. cities. The total amount of PM 2.5 removed annually by trees varied from 4.7 tonnes in Syracuse to 64.5 tonnes in Atlanta, with annual values varying from $1.1 million in Syracuse to $60.1 million in New York City. Most of these values were from the effects of reducing human mortality. Mortality reductions were typically around 1 person yr −1 per city, but were as high as 7.6 people yr −1 in New York City. Average annual percent air quality improvement ranged between 0.05% in San Francisco and 0.24% in Atlanta. Understanding the impact of urban trees on air quality can lead to improved urban forest management strategies to sustain human health in cities. -- Highlights: •Paper provides the first broad-scale estimates of city-wide tree impacts on PM 2.5 . •Trees improve overall air quality by intercepting particulate matter. •Particle resuspension can lead to short-term increases in pollutant concentrations. •Urban trees produce substantial health improvements and values. -- Air pollution modeling reveals broad-scale impacts of pollution removal by urban trees on PM 2.5 concentrations and human health

  6. Modeling the Health Effects of Expanding e-Cigarette Sales in the United States and United Kingdom

    Science.gov (United States)

    Kalkhoran, Sara; Glantz, Stanton A.

    2015-01-01

    IMPORTANCE The prevalence of electronic cigarette (e-cigarette) use is increasing. Population health effects will depend on cigarette smoking behaviors, levels of dual use with conventional cigarettes, and e-cigarette toxicity. OBJECTIVE To evaluate potential health effects of various scenarios of increasing promotion and use of e-cigarettes. DESIGN, SETTING, AND PARTICIPANTS A base case model was developed using data on actual cigarette and e-cigarette use patterns that quantifies transitions from an initial state of no cigarette or e-cigarette use to 1 of 5 final states: never use of cigarettes or e-cigarettes, cigarette use, e-cigarette use, dual use of cigarettes and e-cigarettes, or quit. Seven scenarios were created that cover a range of use patterns, depending on how the e-cigarette market might develop, as well as a range of possible long-term health effects of e-cigarette use. Scenarios for changes from the base case were evaluated using Monte Carlo simulations. Separate sets of base case model parameters were evaluated for the US and UK populations. MAIN OUTCOMES AND MEASURES We assigned unitless health “costs” for each final state on a scale of 0 to 100. Population health “costs” were compared with the base case (status quo) assuming e-cigarette use health “costs” from 1% to 50% as dangerous as conventional cigarette use health costs. RESULTS Compared with the base case, a harm reduction scenario in which e-cigarette use increases only among smokers who are interested in quitting with more quit attempts and no increased initiation of e-cigarette use among nonsmokers, and another scenario in which e-cigarettes are taken up only by youth who would have smoked conventional cigarettes, had population-level health benefits regardless of e-cigarette health costs in both the United States and United Kingdom. Conversely, scenarios in which e-cigarette promotion leads to renormalization of cigarette smoking or e-cigarettes are used primarily by youth

  7. Communication models in environmental health.

    Science.gov (United States)

    Guidotti, Tee L

    2013-01-01

    Communication models common in environmental health are not well represented in the literature on health communication. Risk communication is a systematic approach to conveying essential information about a specific environmental issue and a framework for thinking about community risk and the alternatives for dealing with it. Crisis communication is intended to provide essential information to people facing an emergency in order to mitigate its effects and to enable them to make appropriate decisions, and it is primarily used in emergency management. Corporate communication is intended to achieve a change in attitude or perception of an organization, and its role in environmental health is usually public relations or to rehabilitate a damaged reputation. Environmental health education is a more didactic approach to science education with respect to health and the environment. Social marketing uses conventional marketing methods to achieve a socially desirable purpose but is more heavily used in health promotion generally. Communication models and styles in environmental health are specialized to serve the needs of the field in communicating with the community. They are highly structured and executed in different ways but have in common a relative lack of emphasis on changing personal or lifestyle behavior compared with health promotion and public health in general and a tendency to emphasize content on specific environmental issues and decision frameworks for protecting oneself or the community through collective action.

  8. The effect of vitrification on embryo development and subsequently postnatal health using a mouse model

    OpenAIRE

    Raja Khalif, Raja

    2016-01-01

    Animal models have shown that vitrification impairs ultrastructure and developmental potential of the oocyte, embryo survival rate, pregnancy rate and results in low birth weight of offspring but any long term effects on offspring are still unknown. In this study, embryos were vitrified at the 8-cell stage and kept in LN2. The first experiment investigated the effect of vitrification on numbers of surviving cells (comparing vitrified and non-vitrified embryos). The blastocysts developed from ...

  9. Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis

    OpenAIRE

    Baggaley, R. F.; Irvine, M. A.; Leber, W.; Cambiano, V.; Figueroa, J.; McMullen, H.; Anderson, J.; Santos, A. C.; Terris-Prestholt, F.; Miners, A.; Hollingsworth, T. D.; Griffiths, C. J.

    2017-01-01

    BACKGROUND: Early HIV diagnosis reduces morbidity, mortality, the probability of onward transmission, and their associated costs, but might increase cost because of earlier initiation of antiretroviral treatment (ART). We investigated this trade-off by estimating the cost-effectiveness of HIV screening in primary care. METHODS: We modelled the effect of the four-times higher diagnosis rate observed in the intervention arm of the RHIVA2 randomised controlled trial done in Hackney, London (UK),...

  10. Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis

    OpenAIRE

    Baggaley, Rebecca F; Irvine, Michael A; Leber, Werner; Cambiano, Valentina; Figueroa, Jose; McMullen, Heather; Anderson, Jane; Santos, Andreia C; Terris-Prestholt, Fern; Miners, Alec; Hollingsworth, T Déirdre; Griffiths, Chris J

    2017-01-01

    Summary Background Early HIV diagnosis reduces morbidity, mortality, the probability of onward transmission, and their associated costs, but might increase cost because of earlier initiation of antiretroviral treatment (ART). We investigated this trade-off by estimating the cost-effectiveness of HIV screening in primary care. Methods We modelled the effect of the four-times higher diagnosis rate observed in the intervention arm of the RHIVA2 randomised controlled trial done in Hackney, London...

  11. Food quality, effects on health and sustainability today: a model case report.

    Science.gov (United States)

    Borroni, Vittorio Natale; Fargion, Silvia; Mazzocchi, Alessandra; Giachetti, Marco; Lanzarini, Achille; Dall'Asta, Margherita; Scazzina, Francesca; Agostoni, Carlo

    2017-02-01

    The Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico is a five-century institution that, besides the unique clinical role in the center of Milan, may rely on benefactor donations such as fields and farming houses not far from the city, for a total of 8500 ha, all managed by the "Sviluppo Ca' Granda' Foundation". Presently, the main products of these fields are represented by rice and cow's milk. During the latest years, farmers and managers have developed a model of sustainable food production, with great attention to the product quality based on compositional analysis and functional nutritional characteristics. This experience represents a new holistic model of food production and consumption, taking great care of both sustainability and health.

  12. The Effect of Education Based on the Health Belief Model on Osteoporosis Prevention Behaviors in Female High School Students

    Directory of Open Access Journals (Sweden)

    Mousaviasl

    2016-09-01

    Full Text Available Background Osteoporosis is one of the most common metabolic bone diseases and is the silent epidemic of this era. Objectives This study evaluates the effect of education that is based on the health belief model on promoting osteoporosis prevention behaviors among female high school students. Methods In this two-group interventional study, 172 students age 11 to 14 years (experimental group = 86 subjects; control group = 86 subjects were randomly selected from Khorramshahr high schools using multistage sampling. Data were collected before the intervention and two months after its completion using a researcher-made questionnaire with four parts: demographic questions, knowledge questions, questions related to the health belief model constructs, and questions regarding preventive behaviors. Data was analyzed using SPSS 22 software and by applying the Mann-Whitney test, the analysis of covariance procedure, and the Wilcoxon statistical test. Results After the intervention, significant statistical differences were seen between the experimental and control groups in mean scores of knowledge, health belief model constructs, and preventive behaviors. Conclusions The education based on health belief model plays an important role in increasing knowledge and improving osteoporosis prevention behaviors in students.

  13. A national prediction model for PM2.5 component exposures and measurement error-corrected health effect inference.

    Science.gov (United States)

    Bergen, Silas; Sheppard, Lianne; Sampson, Paul D; Kim, Sun-Young; Richards, Mark; Vedal, Sverre; Kaufman, Joel D; Szpiro, Adam A

    2013-09-01

    Studies estimating health effects of long-term air pollution exposure often use a two-stage approach: building exposure models to assign individual-level exposures, which are then used in regression analyses. This requires accurate exposure modeling and careful treatment of exposure measurement error. To illustrate the importance of accounting for exposure model characteristics in two-stage air pollution studies, we considered a case study based on data from the Multi-Ethnic Study of Atherosclerosis (MESA). We built national spatial exposure models that used partial least squares and universal kriging to estimate annual average concentrations of four PM2.5 components: elemental carbon (EC), organic carbon (OC), silicon (Si), and sulfur (S). We predicted PM2.5 component exposures for the MESA cohort and estimated cross-sectional associations with carotid intima-media thickness (CIMT), adjusting for subject-specific covariates. We corrected for measurement error using recently developed methods that account for the spatial structure of predicted exposures. Our models performed well, with cross-validated R2 values ranging from 0.62 to 0.95. Naïve analyses that did not account for measurement error indicated statistically significant associations between CIMT and exposure to OC, Si, and S. EC and OC exhibited little spatial correlation, and the corrected inference was unchanged from the naïve analysis. The Si and S exposure surfaces displayed notable spatial correlation, resulting in corrected confidence intervals (CIs) that were 50% wider than the naïve CIs, but that were still statistically significant. The impact of correcting for measurement error on health effect inference is concordant with the degree of spatial correlation in the exposure surfaces. Exposure model characteristics must be considered when performing two-stage air pollution epidemiologic analyses because naïve health effect inference may be inappropriate.

  14. Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine.

    Science.gov (United States)

    Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

    2017-11-01

    The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.

  15. The short-term effects of an integrated care model for the frail elderly on health, quality of life, health care use and satisfaction with care

    Directory of Open Access Journals (Sweden)

    Wilhelmina Mijntje Looman

    2014-12-01

    Full Text Available Purpose: This study explores the short-term value of integrated care for the frail elderly by evaluating the effects of the Walcheren Integrated Care Model on health, quality of life, health care use and satisfaction with care after three months. Intervention: Frailty was preventively detected in elderly living at home with the Groningen Frailty Indicator. Geriatric nurse practitioners and secondary care geriatric nursing specialists were assigned as case managers and co-ordinated the care agreed upon in a multidisciplinary meeting. The general practitioner practice functions as a single entry point and supervises the co-ordination of care. The intervention encompasses task reassignment between nurses and doctors and consultations between primary, secondary and tertiary care providers. The entire process was supported by multidisciplinary protocols and web-based patient files. Methods: The design of this study was quasi-experimental. In this study, 205 frail elderly patients of three general practitioner practices that implemented the integrated care model were compared with 212 frail elderly patients of five general practitioner practices that provided usual care. The outcomes were assessed using questionnaires. Baseline measures were compared with a three-month follow-up by chi-square tests, t-tests and regression analysis. Results and conclusion: In the short term, the integrated care model had a significant effect on the attachment aspect of quality of life. The frail elderly patients were better able to obtain the love and friendship they desire. The use of care did not differ despite the preventive element and the need for assessments followed up with case management in the integrated care model. In the short term, there were no significant changes in health. As frailty is a progressive state, it is assumed that three months are too short to influence changes in health with integrated care models. A more longitudinal approach is

  16. Effects of zinc and "health belief model" education on upper respiratory infections in hajj travelers: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mahmoudian S.A

    2007-09-01

    Full Text Available Background: The common cold is the most prevalent sickness and an important cause of absence from job. Furthermore, it often disturbs travel, including the practice of hajj, causing the use of many inappropriate drugs by these travelers. The health belief model is a psychological model that attempts to explain and predict health behaviors. The purpose of this study was to determine the effects of zinc and health belief model based educational intervention on the behavior of hajj travelers with regard to viral upper respiratory tract infections (URTI.Methods: This double-blinded randomized controlled trial was performed among hajj travelers in 2005. Preventive measures were randomly allocated to four groups: 1- education + zinc sulfate. 2- education + placebo. 3- zinc sulfate only 4- placebo only. Data regarding incidence and duration of URTIs, background disorders, vaccination and health behaviors for cold were gathered by questionnaire by physicians and finally analyzed by SPSS 11.5 software using chi-square, t-test and independent samples t-test.Results: A total of 646 travelers were studied. The incidence of common cold in groups receiving zinc were significantly less than that for those receiving the placebo. (P=0.05. However, incidence was statistically the same for those who received education versus those who did not. Use of handkerchief was the most prevalent behavior and use of mask was the least prevalent behavior. Mean duration of symptoms was less in those receiving zinc and education (3.7 days comparing to those who received placebo and education (5.6 days.  Conclusions: This study showed that zinc consumption can decrease the incidence and duration of the common cold. Health belief model based education could promote some preventive behaviors although most people do not take advantage of them. We recommend the use of zinc by those attending hajj.

  17. School-Based Mental Health Services: Definitions and Models of Effective Practice

    Science.gov (United States)

    Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.

    2017-01-01

    School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…

  18. Taxes and Subsidies for Improving Diet and Population Health in Australia: A Cost-Effectiveness Modelling Study.

    Directory of Open Access Journals (Sweden)

    Linda J Cobiac

    2017-02-01

    Full Text Available An increasing number of countries are implementing taxes on unhealthy foods and drinks to address the growing burden of dietary-related disease, but the cost-effectiveness of combining taxes on unhealthy foods and subsidies on healthy foods is not well understood.Using a population model of dietary-related diseases and health care costs and food price elasticities, we simulated the effect of taxes on saturated fat, salt, sugar, and sugar-sweetened beverages and a subsidy on fruits and vegetables, over the lifetime of the Australian population. The sizes of the taxes and subsidy were set such that, when combined as a package, there would be a negligible effect on average weekly expenditure on food (<1% change. We evaluated the cost-effectiveness of the interventions individually, then determined the optimal combination based on maximising net monetary benefit at a threshold of AU$50,000 per disability-adjusted life year (DALY. The simulations suggested that the combination of taxes and subsidy might avert as many as 470,000 DALYs (95% uncertainty interval [UI]: 420,000 to 510,000 in the Australian population of 22 million, with a net cost-saving of AU$3.4 billion (95% UI: AU$2.4 billion to AU$4.6 billion; US$2.3 billion to the health sector. Of the taxes evaluated, the sugar tax produced the biggest estimates of health gain (270,000 [95% UI: 250,000 to 290,000] DALYs averted, followed by the salt tax (130,000 [95% UI: 120,000 to 140,000] DALYs, the saturated fat tax (97,000 [95% UI: 77,000 to 120,000] DALYs, and the sugar-sweetened beverage tax (12,000 [95% UI: 2,100 to 21,000] DALYs. The fruit and vegetable subsidy (-13,000 [95% UI: -44,000 to 18,000] DALYs was a cost-effective addition to the package of taxes. However, it did not necessarily lead to a net health benefit for the population when modelled as an intervention on its own, because of the possible adverse cross-price elasticity effects on consumption of other foods (e.g., foods high in

  19. Health effects of radon

    International Nuclear Information System (INIS)

    Easterly, C.

    1994-01-01

    Exposure of people to radon has taken on increased interest during the last decade because of the understanding that buildings can serve to trap radon and its daughters, and thereby build up undesirable concentrations of these radioactive elements. Numerous studies of underground miners (often uranium miners) have shown an increased risk of lung cancer in comparison with nonexposed populations. Laboratory animals exposed to radon daughters also develop lung cancer. The abundant epidemiological and experimental data have established the carcinogenicity of radon progeny. Those observations are of considerable importance, because uranium, from which radon and its progeny arise, is ubiquitous in the earth's crust, including coal mines. Risk estimates of the health effects of long-term exposures at relatively low levels require continued development, especially to address the potential health effects of radon and radon daughters in homes and occupational settings where the exposure levels are less than levels in underground uranium and other metal mines that have been the subject of epidemiological studies. Two approaches can be used to characterize the lung-cancer risks associated with radon-daughter exposure: mathematical representations of the respiratory tract that model radiation doses to target cells and epidemiological investigation of exposed populations, mainly underground uranium miners. The mathematically-based dosimetric approach provides an estimate of lung cancer risk related to radon-daughter exposure based specifically on modeling of the dose to target cells. The various dosimetric models all require assumptions, some of which are not subject to direct verification, as to breathing rates; the deposition of radon daughters in the respiratory tract; and the type, nature, and location of the target cells for cancer induction. The most recent large committee effort drawn together to evaluate this issue was sponsored by the National Research Council

  20. A cooperative reduction model for regional air pollution control in China that considers adverse health effects and pollutant reduction costs.

    Science.gov (United States)

    Xie, Yujing; Zhao, Laijun; Xue, Jian; Hu, Qingmi; Xu, Xiang; Wang, Hongbo

    2016-12-15

    How to effectively control severe regional air pollution has become a focus of global concern recently. The non-cooperative reduction model (NCRM) is still the main air pollution control pattern in China, but it is both ineffective and costly, because each province must independently fight air pollution. Thus, we proposed a cooperative reduction model (CRM), with the goal of maximizing the reduction in adverse health effects (AHEs) at the lowest cost by encouraging neighboring areas to jointly control air pollution. CRM has two parts: a model of optimal pollutant removal rates using two optimization objectives (maximizing the reduction in AHEs and minimizing pollutant reduction cost) while meeting the regional pollution control targets set by the central government, and a model that allocates the cooperation benefits (i.e., health improvement and cost reduction) among the participants according to their contributions using the Shapley value method. We applied CRM to the case of sulfur dioxide (SO 2 ) reduction in Yangtze River Delta region. Based on data from 2003 to 2013, and using mortality due to respiratory and cardiovascular diseases as the health endpoints, CRM saves 437 more lives than NCRM, amounting to 12.1% of the reduction under NCRM. CRM also reduced costs by US $65.8×10 6 compared with NCRM, which is 5.2% of the total cost of NCRM. Thus, CRM performs significantly better than NCRM. Each province obtains significant benefits from cooperation, which can motivate them to actively cooperate in the long term. A sensitivity analysis was performed to quantify the effects of parameter values on the cooperation benefits. Results shown that the CRM is not sensitive to the changes in each province's pollutant carrying capacity and the minimum pollutant removal capacity, but sensitive to the maximum pollutant reduction capacity. Moreover, higher cooperation benefits will be generated when a province's maximum pollutant reduction capacity increases. Copyright

  1. Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia

    Directory of Open Access Journals (Sweden)

    Paul C. Hewett

    2016-08-01

    Full Text Available Abstract Background Provision of HIV prevention and sexual and reproductive health services in Zambia is largely characterized by discrete service provision with weak client referral and linkage. The literature reveals gaps in the continuity of care for HIV and sexual and reproductive health. This study assessed whether improved service delivery models increased the uptake and cost-effectiveness of HIV and sexual and reproductive health services. Methods Adult clients 18+ years of age accessing family planning (females, HIV testing and counseling (females and males, and male circumcision services (males were recruited, enrolled and individually randomized to one of three study arms: 1 the standard model of service provision at the entry point (N = 1319; 2 an enhanced counseling and referral to add-on service with follow-up (N = 1323; and 3 the components of study arm two, with the additional offer of an escort (N = 1321. Interviews were conducted with the same clients at baseline, six weeks and six months. Uptake of services for HIV, family planning, male circumcision, and cervical cancer screening at six weeks and six months were the primary endpoints. Pairwise chi-square and multivariable logistic regression statistical tests assessed differences across study arms, which were also assessed for incremental cost-efficiency and cost-effectiveness. Results A total of 3963 clients, 1920 males and 2043 females, were enrolled; 82 % of participants at six weeks were tracked and 81 % at six months; follow-up rates did not vary significantly by study arm. The odds of clients accessing HIV testing and counseling, cervical cancer screening services among females, and circumcision services among males varied significantly by study arm at six weeks and six months; less consistent findings were observed for HIV care and treatment. Client uptake of family planning services did not vary significantly by study arm. Integrated services were found

  2. Improving Health Outcomes of Children through Effective Parenting: Model and Methods

    Science.gov (United States)

    Okafor, Martha; Sarpong, Daniel F.; Ferguson, Aneeqah; Satcher, David

    2013-01-01

    This article reports on the design, development, testing and presentation of preliminary evidence of a translational, culturally relevant parenting education model, titled Smart and Secured Children (SSC). SSC, a quality parenting curriculum, prepares disparate African American parents as leaders for transforming their parenting behaviors and leading their peers and community in changing existing parenting culture. The article recommends expanded utility of identified promising processes, approaches and practices to engage African American parents to lead in addressing health inequity conditions in their families and communities. It adds to the growing scientific literature on the association between parent–child relationship quality and a wide variety of children physical, emotional and social outcomes. SSC applied principles of developmental theories; community based participatory research (CBPR), and iterative Delphi method between the community stakeholders, parents and researchers. The delivery approach of SSC was revamped from professional-led to parent-led content presentation and delivery methods using a conversational learning approach, referred to as ‘conversepedia’. Parents’ leadership development training and delivery of this curriculum in social supportive groups improved their mental wellbeing, parenting capacity and leadership skills. Parents do matter and can choose positive influence in their lives and are capable of reversing negative peer influence. PMID:24366048

  3. Improving Health Outcomes of Children through Effective Parenting: Model and Methods

    Directory of Open Access Journals (Sweden)

    Martha Okafor

    2013-12-01

    Full Text Available This article reports on the design, development, testing and presentation of preliminary evidence of a translational, culturally relevant parenting education model, titled Smart and Secured Children (SSC. SSC, a quality parenting curriculum, prepares disparate African American parents as leaders for transforming their parenting behaviors and leading their peers and community in changing existing parenting culture. The article recommends expanded utility of identified promising processes, approaches and practices to engage African American parents to lead in addressing health inequity conditions in their families and communities. It adds to the growing scientific literature on the association between parent–child relationship quality and a wide variety of children physical, emotional and social outcomes. SSC applied principles of developmental theories; community based participatory research (CBPR, and iterative Delphi method between the community stakeholders, parents and researchers. The delivery approach of SSC was revamped from professional-led to parent-led content presentation and delivery methods using a conversational learning approach, referred to as ‘conversepedia’. Parents’ leadership development training and delivery of this curriculum in social supportive groups improved their mental wellbeing, parenting capacity and leadership skills. Parents do matter and can choose positive influence in their lives and are capable of reversing negative peer influence.

  4. Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach.

    Directory of Open Access Journals (Sweden)

    John Paul Ekwaru

    Full Text Available The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach.We developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY, from a school system's cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate.The incremental cost-effectiveness ratio(ICER of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER < CA$50,000. In probabilistic sensitivity analysis, APPLE Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICERhealth promotion, such as APPLE Schools is a cost-effective intervention for obesity prevention and reduction of chronic disease risk over the lifetime. Expanding the coverage and allocating resources towards school-based programs like the APPLE Schools program, is likely to reduce the public health burden of obesity and chronic diseases.

  5. Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach.

    Science.gov (United States)

    Ekwaru, John Paul; Ohinmaa, Arto; Tran, Bach Xuan; Setayeshgar, Solmaz; Johnson, Jeffrey A; Veugelers, Paul J

    2017-01-01

    The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach. We developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY), from a school system's cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate. The incremental cost-effectiveness ratio(ICER) of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICERSchool-based health promotion, such as APPLE Schools is a cost-effective intervention for obesity prevention and reduction of chronic disease risk over the lifetime. Expanding the coverage and allocating resources towards school-based programs like the APPLE Schools program, is likely to reduce the public health burden of obesity and chronic diseases.

  6. Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries

    Science.gov (United States)

    Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

    2015-01-01

    Summary Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011. Findings Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Interpretation Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax

  7. Financing universal health coverage--effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries.

    Science.gov (United States)

    Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

    2015-07-18

    How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995-2011. Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9.86 (95% CI 3.92-15.8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16.7, 9.16 to 24.3), but not for consumption taxes on goods and services (-$4.37, -12.9 to 4.11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6.74 percentage points (95% CI 0.87-12.6) and the extent of financial coverage by 11.4 percentage points (5.51-17.2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax policies within a pro-poor framework might accelerate progress toward achieving major

  8. Modeling minority stress effects on homelessness and health disparities among young men who have sex with men.

    Science.gov (United States)

    Bruce, Douglas; Stall, Ron; Fata, Aimee; Campbell, Richard T

    2014-06-01

    Sexual minority youth are more likely to experience homelessness, and homeless sexual minority youth report greater risk for mental health and substance abuse symptoms than homeless heterosexual youth, yet few studies have assessed determinants that help explain the disparities. Minority stress theory proposes that physical and mental health disparities among sexual minority populations may be explained by the stress produced by living in heterosexist social environments characterized by stigma and discrimination directed toward sexual minority persons. We used data from a sample of 200 young men who have sex with men (YMSM) (38 % African American, 26.5 % Latino/Hispanic, 23.5 % White, 12 % multiracial/other) to develop an exploratory path model measuring the effects of experience and internalization of sexual orientation stigma on depression and substance use via being kicked out of home due to sexual orientation and current homelessness. Direct significant paths were found from experience of sexual orientation-related stigma to internalization of sexual orientation-related stigma, having been kicked out of one's home, experiencing homelessness during the past year, and major depressive symptoms during the past week. Having been kicked out of one's home had a direct significant effect on experiencing homelessness during the past 12 months and on daily marijuana use. Internalization of sexual orientation-related stigma and experiencing homelessness during the past 12 months partially mediated the direct effect of experience of sexual orientation-related stigma on major depressive symptoms. Our empirical testing of the effects of minority stress on health of YMSM advances minority stress theory as a framework for investigating health disparities among this population.

  9. The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model.

    Science.gov (United States)

    Maddineshat, Maryam; Hashemi, Mitra; Besharati, Reza; Gholami, Sepideh; Ghavidel, Fatemeh

    2018-01-01

    Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick's model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. The students have evaluated clinical supervision as a useful approach, and appreciated the instructor's supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick's model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students' attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. The results of clinical mental health teaching through clinical supervision and Kirkpatrick's model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To

  10. Effect of Educational Intervention on Oral Health Behaviour based on Health Belief Model in Female Secondary School Students of Paveh in 2011

    Directory of Open Access Journals (Sweden)

    Mostafa Hosseini

    2014-04-01

    Full Text Available Introduction: Education is a powerful tool in reducing dental diseases. It is known as an essential part of oral health services. This study evaluated the impact of education on oral health behavior of students based on health belief model. Methods: This educational intervention study was carried out on secondary school girls of Paveh, Iran in 2011. A standard questionnaire was used to collect the data, including demographic characteristics, dimensions of health belief model and performance of students before and after intervention. The educational intervention was conducted over three sessions. To examine differences between groups in terms of demographic factors, dimensions of health belief model and performance status before and after the intervention, Chi-square test and logistic regression were used. P0.05. Conclusion: The importance of education caused promoting dental health behaviors of students. It also emphasized adopting more appropriate methods for oral health training.

  11. Cost-effectiveness of the Mental Health and Development model for schizophrenia-spectrum and bipolar disorders in rural Kenya.

    Science.gov (United States)

    de Menil, V; Knapp, M; McDaid, D; Raja, S; Kingori, J; Waruguru, M; Wood, S K; Mannarath, S; Lund, C

    2015-10-01

    The treatment gap for serious mental disorders across low-income countries is estimated to be 89%. The model for Mental Health and Development (MHD) offers community-based care for people with mental disorders in 11 low- and middle-income countries. In Kenya, using a pre-post design, 117 consecutively enrolled participants with schizophrenia-spectrum and bipolar disorders were followed-up at 10 and 20 months. Comparison outcomes were drawn from the literature. Costs were analysed from societal and health system perspectives. From the societal perspective, MHD cost Int$ 594 per person in the first year and Int$ 876 over 2 years. The cost per healthy day gained was Int$ 7.96 in the first year and Int$ 1.03 over 2 years - less than the agricultural minimum wage. The cost per disability-adjusted life year averted over 2 years was Int$ 13.1 and Int$ 727 from the societal and health system perspectives, respectively, on par with antiretrovirals for HIV. MHD achieved increasing returns over time. The model appears cost-effective and equitable, especially over 2 years. Its affordability relies on multi-sectoral participation nationally and internationally.

  12. Public health impact and cost effectiveness of routine childhood vaccination for hepatitis a in Jordan: a dynamic model approach.

    Science.gov (United States)

    Hayajneh, Wail A; Daniels, Vincent J; James, Cerise K; Kanıbir, Muhammet Nabi; Pilsbury, Matthew; Marks, Morgan; Goveia, Michelle G; Elbasha, Elamin H; Dasbach, Erik; Acosta, Camilo J

    2018-03-07

    As the socioeconomic conditions in Jordan have improved over recent decades the disease and economic burden of Hepatitis A has increased. The purpose of this study is to assess the potential health and economic impact of a two-dose hepatitis A vaccine program covering one-year old children in Jordan. We adapted an age-structured population model of hepatitis A transmission dynamics to project the epidemiologic and economic impact of vaccinating one-year old children for 50 years in Jordan. The epidemiologic model was calibrated using local data on hepatitis A in Jordan. These data included seroprevalence and incidence data from the Jordan Ministry of Health as well as hospitalization data from King Abdullah University Hospital in Irbid, Jordan. We assumed 90% of all children would be vaccinated with the two-dose regimen by two years of age. The economic evaluation adopted a societal perspective and measured benefits using the quality-adjusted life-year (QALY). The modeled vaccination program reduced the incidence of hepatitis A in Jordan by 99%, 50 years after its introduction. The model projected 4.26 million avoided hepatitis A infections, 1.42 million outpatient visits, 22,475 hospitalizations, 508 fulminant cases, 95 liver transplants, and 76 deaths over a 50 year time horizon. In addition, we found, over a 50 year time horizon, the vaccination program would gain 37,502 QALYs and save over $42.6 million in total costs. The vaccination program became cost-saving within 6 years of its introduction and was highly cost-effective during the first 5 years. A vaccination program covering one-year old children is projected to be a cost-saving intervention that will significantly reduce the public health and economic burden of hepatitis A in Jordan.

  13. Climate changes and their effects in the public health: use of poisson regression models

    Directory of Open Access Journals (Sweden)

    Jonas Bodini Alonso

    2010-08-01

    Full Text Available In this paper, we analyze the daily number of hospitalizations in São Paulo City, Brazil, in the period of January 01, 2002 to December 31, 2005. This data set relates to pneumonia, coronary ischemic diseases, diabetes and chronic diseases in different age categories. In order to verify the effect of climate changes the following covariates are considered: atmosphere pressure, air humidity, temperature, year season and also a covariate related to the week day when the hospitalization occurred. The possible effects of the assumed covariates in the number of hospitalization are studied using a Poisson regression model in the presence or not of a random effect which captures the possible correlation among the hospitalization accounting for the different age categories in the same day and the extra-Poisson variability for the longitudinal data. The inferences of interest are obtained using the Bayesian paradigm and MCMC (Markov chain Monte Carlo methods.Neste artigo, analisamos os dados relativos aos números diários de hospitalizações na cidade de São Paulo, Brasil no período de 01/01/2002 a 31/12/2005 devido a pneumonia, doenças isquêmicas, diabetes e doenças crônicas e de acordo com a faixa etária. Com o objetivo de estudar o efeito de mudanças climáticas são consideradas algumas covariáveis climáticas os índices diários de pressão atmosférica, umidade do ar, temperatura e estação do ano, e uma covariável relacionada ao dia da semana da ocorrência de hospitalização. Para verificar os efeitos das covariáveis nas respostas dadas pelo numero de hospitalizações, consideramos um modelo de regressão de Poisson na presença ou não de um efeito aleatório que captura a possível correlação entre as contagens para as faixas etárias de um mesmo dia e a variabilidade extra-poisson para os dados longitudinais. As inferências de interesse são obtidas usando o paradigma bayesiano e métodos de simulação MCMC (Monte Carlo

  14. The use of random-effects models to identify health care center-related characteristics modifying the effect of antipsychotic drugs.

    Science.gov (United States)

    Nordon, Clementine; Battin, Constance; Verdoux, Helene; Haro, Josef Maria; Belger, Mark; Abenhaim, Lucien; van Staa, Tjeerd Pieter

    2017-01-01

    A case study was conducted, exploring methods to identify drugs effects modifiers, at a health care center level. Data were drawn from the Schizophrenia Outpatient Health Outcome cohort, including hierarchical information on 6641 patients, recruited from 899 health care centers from across ten European countries. Center-level characteristics included the following: psychiatrist's gender, age, length of practice experience, practice setting and type, countries' Healthcare System Efficiency score, and psychiatrist density in the country. Mixed multivariable linear regression models were used: 1) to estimate antipsychotic drugs' effectiveness (defined as the association between patients' outcome at 3 months - dependent variable, continuous - and antipsychotic drug initiation at baseline - drug A vs other antipsychotic drug); 2) to estimate the similarity between clustered data (using the intra-cluster correlation coefficient); and 3) to explore antipsychotic drug effects modification by center-related characteristics (using the addition of an interaction term). About 23% of the variance found for patients' outcome was explained by unmeasured confounding at a center level. Psychiatrists' practice experience was found to be associated with patient outcomes ( p =0.04) and modified the relative effect of "drug A" ( p <0.001), independent of center- or patient-related characteristics. Mixed models may be useful to explore how center-related characteristics modify drugs' effect estimates, but require numerous assumptions.

  15. Modeling energy efficiency to improve air quality and health effects of China's cement industry

    NARCIS (Netherlands)

    Zhang, Shaohui; Worrell, Ernst|info:eu-repo/dai/nl/106856715; Crijns-Graus, Wina|info:eu-repo/dai/nl/308005015; Krol, Maarten|info:eu-repo/dai/nl/078760410; de Bruine, Marco|info:eu-repo/dai/nl/411965085; Geng, Guangpo; Wagner, Fabian; Cofala, Janusz

    2016-01-01

    Actions to reduce the combustion of fossil fuels often decrease GHG emissions as well as air pollutants and bring multiple benefits for improvement of energy efficiency, climate change, and air quality associated with human health benefits. The China's cement industry is the second largest energy

  16. The Stages of Change Model: An Effective Audience Analysis Tool Used To Design and Implement Health Promoting Messages.

    Science.gov (United States)

    Smith, Ronda L.

    Researchers have been slow to acknowledge the salient role communication can play in motivating people to adopt more healthy lifestyles. Because persuasive messages increase awareness and can increase health promoting behaviors, it is important to determine the most effective health promoting messages in various health contexts. Thus, the primary…

  17. Ensemble prediction of air quality using the WRF/CMAQ model system for health effect studies in China

    Science.gov (United States)

    Hu, Jianlin; Li, Xun; Huang, Lin; Ying, Qi; Zhang, Qiang; Zhao, Bin; Wang, Shuxiao; Zhang, Hongliang

    2017-11-01

    Accurate exposure estimates are required for health effect analyses of severe air pollution in China. Chemical transport models (CTMs) are widely used to provide spatial distribution, chemical composition, particle size fractions, and source origins of air pollutants. The accuracy of air quality predictions in China is greatly affected by the uncertainties of emission inventories. The Community Multiscale Air Quality (CMAQ) model with meteorological inputs from the Weather Research and Forecasting (WRF) model were used in this study to simulate air pollutants in China in 2013. Four simulations were conducted with four different anthropogenic emission inventories, including the Multi-resolution Emission Inventory for China (MEIC), the Emission Inventory for China by School of Environment at Tsinghua University (SOE), the Emissions Database for Global Atmospheric Research (EDGAR), and the Regional Emission inventory in Asia version 2 (REAS2). Model performance of each simulation was evaluated against available observation data from 422 sites in 60 cities across China. Model predictions of O3 and PM2.5 generally meet the model performance criteria, but performance differences exist in different regions, for different pollutants, and among inventories. Ensemble predictions were calculated by linearly combining the results from different inventories to minimize the sum of the squared errors between the ensemble results and the observations in all cities. The ensemble concentrations show improved agreement with observations in most cities. The mean fractional bias (MFB) and mean fractional errors (MFEs) of the ensemble annual PM2.5 in the 60 cities are -0.11 and 0.24, respectively, which are better than the MFB (-0.25 to -0.16) and MFE (0.26-0.31) of individual simulations. The ensemble annual daily maximum 1 h O3 (O3-1h) concentrations are also improved, with mean normalized bias (MNB) of 0.03 and mean normalized errors (MNE) of 0.14, compared to MNB of 0.06-0.19 and

  18. Ensemble prediction of air quality using the WRF/CMAQ model system for health effect studies in China

    Directory of Open Access Journals (Sweden)

    J. Hu

    2017-11-01

    Full Text Available Accurate exposure estimates are required for health effect analyses of severe air pollution in China. Chemical transport models (CTMs are widely used to provide spatial distribution, chemical composition, particle size fractions, and source origins of air pollutants. The accuracy of air quality predictions in China is greatly affected by the uncertainties of emission inventories. The Community Multiscale Air Quality (CMAQ model with meteorological inputs from the Weather Research and Forecasting (WRF model were used in this study to simulate air pollutants in China in 2013. Four simulations were conducted with four different anthropogenic emission inventories, including the Multi-resolution Emission Inventory for China (MEIC, the Emission Inventory for China by School of Environment at Tsinghua University (SOE, the Emissions Database for Global Atmospheric Research (EDGAR, and the Regional Emission inventory in Asia version 2 (REAS2. Model performance of each simulation was evaluated against available observation data from 422 sites in 60 cities across China. Model predictions of O3 and PM2.5 generally meet the model performance criteria, but performance differences exist in different regions, for different pollutants, and among inventories. Ensemble predictions were calculated by linearly combining the results from different inventories to minimize the sum of the squared errors between the ensemble results and the observations in all cities. The ensemble concentrations show improved agreement with observations in most cities. The mean fractional bias (MFB and mean fractional errors (MFEs of the ensemble annual PM2.5 in the 60 cities are −0.11 and 0.24, respectively, which are better than the MFB (−0.25 to −0.16 and MFE (0.26–0.31 of individual simulations. The ensemble annual daily maximum 1 h O3 (O3-1h concentrations are also improved, with mean normalized bias (MNB of 0.03 and mean normalized errors (MNE of 0.14, compared to MNB

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

    International Nuclear Information System (INIS)

    Collins, J.J.; Lundy, R.T.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projections. The model extends several health risk projection models by making realistic assumptions about the population at risk, and thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This volume gives the more advanced user of the SPAHR computer package the information required to create tailor-made programs for addressing specific issues not covered by the three interactive packages. It assumes that the user is familiar with the concepts and terms relating to demography and health risk assessment

  20. Health Effects of Air Pollution

    Science.gov (United States)

    ... Health effects of air pollution Health effects of air pollution Breathing air that is not clean can hurt ... important to know about the health effects that air pollution can have on you and others. Once you ...

  1. Mediating effects of emotional exhaustion on the relationship between job demand–control model and mental health.

    Science.gov (United States)

    Huang, Yu-Hwa; Du, Pey-Ian; Chen, Chin-Hui; Yang, Chin-Ann; Huang, Ing-Chung

    2011-04-01

    This study attempted to investigate the role of emotional exhaustion as a mediator on the relationship between job demands-control (JDC) model and mental health. Three-wave data from 297 employees were collected. The results showed that job demands were positively related to emotional exhaustion, and increasing job demands will increase the level of emotional exhaustion. Job control was negatively associated with emotional exhaustion; therefore, increasing job control will decrease the level of emotional exhaustion. Emotional exhaustion was negatively related to mental health. Emotional exhaustion fully mediated the relationship between job demands and mental health, and partially mediated the positive relationship between job control and mental health. In addition, job control was positively associated with mental health directly. The remarkable finding of the present study was that emotional exhaustion served as the key mediator between the JDC model and mental health. Theoretical and managerial implications and limitations were discussed.

  2. The use of random-effects models to identify health care center-related characteristics modifying the effect of antipsychotic drugs

    Directory of Open Access Journals (Sweden)

    Nordon C

    2017-12-01

    Full Text Available Clementine Nordon,1 Constance Battin,1 Helene Verdoux,2 Josef Maria Haro,3 Mark Belger,4 Lucien Abenhaim,1 Tjeerd Pieter van Staa5 On behalf of the IMI GetReal WP2 Group 1Epidemiological Research, Analytica LASER, Paris, 2Population Health Research Center, Team Pharmaco-Epidemiology, UMR 1219, Bordeaux-2 University, INSERM, Bordeaux, France; 3Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Barcelona, Spain; 4Eli Lilly and Company Limited, Erl Wood Manor, Windlesham, 5Farr Institute, University of Manchester, Manchester, UK Purpose: A case study was conducted, exploring methods to identify drugs effects modifiers, at a health care center level.Patients and methods: Data were drawn from the Schizophrenia Outpatient Health Outcome cohort, including hierarchical information on 6641 patients, recruited from 899 health care centers from across ten European countries. Center-level characteristics included the following: psychiatrist’s gender, age, length of practice experience, practice setting and type, countries’ Healthcare System Efficiency score, and psychiatrist density in the country. Mixed multivariable linear regression models were used: 1 to estimate antipsychotic drugs’ effectiveness (defined as the association between patients’ outcome at 3 months – dependent variable, continuous – and antipsychotic drug initiation at baseline – drug A vs other antipsychotic drug; 2 to estimate the similarity between clustered data (using the intra-cluster correlation coefficient; and 3 to explore antipsychotic drug effects modification by center-related characteristics (using the addition of an interaction term.Results: About 23% of the variance found for patients’ outcome was explained by unmeasured confounding at a center level. Psychiatrists’ practice experience was found to be associated with patient outcomes (p=0.04 and modified the relative effect of “drug A” (p<0.001, independent of center- or patient

  3. Improving Health Outcomes of Children through Effective Parenting: Model and Methods

    OpenAIRE

    Okafor, Martha; Sarpong, Daniel; Ferguson, Aneeqah; Satcher, David

    2013-01-01

    This article reports on the design, development, testing and presentation of preliminary evidence of a translational, culturally relevant parenting education model, titled Smart and Secured Children (SSC). SSC, a quality parenting curriculum, prepares disparate African American parents as leaders for transforming their parenting behaviors and leading their peers and community in changing existing parenting culture. The article recommends expanded utility of identified promising processes, app...

  4. [The effects of two health education models on psychological and nutritional profile of patients waiting for kidney transplantation].

    Science.gov (United States)

    Ye, Hui-juan; Hu, Li-jun; Yao, Yuan-yuan; Chen, Jiang-hua

    2011-10-01

    To investigate the effects of two health education models on the psychology and nutrition of patients waiting for cadaveric renal transplantation. A total of 125 patients waiting for cadaveric renal transplantations were involved in our study. They were diagnosed with chronic renal failure in our hospital during September 1, 2009 to August 30, 2010. The patients were randomly divided into control group (n = 62) and observational group (n = 63). Patients in the control group received traditional health education with routine preoperative education during hospitalization. In the observational group, full-time nurses assessed the nutrition status of each patient and monitored the data. The observational patients were followed up and were given dietary guidance and knowledge of transplantation. Various kinds of education formats were adopted in observational group to provide communication opportunities between patients and surgeons in charge as well as patients who underwent transplantation. Psychological testings of patients in both groups were tested by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after the health education. Triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC) and biochemistry index were also tested. Psychological and nutritional status of patients in the two groups was compared. There were no significant differences in scores of the SAS, SDS, TSF, Hb, and albumin (Alb) between the two groups (all P > 0.05) before health education. After health education, SAS and SDS in observational group were lower than those in the control group (40.02 ± 9.05 vs 47.05 ± 10.32, 42.70 ± 10.01 vs 50.83 ± 10.12; both P < 0.01). Both TSF and Hb were elevated after education (P < 0.001 or 0.05). Alb was significantly elevated in the observational group [(35.67 ± 6.19) g/L vs (37.48 ± 5.09) g/L, P < 0.01]. Comprehensive and various health education methods can significantly alleviate mental stress and improve

  5. The Effect of Pender’s Health Promotion Model in Improving the Nutritional Behavior of Overweight and Obese Women

    Directory of Open Access Journals (Sweden)

    Masoud Khodaveisi

    2017-04-01

    Full Text Available Background: Changes in lifestyle and eating habits have put women at risk of obesity and overweight more than ever. This aim of this study was to investigate the effect of Pender’s Health Promotion Model (HPM to improve the nutritional behavior of overweight and obese women admitted to Fatemiyeh Hospital clinics in Hamadan, west Iran in 2015. Methods: n this quasi-experimental study, 108 eligible women were selected and randomly assigned to two groups: one experimental and one control. Data were gathered using three questionnaires: demographics, Pender’s HPM constructs, and nutritional behavior. The questionnaires were filled out by both groups as pre-test and two months later. A Pender’s HPM-based intervention was conducted for the experimental group. The data were analyzed by paired and independent t-tests, ANCOVA, and Spearmans’ correlation coefficient in SPSS/16. The level of significance was considered to be <0.05. Results: The mean score of nutritional behavior was 41.75±3.28 and 42.36±3.69 before the intervention and 79.09±5.27 and 49.72±9.49 after it in the experimental and control groups, respectively. The difference was significant only between before and after the intervention in the experimental group (P<0.001. Furthermore, the mean scores of the following variables were significantly different between before and after the intervention in the experimental group: nutritional behavior, perceived benefits, perceived self-efficacy, commitment to action, interpersonal and situational influences, behavior-related affect, and perceived barriers (P<0.001. Conclusion: The results showed that Pender’s HPM-based training improved nutritional behavior and some constructs of the model. Therefore, this educative model can be used by healthcare providers to improve the nutritional and other health promoting behaviors.

  6. Maturity associated variance in physical activity and health-related quality of life in adolescent females: a mediated effects model.

    Science.gov (United States)

    Smart, Joan E Hunter; Cumming, Sean P; Sherar, Lauren B; Standage, Martyn; Neville, Helen; Malina, Robert M

    2012-01-01

    This study tested a mediated effects model of psychological and behavioral adaptation to puberty within the context of physical activity (PA). Biological maturity status, physical self-concept, PA, and health-related quality of life (HRQoL) were assessed in 222 female British year 7 to 9 pupils (mean age = 12.7 years, SD = .8). Structural equation modeling using maximum likelihood estimation and bootstrapping procedures supported the hypothesized model. Maturation status was inversely related to perceptions of sport competence, body attractiveness, and physical condition; and indirectly and inversely related to physical self-worth, PA, and HRQoL. Examination of the bootstrap-generated bias-corrected confidence intervals representing the direct and indirect paths between suggested that physical self-concept partially mediated the relations between maturity status and PA, and maturity status and HRQoL. Evidence supports the contention that perceptions of the physical self partially mediate relations maturity, PA, and HRQoL in adolescent females.

  7. Modeled effects of an improved building insulation scenario in Europe on air pollution, health and societal costs

    DEFF Research Database (Denmark)

    Bønløkke, Jakob Hjort; Holst, Gitte Juel; Sigsgaard, Torben

    2015-01-01

    scenario in Europe would have substantial benefits on health through improvements in air pollution. Health effects and societal cost savings may significantly counterbalance investment costs and should be taken into account when evaluating strategies for mitigation of global warming....... with extensions. Mean annual changes in the main air pollutants were derived for each country. World Health Organization (WHO) and European Union (EU) data on populations and on impacts of pollutants were used to derive health effects and costs. Effects on indoor air quality were not assessed. Results: Projected...... 78678 LY in Europe. A total of 7173 cases of persistent chronic bronchitis could be avoided annually. Several other health outcomes improved similarly. The saved societal costs totaled 6.64 billion € annually. Conclusions: In addition to carbon emission reductions, an improved building insulation...

  8. Modeling the Health Effects of Expanding e-Cigarette Sales in the United States and United Kingdom: A Monte Carlo Analysis.

    Science.gov (United States)

    Kalkhoran, Sara; Glantz, Stanton A

    2015-10-01

    The prevalence of electronic cigarette (e-cigarette) use is increasing. Population health effects will depend on cigarette smoking behaviors, levels of dual use with conventional cigarettes, and e-cigarette toxicity. To evaluate potential health effects of various scenarios of increasing promotion and use of e-cigarettes. A base case model was developed using data on actual cigarette and e-cigarette use patterns that quantifies transitions from an initial state of no cigarette or e-cigarette use to 1 of 5 final states: never use of cigarettes or e-cigarettes, cigarette use, e-cigarette use, dual use of cigarettes and e-cigarettes, or quit. Seven scenarios were created that cover a range of use patterns, depending on how the e-cigarette market might develop, as well as a range of possible long-term health effects of e-cigarette use. Scenarios for changes from the base case were evaluated using Monte Carlo simulations. Separate sets of base case model parameters were evaluated for the US and UK populations. We assigned unitless health "costs" for each final state on a scale of 0 to 100. Population health "costs" were compared with the base case (status quo) assuming e-cigarette use health "costs" from 1% to 50% as dangerous as conventional cigarette use health costs. Compared with the base case, a harm reduction scenario in which e-cigarette use increases only among smokers who are interested in quitting with more quit attempts and no increased initiation of e-cigarette use among nonsmokers, and another scenario in which e-cigarettes are taken up only by youth who would have smoked conventional cigarettes, had population-level health benefits regardless of e-cigarette health costs in both the United States and United Kingdom. Conversely, scenarios in which e-cigarette promotion leads to renormalization of cigarette smoking or e-cigarettes are used primarily by youth who never would have smoked showed net health harms across all e-cigarette health costs. In other

  9. Effect of High Fat Dietary Intake during Maternal Gestation on Offspring Ovarian Health in a Pig Model

    Directory of Open Access Journals (Sweden)

    Mengmeng Xu

    2016-08-01

    Full Text Available Excessive fat intake is a global health concern as women of childbearing age increasingly ingest a high fat diet. We therefore determined the association of a maternal high fat diet in pregnancy with offspring ovarian health during the gestation and postnatal female offspring in pig a model. Thirty-two Yorkshire gilts with similar bodyweights mated at the third estrus were randomly assigned to two nutrition levels of either a control (CON, crude fat: 7.27% or a high fat diet (HFD, crude fat: 11.78%. Ovary samples were collected during the fetal (Day 55 (g55 and Day 90 of gestation (g90 and offspring (prepuberty Day 160 (d160 and age at puberty period to detect ovary development, antioxidant status and apoptosis cells. Maternal HFD did not influence notch signaling gene expression, which regulates primordial follicle formation and transformation, and ovarian histological effect at g55 and g90. However, maternal HFD reduced the numbers of large follicles at d160 and small follicle numbers upon puberty compared to CON in offspring. The results also revealed that the antioxidant index of total antioxidative capability (T-AOC, cytoplasmic copper/zinc superoxide dismutase (CuZn-SOD, glutathione peroxidase (GPx activities and mRNA expression were higher in the CON than the HFD at g90 and d160, whereas, malondialdehyde (MDA concentration was decreased in the CON. Maternal HFD increased the inhibitor of the apoptosis-related gene of B-cell lymphoma-2 (bcl2 mRNA expression at g90 and d160, whereas, pro-apoptotic-related gene bcl-2 assaciated X protein (bax was reduced. These data show that the maternal high fat diet does not delay fetal ovarian development, but it changes ovarian health by the induction of oxidative stress and accelerating cell apoptosis in offspring.

  10. Modeling Health Care Expenditures and Use.

    Science.gov (United States)

    Deb, Partha; Norton, Edward C

    2018-04-01

    Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits. Modeling the outcomes with a two-part or hurdle model, instead of a single-equation model, reveals that the ACA policy increased the number of office-based visits but decreased emergency department visits and overall spending.

  11. Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study.

    Science.gov (United States)

    Lokkerbol, Joran; Adema, Dirk; Cuijpers, Pim; Reynolds, Charles F; Schulz, Richard; Weehuizen, Rifka; Smit, Filip

    2014-03-01

    Depressive disorders are significant causes of disease burden and are associated with substantial economic costs. It is therefore important to design a healthcare system that can effectively manage depression at sustainable costs. This article computes the benefit-to-cost ratio of the current Dutch healthcare system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compared a base case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome was the benefit-to-cost ratio, also known as return-on-investment (ROI). In terms of ROI, a healthcare system with preventive telemedicine for depressive disorders offers better value for money than a healthcare system without Internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base case scenario to €1.76 ($2.09) in the alternative scenario in which preventive telemedicine is offered. In a scenario in which the costs of offering preventive telemedicine are balanced by reducing the expenditures for curative interventions, ROI increases to €1.77 ($2.10), while keeping the healthcare budget constant. For a healthcare system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  12. Assessing the effect of an educational intervention program based on Health Belief Model on preventive behaviors of internet addiction

    Science.gov (United States)

    Maheri, Aghbabak; Tol, Azar; Sadeghi, Roya

    2017-01-01

    INTRODUCTION: Internet addiction refers to the excessive use of the internet that causes mental, social, and physical problems. According to the high prevalence of internet addiction among university students, this study aimed to determine the effect of an educational intervention on preventive behaviors of internet addiction among Tehran University of Medical Sciences students. MATERIALS AND METHODS: This study was a quasi-experimental study conducted among female college students who live in the dormitories of Tehran University of Medical Sciences. Two-stage cluster sampling was used for selection of eighty participants in each study groups; data were collected using “Young's Internet Addiction” and unstructured questionnaire. Validity and reliability of unstructured questionnaire were evaluated by expert panel and were reported as Cronbach's alpha. Information of study groups before and 4 months after the intervention was compared using statistical methods by SPSS 16. RESULTS: After the intervention, the mean scores of internet addiction, perceived barriers construct, and the prevalence of internet addiction significantly decreased in the intervention group than that in the control group and the mean scores of knowledge and Health Belief Model (HBM) constructs (susceptibility, severity, benefits, self-efficacy) significantly increased. CONCLUSIONS: Education based on the HBM was effective on the reduction and prevention of internet addiction among female college students, and educational interventions in this field are highly recommended. PMID:28852654

  13. Models selected for calculation of doses, health effects and economic costs due to accidental radionuclide releases from nuclear power plants. Technical report

    International Nuclear Information System (INIS)

    Strenge, D.L.; Acharya, S.; Baker, D.A.; Droppo, J.G.; McPherson, R.B.

    1980-05-01

    Models are described for use in site-specific environmental consequence analysis of nuclear reactor accidents of Classes 3 through 9. The models presented relate radioactivity released to resulting doses, health effects, and costs of remedial actions. Specific models are presented for the major exposure pathways of airborne releases, waterborne releases and direct irradiation from activity within the facility buildings, such as the containment. Time-dependent atmospheric dispersion parameters, crop production parameters, and other variable parameters are used in the models. The environmental effects are analyzed for several accident start times during the year. Several remedial actions are considered

  14. Perspectives on quality mental health care from Brazilian and Cape Verdean outpatients: implications for effective patient-centered policies and models of care.

    Science.gov (United States)

    De Jesus, Maria; Earl, Tara R

    2014-01-01

    Mental health providers are increasingly coming into contact with large and growing multi-racial/ethnic and immigrant patient populations in the United States. Knowledge of patient perspectives on what constitutes quality mental health care is necessary for these providers. The aim of this study was to identify indicators of quality of mental health care that matter most to two underrepresented immigrant patient groups of Portuguese background: Brazilians and Cape Verdeans. A qualitative design was adopted using focus group discussions. Six focus groups of patients (n=24 Brazilians; n=24 Cape Verdeans) who received outpatient mental health treatment through public safety net clinics in the northeast region of the United States were conducted. The Consensual Qualitative Research analytic method allowed us to identify three quality of care domains: provider performance, aspects of mental health care environment, and effectiveness of mental health care treatment. Provider performance was associated with five categories: relational, communication, linguistic, cultural, and technical competencies. Aspects of mental health care environment were linked to two categories: psychosocial and physical environment. Effectiveness of mental health care treatment was related to two categories: therapeutic relationship and treatment outcomes. Study findings provide useful data for the development of more culturally appropriate and effective patient-centered models and policies in mental health care.

  15. Simulating Effects of Long Term Use of Wastewater on Farmers Health Using System Dynamics Modeling (Case Study: Varamin Plain

    Directory of Open Access Journals (Sweden)

    Hamzehali Alizadeh

    2017-06-01

    -growing season starting year 2016, (iii similar to scenario number two w/o artificial aquifer recharge and (iv similar to scenario number two plus allocating 50 MCM starting year 2021]. Mass flow or convection method by considering surface adsorption of solute was used to survey movement and adsorption of elements in soil. Adsorption isotherms delineated and determined by field and experimental measurement. Results and Discussion: The result indicated that if raw wastewater be used till 2031, Cadmium and Copeer concentration will be outstanding and will have harmful effects on farmer’s health. Utilization of treated wastewater will be safe and will have not harmful effects on farmer’s health by heavy metals, to about 150 future years. Also, simulating result showed that Nitrate concentration in groundwater will exceed from allowable limitation for potable water in all scenarios to 2031. Application of scenarios (iv and (iii lead to the lowest and the highest Nitrate concentration, respectively. Conclusion: In this model a systems system dynamics approach was applied to understand how various factors related to operation of wastewater and water sustainability interrelate. The developed model is capable to simulation of all factors, aspects and interactions that affect wastewater utilization. Result of this study demonstrated that SD is a useful decision support tool for sustainable wastewater management. By considering severe water shortage problems in the study area, and safe utilization of treated wastewater, treated wastewater transmission of Tehran plant to Varamin Plain can help to solve water shortage problems. Increase of treated wastewater allocation lead to decrease of raw sewage and hereby decreasing hygienic harmful effects.

  16. Effects of Interventions Based on Health Behavior Models on Breast Cancer Screening Behaviors of Migrant Women in Turkey.

    Science.gov (United States)

    Tuzcu, Ayla; Bahar, Zuhal; Gözüm, Sebahat

    2016-01-01

    Antalya is a city receiving internal and external migration in Turkey, including migrant women in need of developing breast cancer screening behaviors. The aim of this study was to develop breast cancer screening behaviors of migrant women through nursing interventions based on the Health Belief Model and the Health Promotion Model. This quasi-experimental study was conducted with 200 women (100 women in the intervention group, 100 women in the control group) in Antalya. The intervention group received training, consultancy service, and reminders and was followed up at 3 and 6 months after interventions. The rates of breast self-examination, clinical breast examination and mammography were higher at months 3 and 6 in women in the intervention group compared with the women in the control group. In the intervention group, perceptions of susceptibility and barriers decreased after the interventions, and benefit, health motivation, and self-efficacy perceptions increased. According to month 6 data, in the intervention group, the decrease of each unit in perception of barriers increased the rate of breast self-examination 0.8 times and the rate of mammography 0.7 times. An increase of each unit in health motivation increased the rate of clinical breast examination 1.3 times and the rate of mammography 1.5 times. Interventions based on health behavior models positively affected breast cancer screening behaviors of migrant women. Health motivations and perceptions of barriers are determinants in performing the screening behaviors. Migrant women should be supported more by healthcare professionals regarding recognition of breast health and disease and in transportation to screening centers in their new location.

  17. Integrating health belief model and technology acceptance model: an investigation of health-related internet use.

    Science.gov (United States)

    Ahadzadeh, Ashraf Sadat; Pahlevan Sharif, Saeed; Ong, Fon Sim; Khong, Kok Wei

    2015-02-19

    Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes. This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use. Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed. Perceived health risk (β=.135, t1999=2.676) and health consciousness (β=.447, t1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (β=.025, t1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (β=.029, t1999=3.609). These results suggest the central role of perceived usefulness of the Internet and

  18. The Effect of Centering Pregnancy versus Traditional Prenatal Care Models on Improved Adolescent Health Behaviors in the Perinatal Period.

    Science.gov (United States)

    Trotman, Gylynthia; Chhatre, Gayatri; Darolia, Renuka; Tefera, Eshetu; Damle, Lauren; Gomez-Lobo, Veronica

    2015-10-01

    To determine if the CenteringPregnancy model of prenatal care improves maternal health behaviors in adolescent pregnancy. We conducted a retrospective chart review comparing 150 pregnant adolescents who received prenatal care between 2008 to 2012 with CenteringPregnancy to those receiving care in traditional prenatal care models with either multiprovider or single-provider visits. Outcome measures included weight gain during pregnancy, compliance to prenatal care appointments, infant feeding method, postpartum follow up and contraceptive use postpartum. A χ(2) analysis was used to compare outcomes between the 3 groups at a 2-tailed α of .05. Fifty individuals were evaluated in each group. Adolescents in the CenteringPregnancy group were more likely to comply with prenatal and postpartum visits and to meet the 2009 Institute of Medicine gestational weight guidelines for weight gain in pregnancy than were adolescents in either multiprovider (62.0% vs 38.0%, P = .02) or single-provider (62.0% vs 38.0%, P = .02) groups. The CenteringPregnancy group was also more likely to solely breastfeed compared with adolescents in the multiprovider group (40.0% vs 20.0%, P = .03) and include breastfeeding in addition to bottle-feeding compared with both multiprovider (32.0% vs 14.0%, P = .03) and single-provider (32.0% vs 12.0%, P = .03) patient groups. Additionally, the CenteringPregnancy group had increased uptake of long-acting reversible contraception and were less likely to suffer from postpartum depression. CenteringPregnancy Prenatal Care program aids in compliance to prenatal visits, appropriate weight gain, increased uptake of highly effective contraception, and breastfeeding among adolescent mothers. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. Health insurance basic actuarial models

    CERN Document Server

    Pitacco, Ermanno

    2014-01-01

    Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

  20. Effectiveness of Education Based on the Health Belief Model on Performing Preventive Measures for Breast Cancer Among Female Teachers in Zahedan

    Directory of Open Access Journals (Sweden)

    Khadijeh Kalan-Farmanfarma

    2014-06-01

    Full Text Available Introduction: Preventive behaviors such as screening tests have an important role in prevention and control of breast cancer. Therefore, this study aimed to determine the effect of educational programs on preventive behaviors of breast cancer based on the health belief model among female teachers of guidance schools in Zahedan city. Materials and Methods: This quasi-experimental study was performed on 240 female teachers from (120 participants in each of the control and intervention groups Zahedan guidance schools. The data-gathering tool was a multipart questionnaire containing demographic variables, knowledge and health belief model structures. An educational program was performed based on the health belief model in five sessions through lectures, training videos, question and answer session for participants in the intervention group. Questionnaires were filled before and two months after the intervention in the two groups. Data was analyzed by independent T-test, chi-square and multiple linear regressions using SPSS-15 software. Results: There was no meaningful difference in the mean scores of knowledge, health belief model constructs, and performance between the two groups before the educational intervention, but the mean scores of variables increased significantly after the intervention (P< 0.05. Conclusion: The health belief model was effective to promote preventive behaviors. Hence, educational interventions with an emphasis on raising awareness, change in beliefs and improving self-efficacy regarding breast cancer are recommended

  1. Integrated HIV testing, malaria, and diarrhea prevention campaign in Kenya: modeled health impact and cost-effectiveness.

    Science.gov (United States)

    Kahn, James G; Muraguri, Nicholas; Harris, Brian; Lugada, Eric; Clasen, Thomas; Grabowsky, Mark; Mermin, Jonathan; Shariff, Shahnaaz

    2012-01-01

    Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over 7 days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals cotrimoxazole prophylaxis and referral for ongoing care. We modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign. We estimated averted deaths and disability-adjusted life years (DALYs) based on published data on baseline mortality and morbidity and on the protective effect of interventions, including antiretroviral therapy. We incorporate a previously estimated scaled-up campaign cost. We used published costs of medical care to estimate savings from averted illness (for all three diseases) and the added costs of initiating treatment earlier in the course of HIV disease. Per 1000 participants, projected reductions in cases of diarrhea, malaria, and HIV infection avert an estimated 16.3 deaths, 359 DALYs and $85,113 in medical care costs. Earlier care for HIV-infected persons adds an estimated 82 DALYs averted (to a total of 442), at a cost of $37,097 (reducing total averted costs to $48,015). Accounting for the estimated campaign cost of $32,000, the campaign saves an estimated $16,015 per 1000 participants. In multivariate sensitivity analyses, 83% of simulations result in net savings, and 93% in a cost per DALY averted of less than $20. A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive.

  2. Integrated HIV testing, malaria, and diarrhea prevention campaign in Kenya: modeled health impact and cost-effectiveness.

    Directory of Open Access Journals (Sweden)

    James G Kahn

    Full Text Available Efficiently delivered interventions to reduce HIV, malaria, and diarrhea are essential to accelerating global health efforts. A 2008 community integrated prevention campaign in Western Province, Kenya, reached 47,000 individuals over 7 days, providing HIV testing and counseling, water filters, insecticide-treated bed nets, condoms, and for HIV-infected individuals cotrimoxazole prophylaxis and referral for ongoing care. We modeled the potential cost-effectiveness of a scaled-up integrated prevention campaign.We estimated averted deaths and disability-adjusted life years (DALYs based on published data on baseline mortality and morbidity and on the protective effect of interventions, including antiretroviral therapy. We incorporate a previously estimated scaled-up campaign cost. We used published costs of medical care to estimate savings from averted illness (for all three diseases and the added costs of initiating treatment earlier in the course of HIV disease.Per 1000 participants, projected reductions in cases of diarrhea, malaria, and HIV infection avert an estimated 16.3 deaths, 359 DALYs and $85,113 in medical care costs. Earlier care for HIV-infected persons adds an estimated 82 DALYs averted (to a total of 442, at a cost of $37,097 (reducing total averted costs to $48,015. Accounting for the estimated campaign cost of $32,000, the campaign saves an estimated $16,015 per 1000 participants. In multivariate sensitivity analyses, 83% of simulations result in net savings, and 93% in a cost per DALY averted of less than $20.A mass, rapidly implemented campaign for HIV testing, safe water, and malaria control appears economically attractive.

  3. Social relationships and the sleep-health nexus in adolescence: evidence from a comprehensive model with bi-directional effects.

    Science.gov (United States)

    Maume, David J

    2017-08-01

    The goal of this study was to assess the bi-directional effects of sleep and health (body mass index [BMI], depression, and substance use) among adolescents in the presence of comprehensive controls for social relationships and daily stressors and supports. Longitudinal survey. Data were obtained from the Study of Early Child Care and Youth Development, a longitudinal survey designed and administered by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. At total of 974 adolescents ages 12-15; 50% girls. Total sleep time was derived from difference between usual bedtime and arise time; youths self-reported the frequency of using alcohol, tobacco, and marijuana, and most of the predictors of sleep-health (e.g., parental monitoring, school and peer attachment); youth's body mass index and physical development (i.e., Tanner stage score) were assessed in clinics. Teen sleep duration declined and health deteriorated from age 12-15, but results from a 2-stage least squares analysis showed and that sleep duration was among the strongest predictors of teen health; by contrast, BMI, depression, and substance use had no effect on sleep duration. Youth sleep and health were both determined by changes in family structure, income, parental monitoring, school and peer attachment, time spent in homework and on the computer, and physical development (health only). The constellation of teens' social ties and daily stressors affects the sleep-health nexus, and future studies should account for this complexity and diversity of teens' lives. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  4. A study of health effect estimates using competing methods to model personal exposures to ambient PM2.5.

    Science.gov (United States)

    Strand, Matthew; Hopke, Philip K; Zhao, Weixiang; Vedal, Sverre; Gelfand, Erwin; Rabinovitch, Nathan

    2007-09-01

    Various methods have been developed recently to estimate personal exposures to ambient particulate matter less than 2.5 microm in diameter (PM2.5) using fixed outdoor monitors as well as personal exposure monitors. One class of estimators involves extrapolating values using ambient-source components of PM2.5, such as sulfate and iron. A key step in extrapolating these values is to correct for differences in infiltration characteristics of the component used in extrapolation (such as sulfate within PM2.5) and PM2.5. When this is not done, resulting health effect estimates will be biased. Another class of approaches involves factor analysis methods such as positive matrix factorization (PMF). Using either an extrapolation or a factor analysis method in conjunction with regression calibration allows one to estimate the direct effects of ambient PM2.5 on health, eliminating bias caused by using fixed outdoor monitors and estimated personal ambient PM2.5 concentrations. Several forms of the extrapolation method are defined, including some new ones. Health effect estimates that result from the use of these methods are compared with those from an expanded PMF analysis using data collected from a health study of asthmatic children conducted in Denver, Colorado. Examining differences in health effect estimates among the various methods using a measure of lung function (forced expiratory volume in 1 s) as the health indicator demonstrated the importance of the correction factor(s) in the extrapolation methods and that PMF yielded results comparable with the extrapolation methods that incorporated correction factors.

  5. Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model.

    Science.gov (United States)

    Li, Jie; Li, Juan; Thornicroft, Graham; Yang, Hui; Chen, Wen; Huang, Yuanguang

    2015-10-26

    Increasing numbers of people with mental disorders receive services at primary care in China. The aims of this study are to evaluate impact of a new training course and supervision for community mental health staff to enhance their levels of mental health knowledge and to reduce their stigmatization toward people with mental illness. A total of 77 community mental health staff from eight regions in Guangzhou in China were recruited for the study.4 regions were randomly allocated to the new training model group, and 4 to the old training model group. Levels of mental health knowledge were measured by purpose-made assessment schedule and by the Mental Health Knowledge Schedule (MAKS). Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). Evaluation questionnaires were given at the beginning of course, at the end, and at 6 month and at 12 month follow-up. After the training period, the 6-month, and the 12-month, knowledge scores of the intervention group were higher than the control group. At 6-month and 12-month follow-up, means scores of MAKS of the intervention group increased more than the control group (both p training, at 6-months, and at 12-months, mean scores of RIBS of the intervention group increased more than the control (p training course and supervision, the new course improved community mental health staff knowledge of mental disorders, improving their attitudes toward people with mental disorder, and increasing their willingness to have contact with people with mental disorder.

  6. The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling.

    Science.gov (United States)

    Choi, Sunha; Lee, Sungkyu; Matejkowski, Jason

    2018-06-01

    This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

  7. Health effects of radiation damage

    International Nuclear Information System (INIS)

    Gasimova, K; Azizova, F; Mehdieva, K.

    2012-01-01

    Full text : A summary of the nature of radiactive contamination would be incomplete without some mention of the human health effects relatied to radioactivity and radioactive materials. Several excellent reviews at the variety of levels of detail have been written and should be consulted by the reader. Internal exposures of alpha and beta particles are important for ingested and inhaled radionuclides. Dosimetry models are used to estimate the dose from internally deposited radioactive particles. As mentioned above weighting parameters that take into account the radiation type, the biological half-life and the tissue or organ at risk are used to convert the physically absorbed dose in units of gray (or red) to the biologically significant committed equivalent dose and effective dose, measured in units of Sv (or rem). There is considerable controversy over the shape of the dose-response curve at the chronic low dose levels important for enviromental contamination. Proposed models include linear models, non-linear models and threshold models. Because risks at low dose must be extrapolated from available date at high doses, the shape of the dose-response curve has important implications for the environmental regulations used to protect the general public. The health effect of radiation damage depends on a combination of events of on the cellular, tissue and systemic levels. These lead to mutations and cellular of the irradiated parent cell. The dose level at which significant damage occurs depends on the cell type. Cells that reproduce rapidily, such as those found in bone marrow or the gastrointestinal tract, will be more sensitive to radiation than those that are longer lived, such as striated muscle or nerve cells. The effects of high radiation doses on an organ depends on the various cell types it contains

  8. Ancillary health effects of climate mitigation scenarios as drivers of policy uptake: a review of air quality, transportation and diet co-benefits modeling studies

    Science.gov (United States)

    Chang, Kelly M.; Hess, Jeremy J.; Balbus, John M.; Buonocore, Jonathan J.; Cleveland, David A.; Grabow, Maggie L.; Neff, Roni; Saari, Rebecca K.; Tessum, Christopher W.; Wilkinson, Paul; Woodward, Alistair; Ebi, Kristie L.

    2017-11-01

    Background: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2 °C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making. Methods/Design: We evaluated the range of methods and choices in modeling health co-benefits of climate mitigation to identify opportunities for increased consistency and collaboration that could better inform policy-making. We reviewed studies quantifying the health co-benefits of climate change mitigation related to air quality, transportation, and diet published since the 2009 Lancet Commission ‘Managing the health effects of climate change’ through January 2017. We documented approaches, methods, scenarios, health-related exposures, and health outcomes. Results/Synthesis: Forty-two studies met the inclusion criteria. Air quality, transportation, and diet scenarios ranged from specific policy proposals to hypothetical scenarios, and from global recommendations to stakeholder-informed local guidance. Geographic and temporal scope as well as validity of scenarios determined policy relevance. More recent studies tended to use more sophisticated methods to address complexity in the relevant policy system. Discussion: Most studies indicated significant, nearer term, local ancillary health benefits providing impetus for policy uptake and net cost savings. However, studies were more suited to describing the interaction of climate policy and health and the magnitude of potential outcomes than to providing specific accurate estimates of health co-benefits. Modeling

  9. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation.

    Science.gov (United States)

    Smed, S; Scarborough, P; Rayner, M; Jensen, J D

    2016-06-01

    The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective of this study is to evaluate the effect of the Danish tax on saturated fat in terms of changes in nutritional quality of the diet, that is, changes in saturated fat consumption, as well as other non-targeted dietary measures, and to model the associated changes in mortality for different age groups and genders. On the basis of household scanner data, we estimate the impact of the tax on consumption of saturated fat, unsaturated fat, salt, fruit, vegetables and fibre. The resultant changes in dietary quality are then used as inputs into a comparative risk assessment model (PRIME (Preventable Risk Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark.

  10. Estimating the effect of lay knowledge and prior contact with pulmonary TB patients, on health-belief model in a high-risk pulmonary TB transmission population.

    Science.gov (United States)

    Zein, Rizqy Amelia; Suhariadi, Fendy; Hendriani, Wiwin

    2017-01-01

    The research aimed to investigate the effect of lay knowledge of pulmonary tuberculosis (TB) and prior contact with pulmonary TB patients on a health-belief model (HBM) as well as to identify the social determinants that affect lay knowledge. Survey research design was conducted, where participants were required to fill in a questionnaire, which measured HBM and lay knowledge of pulmonary TB. Research participants were 500 residents of Semampir, Asemrowo, Bubutan, Pabean Cantian, and Simokerto districts, where the risk of pulmonary TB transmission is higher than other districts in Surabaya. Being a female, older in age, and having prior contact with pulmonary TB patients significantly increase the likelihood of having a higher level of lay knowledge. Lay knowledge is a substantial determinant to estimate belief in the effectiveness of health behavior and personal health threat. Prior contact with pulmonary TB patients is able to explain the belief in the effectiveness of a health behavior, yet fails to estimate participants' belief in the personal health threat. Health authorities should prioritize males and young people as their main target groups in a pulmonary TB awareness campaign. The campaign should be able to reconstruct people's misconception about pulmonary TB, thereby bringing around the health-risk perception so that it is not solely focused on improving lay knowledge.

  11. The effect of safety education based on Health Belief Model (HBM on the workers practice of Borujen industrial town in using the personal protection respiratory equipments

    Directory of Open Access Journals (Sweden)

    A. Hasanzadeh

    2008-04-01

    Full Text Available Background and aims   Every year 50-158 million occupational diseases and job accidents occur in the world. Studies on the job injuries show that about 150000 injuries occur annually in  Iran. Unhealthy behaviors are important problems in public health. Education is one of the best ways to change unhealthy behaviors. Interventions based on model and theories have many  capacities for behavior change. Health Belief Model is one of the health education models that are  useful for behavior change. This research has been performed in order to assess the effect of health  education program based on health belief model (HBM to prevent occupational respiratory   diseases in workers.   Methods   Aquasi-experimental design was used for this interventional study, in which 88 of workers of Borujen industrial town participated, who were randomly assigned to experimental and control group. Data collecting tool were a self-administered questionnaire including 53 questions based on health belief model that was completed by the workers, in addition to the performance check list which was conducted by researcher via insensible controlling the workers' safety behaviour. Validity and reliability of the tools were examined prior to the study. Educational  intervention was conducted in the first stage following by the second data collection one month  later. The data of both experimental and control group were compared statistically before and  after the intervention.   Results   The results showed that the mean of the grade of all parts of health belief model  (HBM and performance mark of the workers about safety and use of personal respiratory  preventive equipment in experimental group after educational intervention compared to prior the  study and also compared to control group were significantly increased.   Conclusion   The results of this survey showed that by enhancement of health belief model (HBM components including

  12. Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo).

    Science.gov (United States)

    Ciccone, Marco Matteo; Aquilino, Ambrogio; Cortese, Francesca; Scicchitano, Pietro; Sassara, Marco; Mola, Ernesto; Rollo, Rodolfo; Caldarola, Pasquale; Giorgino, Francesco; Pomo, Vincenzo; Bux, Francesco

    2010-05-06

    Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM) model and of the introduction of "care manager" nurses, trained in this specialized role, into the primary health care system. Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative "team" consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD), diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk) to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization. Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services as well as treatment paths helped promote confidence and enhance safety of chronic patient management at home. Physicians, care managers, and patients showed unanimous agreement regarding the positive impact on patient health and self-management, and attributed the outcomes to the strong "partnership" between the care manager and the patient and the collaboration between the physician and the care manager. Future studies should consider the possibility of incorporating a patient empowerment model which considers the patient as the most important member of the health team and care managers as key health care collaborators able to enhance and support services to patients provided by physicians in

  13. An Innovative School Health Education Model Designed for Student Achievement.

    Science.gov (United States)

    Rohwer, John; Wandberg, Bob

    New threats to the health of American children, often psychosocial in nature due to societal changes, must be addressed. The Minnesota School Health Education Model is based on the integration of four primary components: (1) school health education goals aimed at health promotion, disease prevention, and long-term positive health effects on…

  14. Study protocol for two randomized controlled trials examining the effectiveness and safety of current weekend allied health services and a new stakeholder-driven model for acute medical/surgical patients versus no weekend allied health services.

    Science.gov (United States)

    Haines, Terry P; O'Brien, Lisa; Mitchell, Deb; Bowles, Kelly-Ann; Haas, Romi; Markham, Donna; Plumb, Samantha; Chiu, Timothy; May, Kerry; Philip, Kathleen; Lescai, David; McDermott, Fiona; Sarkies, Mitchell; Ghaly, Marcelle; Shaw, Leonie; Juj, Genevieve; Skinner, Elizabeth H

    2015-04-02

    Disinvestment from inefficient or ineffective health services is a growing priority for health care systems. Provision of allied health services over the weekend is now commonplace despite a relative paucity of evidence supporting their provision. The relatively high cost of providing this service combined with the paucity of evidence supporting its provision makes this a potential candidate for disinvestment so that resources consumed can be used in other areas. This study aims to determine the effectiveness, cost-effectiveness and safety of the current model of weekend allied health service and a new stakeholder-driven model of weekend allied health service delivery on acute medical and surgical wards compared to having no weekend allied health service. Two stepped wedge, cluster randomised trials of weekend allied health services will be conducted in six acute medical/surgical wards across two public metropolitan hospitals in Melbourne (Australia). Wards have been chosen to participate by management teams at each hospital. The allied health services to be investigated will include physiotherapy, occupational therapy, speech therapy, dietetics, social work and allied health assistants. At baseline, all wards will be receiving weekend allied health services. Study 1 intervention will be the sequential disinvestment (roll-in) of the current weekend allied health service model from each participating ward in monthly intervals and study 2 will be the roll-out of a new stakeholder-driven model of weekend allied health service delivery. The order in which weekend allied health services will be rolled in and out amongst participating wards will be determined randomly. This trial will be conducted in each of the two participating hospitals at a different time interval. Primary outcomes will be length of stay, rate of unplanned hospital readmission within 28 days and rate of adverse events. Secondary outcomes will be number of complaints and compliments, staff absenteeism

  15. Modeling the Personal Health Ecosystem.

    Science.gov (United States)

    Blobel, Bernd; Brochhausen, Mathias; Ruotsalainen, Pekka

    2018-01-01

    Complex ecosystems like the pHealth one combine different domains represented by a huge variety of different actors (human beings, organizations, devices, applications, components) belonging to different policy domains, coming from different disciplines, deploying different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. For correctly modeling such systems, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. However, most of the existing standards, specifications and tools for describing, representing, implementing and managing health (information) systems reflect the advancement of information and communication technology (ICT) represented by different evolutionary levels of data modeling. The paper presents a methodology for integrating, adopting and advancing models, standards, specifications as well as implemented systems and components on the way towards the aforementioned ultimate approach, so meeting the challenge we face when transforming health systems towards ubiquitous, personalized, predictive, preventive, participative, and cognitive health and social care.

  16. Implementation Intention and Reminder Effects on Behavior Change in a Mobile Health System: A Predictive Cognitive Model.

    Science.gov (United States)

    Pirolli, Peter; Mohan, Shiwali; Venkatakrishnan, Anusha; Nelson, Les; Silva, Michael; Springer, Aaron

    2017-11-30

    Implementation intentions are mental representations of simple plans to translate goal intentions into behavior under specific conditions. Studies show implementation intentions can produce moderate to large improvements in behavioral goal achievement. Human associative memory mechanisms have been implicated in the processes by which implementation intentions produce effects. On the basis of the adaptive control of thought-rational (ACT-R) theory of cognition, we hypothesized that the strength of implementation intention effect could be manipulated in predictable ways using reminders delivered by a mobile health (mHealth) app. The aim of this experiment was to manipulate the effects of implementation intentions on daily behavioral goal success in ways predicted by the ACT-R theory concerning mHealth reminder scheduling. An incomplete factorial design was used in this mHealth study. All participants were asked to choose a healthy behavior goal associated with eat slowly, walking, or eating more vegetables and were asked to set implementation intentions. N=64 adult participants were in the study for 28 days. Participants were stratified by self-efficacy and assigned to one of two reminder conditions: reminders-presented versus reminders-absent. Self-efficacy and reminder conditions were crossed. Nested within the reminders-presented condition was a crossing of frequency of reminders sent (high, low) by distribution of reminders sent (distributed, massed). Participants in the low frequency condition got 7 reminders over 28 days; those in the high frequency condition were sent 14. Participants in the distributed conditions were sent reminders at uniform intervals. Participants in the massed distribution conditions were sent reminders in clusters. There was a significant overall effect of reminders on achieving a daily behavioral goal (coefficient=2.018, standard error [SE]=0.572, odds ratio [OR]=7.52, 95% CI 0.9037-3.2594, Pbehavioral goals. Computational cognitive

  17. Health effects from fallout.

    Science.gov (United States)

    Gilbert, Ethel S; Land, Charles E; Simon, Steven L

    2002-05-01

    This paper primarily discusses health effects that have resulted from exposures received as a result of above-ground nuclear tests, with emphasis on thyroid disease from exposure to 131I and leukemia and solid cancers from low dose rate external and internal exposure. Results of epidemiological studies of fallout exposures in the Marshall Islands and from the Nevada Test Site are summarized, and studies of persons with exposures similar to those from fallout are briefly reviewed (including patients exposed to 131I for medical reasons and workers exposed externally at low doses and low dose rates). Promising new studies of populations exposed in countries of the former Soviet Union are also discussed and include persons living near the Semipalatinsk Test Site in Kazakhstan, persons exposed as a result of the Chernobyl accident, and persons exposed as a result of operations of the Mayak Nuclear Plant in the Russian Federation. Very preliminary estimates of cancer risks from fallout doses received by the United States population are presented.

  18. Evaluation of a Digital Game-Based Learning Program for Enhancing Youth Mental Health: A Structural Equation Modeling of the Program Effectiveness.

    Science.gov (United States)

    Huen, Jenny My; Lai, Eliza Sy; Shum, Angie Ky; So, Sam Wk; Chan, Melissa Ky; Wong, Paul Wc; Law, Y W; Yip, Paul Sf

    2016-10-07

    Digital game-based learning (DGBL) makes use of the entertaining power of digital games for educational purposes. Effectiveness assessment of DGBL programs has been underexplored and no attempt has been made to simultaneously model both important components of DGBL: learning attainment (ie, educational purposes of DGBL) and engagement of users (ie, entertaining power of DGBL) in evaluating program effectiveness. This study aimed to describe and evaluate an Internet-based DGBL program, Professor Gooley and the Flame of Mind, which promotes mental health to adolescents in a positive youth development approach. In particular, we investigated whether user engagement in the DGBL program could enhance their attainment on each of the learning constructs per DGBL module and subsequently enhance their mental health as measured by psychological well-being. Users were assessed on their attainment on each learning construct, psychological well-being, and engagement in each of the modules. One structural equation model was constructed for each DGBL module to model the effect of users' engagement and attainment on the learning construct on their psychological well-being. Of the 498 secondary school students that registered and participated from the first module of the DGBL program, 192 completed all 8 modules of the program. Results from structural equation modeling suggested that a higher extent of engagement in the program activities facilitated users' attainment on the learning constructs on most of the modules and in turn enhanced their psychological well-being after controlling for users' initial psychological well-being and initial attainment on the constructs. This study provided evidence that Internet intervention for mental health, implemented with the technologies and digital innovations of DGBL, could enhance youth mental health. Structural equation modeling is a promising approach in evaluating the effectiveness of DGBL programs.

  19. The Effect of Education about Preventive Behaviors of Urinary Infection Based on Health Belief Model by Attending and Non- Attending Educational Programs in Pregnant Women

    Directory of Open Access Journals (Sweden)

    F. Noroozi

    2015-11-01

    Full Text Available Background: Urinary tract infection is the second most common complication of pregnancy, maternal and fetal complications and serious consequences will follow. So, the purpose of this study is comparison of education effect between attend and non-attend methods on promotion prevailing behavior from urinary tract infection in pregnant women based on the health belief model. Materials and Methods: In this clinical trial, 140 pregnant women coming to Bushehr medical center, in two group (70 people each were studied. In attend group, two education meetings, including 1.5 hour were hold based on the health belief model with an interval of a week. Non-attend education group, just received a booklet arranged based on health belief model. The information about awareness, structures model and function were collected before, one week and three months later via questionnaire. The urinary test results were collected before and three months after the intervention. After getting information, data were analyzed by software SPSS version 20 via perfect tests. Results: Before educational intervention, knowledge, preventive behaviors of urinary infection and all structures model were same in both groups. After the intervention, average of perceived susceptibility, severity, benefit and self-efficacy increased and average of perceived barrier decreased significantly in attend education group (P≤0/001, and in non-attend education group, awareness score and perceived susceptibility, benefit and self-efficacy increased and average of perceived barrier decreased significantly. Average of perceived susceptibility, barrier, self-efficacy, awareness, and mean of preventive behaviors of urinary infection between two groups were different significantly (P≤0/001. Conclusion: Regarding to changes in health belief model constructs, knowledge and function in two groups after education, using booklets based on health belief model for pregnant women can be useful due to their

  20. The effectiveness of an integrated collaborative care model vs. a shifted outpatient collaborative care model on community functioning, residential stability, and health service use among homeless adults with mental illness: a quasi-experimental study.

    Science.gov (United States)

    Stergiopoulos, Vicky; Schuler, Andrée; Nisenbaum, Rosane; deRuiter, Wayne; Guimond, Tim; Wasylenki, Donald; Hoch, Jeffrey S; Hwang, Stephen W; Rouleau, Katherine; Dewa, Carolyn

    2015-08-28

    Although a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model. In total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains. We observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures. Our findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.

  1. Effect of an Educational Program Based on the Health Belief Model to Reduce Cell Phone Usage During Driving in Taxi drivers

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-09-01

    Full Text Available Introduction: Cell phone usage during driving has become a threat to traffic safety. This study aimed to determine the effectiveness of an educational program based on the health belief model to reduce cell phone usage during driving in taxi drivers of Tuyserkan. Materials and Methods: In this quasi-experimental study, 110 taxi drivers younger than 35 years were randomly divided into two experimental and control groups in Tuyserkan, Iran. Data was collected using a questionnaire including the health belief model constructs, knowledge, behaviors of using cell phone and demographic variables. The questionnaires were self-reported. Intervention was three sessions applied in the experimental group. Both groups were followed for two months after the intervention. Finally, data analysis was performed using SPSS- 19 by Chi-square, Independent T-test, Paired T-test and McNemar. Results: The mean scores for the constructs of health belief model (perceived susceptibility, severity, barriers, perceived benefits, self-efficacy and cues to action, knowledge and desired behaviors about the use of cell phone during driving showed no significant differences between the two groups before the intervention. After the educational intervention, significant differences were observed in experimental group compared to control group. After educational intervention, cell phone usage reduced by 35.14% in the experimental group. Conclusion: An educational intervention based on the health belief model could reduce cell phone usage during driving in taxi drivers.

  2. Surgery for Otitis Media in a Universal Health Care Model: Socioeconomic Status and Race/Ethnicity Effects.

    Science.gov (United States)

    Ambrosio, Art; Brigger, Matthew T

    2014-07-01

    (1) To determine the association between socioeconomic status (SES), race/ethnicity, and other demographic risk factors in surgically managed otitis media within a model of universal health care. 2) To determine quality of life (QOL) outcomes of surgically managed otitis media in this model. Tertiary academic medical center. Prospective cohort study. A prospective study was conducted between June 2011 and December 2012 with dependent children of military families. TRICARE provides equal access to care among all beneficiaries regardless of a wide range of annual incomes. Caretakers of children scheduled for bilateral myringotomy and tympanostomy tube (BMT) placement were administered a demographic survey, as well as OM-6 QOL instrument preoperatively and 6 weeks postoperatively. A control group who did not undergo BMT was also administered both the survey and OM-6 for comparison. Two hundred forty patients were enrolled (120 surgical patients and 120 controls). Logistic regression demonstrated age younger than 6 years old (P otitis media-6 (OM-6) scores after surgical management from 3.00 (95% confidence interval [CI], 2.79-3.20) to 1.35 (95% CI, 1.22-1.47). In a universal health care model serving more than 2 million children, previously reported proxies of low SES as well as minority race/ethnicity were not associated with surgically managed otitis media contrary to reported literature. Caucasian race, young age, and day care attendance were associated with surgery. Surgery improved QOL outcomes 6 weeks postoperatively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  3. The Effect of an Educational Intervention Program on the Adoption of Low Back Pain Preventive Behaviors in Nurses: An Application of the Health Belief Model

    OpenAIRE

    Sharafkhani, Naser; Khorsandi, Mahboobeh; Shamsi, Mohsen; Ranjbaran, Mehdi

    2015-01-01

    Study Design?Randomized controlled trial. Objective?The purpose of this study was to identify the effect of a theory-based educational intervention program on the level of knowledge and Health Belief Model (HBM) constructs among nurses in terms of the adoption of preventive behaviors. Methods?This pretest/posttest quasi-experimental study was conducted on 100 nurses who were recruited through the multistage sampling method. The nurses were randomly assigned to intervention and control groups....

  4. Smokeless Tobacco: Health Effects

    Science.gov (United States)

    ... t start. If you do use them, quit. Addiction to Smokeless Tobacco Smokeless tobacco contains nicotine, which ... Smoking and Health E-mail: tobaccoinfo@cdc.gov Phone: 1-800-CDC-INFO Media Inquiries: Contact CDC’s ...

  5. Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments

    Directory of Open Access Journals (Sweden)

    Bethany Shinkins

    2017-04-01

    Full Text Available Abstract Background Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1 what evidence aside from test accuracy was searched for and synthesised, 2 which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3 how/whether threshold effects were explored, 4 how the potential dependency between multiple tests in a pathway was accounted for, and 5 for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings

  6. Effects of the Educational Intervention on some Health Belief Model Constructs regarding the Prevention of Obesity in Students

    Directory of Open Access Journals (Sweden)

    Ahmadreza Noorbakhsh

    2017-08-01

    Full Text Available Background Obesity causes depression and undermines mental health in adolescents. It is also related to adulthood diseases and mortality. The current study drew upon an educational intervention to modify some Health Belief Model constructs to preventing overweight and obesity among adolescents.  Materials and Methods: In this quasi-experimental study 100 boy students recruited from selected boys junior high schools in Isfahan. They were randomly assigned to intervention (n=50 and control (n=50 groups. In 4 training sessions, a nutritionist introduced different types of healthy foods and explained how to consume them. A sports coach also taught how to do physical exercises well in 4 sessions (each one 90 minutes in terms of nutrition and physical activity. Data of pretest and posttest gathered from demographic and a valid questionnaire were fed into the SPSS software, version 20.0 and analyzed using relevant statistical tests. Results: The independent t-test revealed that, before the intervention, there was no significant difference between the two groups in the mean scores of knowledge, perceived benefits, perceived barriers, physical activity, and nutrition behavior (P>0.05; but, after the intervention, this difference between the two groups was significant (P

  7. Feasibility and effectiveness of a disease and care management model in the primary health care system for patients with heart failure and diabetes (Project Leonardo

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2010-04-01

    Full Text Available Marco Matteo Ciccone1, Ambrogio Aquilino2, Francesca Cortese1, Pietro Scicchitano1, Marco Sassara1, Ernesto Mola3, Rodolfo Rollo4,Pasquale Caldarola5, Francesco Giorgino6, Vincenzo Pomo2, Francesco Bux21Section of Cardiovascular Disease, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, Italy; 2Agenzia Regionale Sanitaria – Regione Puglia (ARES, Apulia, Italy; 3ASL, Lecce, Italy; 4ASL, Brindisi, Italy; 5Cardiologia, Ospedale “Sarcone”, Terlizzi, Italy; 6Section of Endocrinology, Department of Emergency and Organ Transplantation, School of Medicine, University of Bari, Bari, ItalyPurpose: Project Leonardo represented a feasibility study to evaluate the impact of a disease and care management (D&CM model and of the introduction of “care manager” nurses, trained in this specialized role, into the primary health care system. Patients and methods: Thirty care managers were placed into the offices of 83 general practitioners and family physicians in the Apulia Region of Italy with the purpose of creating a strong cooperative and collaborative “team” consisting of physicians, care managers, specialists, and patients. The central aim of the health team collaboration was to empower 1,160 patients living with cardiovascular disease (CVD, diabetes, heart failure, and/or at risk of cardiovascular disease (CVD risk to take a more active role in their health. With the support of dedicated software for data collection and care management decision making, Project Leonardo implemented guidelines and recommendations for each condition aimed to improve patient health outcomes and promote appropriate resource utilization.Results: Results show that Leonardo was feasible and highly effective in increasing patient health knowledge, self-management skills, and readiness to make changes in health behaviors. Patient skill-building and ongoing monitoring by the health care team of diagnostic tests and services

  8. THE EFFECT OF FAMILY THERAPY WITH SPIRITUAL APPROACH TOWARD FAMILY’S HEALTH BELIEF MODEL IN TAKING CARE OF PATIENT WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-04-01

    Full Text Available Introduction: Schizophrenia is the problem with kognitive, mal-adaptive thought and behavior. Family who have a member with mental disorder can experience serious conflict, become an objective and subjective burden, blame each other, get involved in hostility among family members. Various negative effect faced by family can caused by wrong family’s health belief model about Schizophrenia, hence the failure on choosing the treatment and taking care of patient at home. Someone with severe stress will seek comfort and strength from God. But so far, the most effective spiritual models to improve the health belief model of the family in caring for patients with schizophrenia has not been found. Method: Design used in this study was experimental (pre post test control group design. The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, chosen by alocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Results: There were significant changes in total of family’s health belief model (p=0,004, there was significantly change in aspects of (1 perceptions about bene fi ts (p=0,009, (2 perception about barriers (p=0,035 and perception about self efficacy (p=0,002. There were no significant changing in perception about susceptibility and severity (p=0,052. Discussion: Family believes that all events experienced by the patient and the family is God's will, hoping the patient can be more independent, and believe mental disorders can be changed for the better. The conclusion of this study is that family therapy with a spiritual approach can improve the health belief model of the family in caring for patients with mental disorders.

  9. Modeling the effects of functional performance and post-transplant comorbidities on health-related quality of life after heart transplantation.

    Science.gov (United States)

    Butler, Javed; McCoin, Nicole S; Feurer, Irene D; Speroff, Theodore; Davis, Stacy F; Chomsky, Don B; Wilson, John R; Merrill, Walter H; Drinkwater, Davis C; Pierson, Richard N; Pinson, C Wright

    2003-10-01

    Health-related quality of life and functional performance are important outcome measures following heart transplantation. This study investigates the impact of pre-transplant functional performance and post-transplant rejection episodes, obesity and osteopenia on post-transplant health-related quality of life and functional performance. Functional performance and health-related quality of life were measured in 70 adult heart transplant recipients. A composite health-related quality of life outcome measure was computed via principal component analysis. Iterative, multiple regression-based path analysis was used to develop an integrated model of variables that affect post-transplant functional performance and health-related quality of life. Functional performance, as measured by the Karnofsky scale, improved markedly during the first 6 months post-transplant and was then sustained for up to 3 years. Rejection Grade > or =2 was negatively associated with health-related quality of life, measured by Short Form-36 and reversed Psychosocial Adjustment to Illness Scale scores. Patients with osteopenia had lower Short Form-36 physical scores and obese patients had lower functional performance. Path analysis demonstrated a negative direct effect of obesity (beta = - 0.28, p or =2 had a negative direct effect on this measure (beta = -0.29, p < 0.05). Either directly or through effects mediated by functional performance, moderate-to-severe rejection, obesity and osteopenia negatively impact health-related quality of life. These findings indicate that efforts should be made to devise immunosuppressive regimens that reduce the incidence of acute rejection, weight gain and osteopenia after heart transplantation.

  10. Toward a humanistic model in health communication.

    Science.gov (United States)

    Werder, Olaf

    2017-03-01

    Since the key to effective health communication lies in its ability to communicate well, some of its core problems are those that relate to the sharing of meaning between communicators. In elaborating on these problems, this paper offers two key propositions: one, health communication has to pass through the filter of a particular world view that creates a discrepancy between expected and actual message reception and response. Two, the assumption of a rational human actor made implicitly by most health psychological models is a contestable issue, as many times message recipients do not follow a cognitive judgment process. The phenomenon of resisting health messages by reasonable people asks the question whether we ought to rethink our adherence to a particular vision of human health as many times the adverse reaction to behaviour modification occurs as the result of a particular dialogical or discursive situation. At the same time, most motivational decisions in people's daily routines are automatic and use a concept known as self-identity to give stability to their behaviour patterns. Finally, health communication as part of organised government practices adheres to predominant value perspectives within health promotion practice that affect the manner in which health issues become problematised. This paper proposes a humanistic model that aims to pay attention to the intricacies of human communication by addressing all of the above problems in turn. It interprets the sharing of meaning element in human communication and addresses the question of how the idea of health is created through discourse. As such, it offers a complementary and constructive paradigm and set of approaches to understand health, its meanings and communication.

  11. Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis.

    Science.gov (United States)

    Walker, Patrick G T; White, Michael T; Griffin, Jamie T; Reynolds, Alison; Ferguson, Neil M; Ghani, Azra C

    2015-07-01

    The ongoing Ebola epidemic in parts of west Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved over the past decade. We quantified this additional indirect burden of Ebola virus disease. We estimated the number of cases and deaths from malaria in Guinea, Liberia, and Sierra Leone from Demographic and Health Surveys data for malaria prevalence and coverage of malaria interventions before the Ebola outbreak. We then removed the effect of treatment and hospital care to estimate additional cases and deaths from malaria caused by reduced health-care capacity and potential disruption of delivery of insecticide-treated bednets. We modelled the potential effect of emergency mass drug administration in affected areas on malaria cases and health-care demand. If malaria care ceased as a result of the Ebola epidemic, untreated cases of malaria would have increased by 45% (95% credible interval 43-49) in Guinea, 88% (83-93) in Sierra Leone, and 140% (135-147) in Liberia in 2014. This increase is equivalent to 3·5 million (95% credible interval 2·6 million to 4·9 million) additional untreated cases, with 10,900 (5700-21,400) additional malaria-attributable deaths. Mass drug administration and distribution of insecticide-treated bednets timed to coincide with the 2015 malaria transmission season could largely mitigate the effect of Ebola virus disease on malaria. These findings suggest that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems. UK Medical Research Council, UK Department for International Development, Bill & Melinda Gates Foundation. Copyright © 2015 Walker et al. Open Access article distributed under the terms of CC BY

  12. Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives - A Review.

    Science.gov (United States)

    Adewole, D I; Kim, I H; Nyachoti, C M

    2016-07-01

    The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review.

  13. Gut Health of Pigs: Challenge Models and Response Criteria with a Critical Analysis of the Effectiveness of Selected Feed Additives — A Review

    Science.gov (United States)

    Adewole, D. I.; Kim, I. H.; Nyachoti, C. M.

    2016-01-01

    The gut is the largest organ that helps with the immune function. Gut health, especially in young pigs has a significant benefit to health and performance. In an attempt to maintain and enhance intestinal health in pigs and improve productivity in the absence of in-feed antibiotics, researchers have evaluated a wide range of feed additives. Some of these additives such as zinc oxide, copper sulphate, egg yolk antibodies, mannan-oligosaccharides and spray dried porcine plasma and their effectiveness are discussed in this review. One approach to evaluate the effectiveness of these additives in vivo is to use an appropriate disease challenge model. Over the years, researchers have used a number of challenge models which include the use of specific strains of enterotoxigenic Escherichia coli, bacteria lipopolysaccharide challenge, oral challenge with Salmonella enteric serotype Typhimurium, sanitation challenge, and Lawsonia intercellularis challenge. These challenge models together with the criteria used to evaluate the responses of the animals to them are also discussed in this review. PMID:26954144

  14. Health informatics model for helminthiasis in Thailand.

    Science.gov (United States)

    Nithikathkul, C; Trevanich, A; Wongsaroj, T; Wongsawad, C; Reungsang, P

    2017-09-01

    At the beginning of the new millennium, helminth infections continue to be prevalent, particularly among impoverished populations. This study attempts to create the first health informatics model of helminthiasis in Thailand. The authors investigate how a health informatics model could be used to predict the control and eradication in a national control campaign. Fish-borne helminthiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of South-East Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The epicentre of this disease is located in north-east Thailand, where high prevalence coexists with a high incidence of cholangiocarcinoma (CHCA). The current report was conducted to determine a mathematical model of surveillance for helminthiasis while also using a geographic information system. The fish-borne helminthiasis model or the predicted equation was Y1 = 3.028 + 0.020 (elevation) - 2.098 (clay). For soil-transmitted helminthiasis, the mathematical model or the predicted equation was Y2 = -1.559 + 0.005 (rainfall) + 0.004 (elevation) - 2.198 (clay). The Ministry of Public Health has concluded that mass treatment for helminthiasis in the Thai population, targeting high-risk individuals, may be a cost-effective way to allocate limited funds. This type of approach, as well as further study on the correlation of clinical symptoms with environmental and geographic information, may offer a novel strategy to the helminth crisis.

  15. Investigating the effect of continuous care model on social health status of family caregivers in hospitalized patients undergoing coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    T NasrAbadi

    2016-09-01

    Full Text Available Introduction: Chronic patient care causes  some problems, including pressure or burden of care, reducing the time for routine activities and self care, also causes compatibility decline in deal with stress and disorders of physical and mental health, emotional, social and financial prosperity of caregivers. The aim of this study was to determine the effect of continuous care model on social health status of  family caregivers in patients  underwent coronary artery bypass surgeries. Methods: This study was  one-group clinical trial research, the samples consisted 48 family caregiver of  the patients  underwent coronary artery bypass graft  surgeries, who  were selected using purposive sampling method. Data collection tools included the standard questionnaire Data collection tool was Novak and Guest caring burden inventory (CBI s as well as demographic questionnaire, which  was  measured at the baseline and 8 weeks after intervention.  Data were analyzed using  descriptive  and analytic statistic (paired t-test, and covariance analysis with SPSS version 16. Results: The mean score of  caring burden realated  to  the social health status before intervention was 3.86±6.11 and after intervention was 1.81±2.33. In examining five dimensions burden of care,  continuous care model had an impact on all aspects of the  caring burden and it led to the reduction of the burden of care  in  all aspects.  So,  it had a significant decrease  in the social health status (p <0.01. Conclusion: Implementation of continuous care model as the intervention of cheaper and available,  can be an effective step inreducing the burden of care of the  patients with  coronary artery disease in health status of social.

  16. Cost-effectiveness of public-health policy options in the presence of pretreatment NNRTI drug resistance in sub-Saharan Africa: a modelling study.

    Science.gov (United States)

    Phillips, Andrew N; Cambiano, Valentina; Nakagawa, Fumiyo; Revill, Paul; Jordan, Michael R; Hallett, Timothy B; Doherty, Meg; De Luca, Andrea; Lundgren, Jens D; Mhangara, Mutsa; Apollo, Tsitsi; Mellors, John; Nichols, Brooke; Parikh, Urvi; Pillay, Deenan; Rinke de Wit, Tobias; Sigaloff, Kim; Havlir, Diane; Kuritzkes, Daniel R; Pozniak, Anton; van de Vijver, David; Vitoria, Marco; Wainberg, Mark A; Raizes, Elliot; Bertagnolio, Silvia

    2018-03-01

    There is concern over increasing prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance in people initiating antiretroviral therapy (ART) in low-income and middle-income countries. We assessed the effectiveness and cost-effectiveness of alternative public health responses in countries in sub-Saharan Africa where the prevalence of pretreatment drug resistance to NNRTIs is high. The HIV Synthesis Model is an individual-based simulation model of sexual HIV transmission, progression, and the effect of ART in adults, which is based on extensive published data sources and considers specific drugs and resistance mutations. We used this model to generate multiple setting scenarios mimicking those in sub-Saharan Africa and considered the prevalence of pretreatment NNRTI drug resistance in 2017. We then compared effectiveness and cost-effectiveness of alternative policy options. We took a 20 year time horizon, used a cost effectiveness threshold of US$500 per DALY averted, and discounted DALYs and costs at 3% per year. A transition to use of a dolutegravir as a first-line regimen in all new ART initiators is the option predicted to produce the most health benefits, resulting in a reduction of about 1 death per year per 100 people on ART over the next 20 years in a situation in which more than 10% of ART initiators have NNRTI resistance. The negative effect on population health of postponing the transition to dolutegravir increases substantially with higher prevalence of HIV drug resistance to NNRTI in ART initiators. Because of the reduced risk of resistance acquisition with dolutegravir-based regimens and reduced use of expensive second-line boosted protease inhibitor regimens, this policy option is also predicted to lead to a reduction of overall programme cost. A future transition from first-line regimens containing efavirenz to regimens containing dolutegravir formulations in adult ART initiators is predicted to be effective and cost-effective in

  17. Health effects of job insecurity

    OpenAIRE

    Green, F.

    2015-01-01

    Research has shown that job insecurity affects both mental and physical health, though the effects are lower when employees are easily re-employable. The detrimental effects of job insecurity can also be partly mitigated by employers allowing greater employee participation in workplace decision-making in order to ensure fair procedures. But as job insecurity is felt by many more people than just the unemployed, the negative health effects during recessions are multiplied and extend through th...

  18. Searching for the best modeling specification for assessing the effects of temperature and humidity on health: a time series analysis in three European cities.

    Science.gov (United States)

    Rodopoulou, Sophia; Samoli, Evangelia; Analitis, Antonis; Atkinson, Richard W; de'Donato, Francesca K; Katsouyanni, Klea

    2015-11-01

    Epidemiological time series studies suggest daily temperature and humidity are associated with adverse health effects including increased mortality and hospital admissions. However, there is no consensus over which metric or lag best describes the relationships. We investigated which temperature and humidity model specification most adequately predicted mortality in three large European cities. Daily counts of all-cause mortality, minimum, maximum and mean temperature and relative humidity and apparent temperature (a composite measure of ambient and dew point temperature) were assembled for Athens, London, and Rome for 6 years between 1999 and 2005. City-specific Poisson regression models were fitted separately for warm (April-September) and cold (October-March) periods adjusting for seasonality, air pollution, and public holidays. We investigated goodness of model fit for each metric for delayed effects up to 13 days using three model fit criteria: sum of the partial autocorrelation function, AIC, and GCV. No uniformly best index for all cities and seasonal periods was observed. The effects of temperature were uniformly shown to be more prolonged during cold periods and the majority of models suggested separate temperature and humidity variables performed better than apparent temperature in predicting mortality. Our study suggests that the nature of the effects of temperature and humidity on mortality vary between cities for unknown reasons which require further investigation but may relate to city-specific population, socioeconomic, and environmental characteristics. This may have consequences on epidemiological studies and local temperature-related warning systems.

  19. 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

  20. Health Effects of Climate Change (Environmental Health Student Portal)

    Science.gov (United States)

    ... change can affect your health. Read About It Climate Change and Human Health (Public Broadcasting Services (including their teacher resources)) - Web ... Health Sciences) - Overview of the potential effects of climate change on human health. Climate and Health Program: Health Effects (Centers for ...

  1. The Study of Educational Program Effect Based on BAZNEF Model on Nutritional Performance of Pregnant Women Reffered to Meraj Health Center of Bushehr in 2013

    Directory of Open Access Journals (Sweden)

    Elham Arabi

    2016-07-01

    Full Text Available Background: Pregnancy is one of the critical periods in a woman’s life. Pregnancy is a suitable time for nutrition education. Pregnant women pay special attention to various aspects of their health, their fetuses’ health and they are accurate about the amount and type of food who consume. So, the aim of this study was to determine the effect of educational program based on BASNEF model on pregnant women’s performance reffered to Meraj health centers in 2013 in Bushehr. Materials and Methods: This quasi-experimental study was conducted in two groups including control and experimental group. Before the intervention in both groups, food frequency questionnaires completed, then educational intervention for experimental group was done in four sessions (three sessions for pregnant women and one session for their husbands and educational pamphlets were given to them about suitable nutrition during pregnancy. Data were analyzed by using SPSS18 software. Results: Results showed that 55% of women had an education level until diploma, most of them were housewives (65% or their income (47.5% was more than one million Tomans. The results showed that between nutrition performance of experimental group in food groups of bread and cereals (F=27.11 and p=0.0001, meat and protein group (F=7.647 and p=0.009, fruit group (F=20.9 and p=0.0001, vegetables (F=6.236 and p=0.018 and dairy products (F=3.66 and p=0.048, had a significant difference with control groups. Conclusion: Designing and implementation of BASNEF model can be effective in pregnancy nutrition. This model can be effective with proper and coordinated structure in improving the pregnant women nutrition. Designing intervention and educational programs is inexpensive, functional and applicable by using this model and provide an organizational framework to individuals as well.

  2. An investigation on the effect of Health Belief Model-based education on refusal skills in high risk situations among female students.

    Science.gov (United States)

    Boroumandfar, Khadijeh; Shabani, Fatemeh; Ghaffari, Mohtasham

    2012-03-01

    Various studies show an association between lack of social skills in adolescents and the future incidence of behavioral disorders. If girls, as future mothers, lack adequate health, awareness, self confidence and social skills, they may act as a source of many social problems. Therefore, the present study has tried to educate this group on one of the most essential social skills, refusal skill in high risk situation. This is a field quasi experimental study conducted on 145 female students in middle schools in Arak, Iran in 2010-2011. The schools were randomly selected. The subjects were selected through systematic random sampling from the schools' log book. The data were collected by questionnaires containing personal and familial characteristics, three health belief model structures, and behavioral intention in high risk situations. The data were analyzed by descriptive statistical tests (frequency distribution, mean, SD) and inferential tests of repetitive variance analysis and T-test through SPSS. In the present study, repetitive variance analysis showed that education by use of a health belief model had a positive effect on refusal skills in high risk situations as well as perceived barriers (p = 0.007), self-efficacy (p = 0.015), behavioral intention (p = 0.048) after educational intervention in the study group, but not on perceived benefits (p = 0.180). The results showed that education significantly increased refusal skills in high risk situations in the study group through the health belief model. With regard to the results, it is essential to equip the students with preventive behaviors to guarantee their physical, emotional and social health.

  3. Using Structural Equation Modeling to Examine the Effects of Sex and Physical Activity on the Metabolic Syndrome and Health-related Quality of Life Relationship

    Directory of Open Access Journals (Sweden)

    Peter D. Hart

    2018-01-01

    Full Text Available Objectives The purpose of this study was to use structural equation modeling (SEM to investigate the moderating effects of sex and the mediating effects of physical activity (PA on the metabolic syndrome (MetS and health-related quality of life (HRQOL relationship. Methods The 2013-14 NHANES was used and included 1,077 adults 50+ years of age. A latent construct of MetS was created using five observed variables: waist circumference, HDL cholesterol, triglycerides, fasting glucose, and mean arterial pressure. A PA variable was created from self-reported moderate and vigorous recreational activity and converted to quartiles of moderate-to-vigorous PA minutes per week. HRQOL was assessed from a question regarding self-rated general health and dichotomized to indicate poor/good HRQOL. Results The MetS latent model showed adequate fit (χ2/df=2.47, GFI=0.99, CFI=0.99, and RMSEA=0.04 and significantly (P<.001 predicted all observed variables. The structural model also showed adequate fit with significant direct effects of MetS on HRQOL (β= −0.118, P<0.001 and PA on HRQOL (β=0.176, P<0.001. The effect of MetS on HRQOL (β= −0.048, P=0.001 through PA revealed that PA mediates the relationship. The multi-group analysis showed that the structural model was significantly different between males and females, with PA completely mediating the MetS and HRQOL relationship in males and partially mediating the relationship in females. Conclusions Results from this study support the use of SEM for investigating moderating and mediating effects while simultaneously measuring a latent construct. Additionally, PA was a stronger mediator to the MetS and HRQOL relationship in older males than in older females.

  4. Effects of Health-Related Food Taxes and Subsidies on Mortality from Diet-Related Disease in New Zealand: An Econometric-Epidemiologic Modelling Study.

    Science.gov (United States)

    Ni Mhurchu, Cliona; Eyles, Helen; Genc, Murat; Scarborough, Peter; Rayner, Mike; Mizdrak, Anja; Nnoaham, Kelechi; Blakely, Tony

    2015-01-01

    Health-related food taxes and subsidies may promote healthier diets and reduce mortality. Our aim was to estimate the effects of health-related food taxes and subsidies on deaths prevented or postponed (DPP) in New Zealand. A macrosimulation model based on household expenditure data, demand elasticities and population impact fractions for 18 diet-related diseases was used to estimate effects of five tax and subsidy regimens. We used price elasticity values for 24 major commonly consumed food groups in New Zealand, and food expenditure data from national Household Economic Surveys. Changes in mortality from cardiovascular disease, cancer, diabetes and other diet-related diseases were estimated. A 20% subsidy on fruit and vegetables would result in 560 (95% uncertainty interval, 400 to 700) DPP each year (1.9% annual all-cause mortality). A 20% tax on major dietary sources of saturated fat would result in 1,500 (950 to 2,100) DPP (5.0%), and a 20% tax on major dietary sources of sodium would result in 2,000 (1300 to 2,700) DPP (6.8%). Combining taxes on saturated fat and sodium with a fruit and vegetable subsidy would result in 2,400 (1,800 to 3,000) DPP (8.1% mortality annually). A tax on major dietary sources of greenhouse gas emissions would generate 1,200 (750 to 1,700) DPP annually (4.0%). Effects were similar or greater for Maori and low-income households in relative terms. Health-related food taxes and subsidies could improve diets and reduce mortality from diet-related disease in New Zealand. Our study adds to the growing evidence base suggesting food pricing policies should improve population health and reduce inequalities, but there is still much work to be done to improve estimation of health impacts.

  5. Effects of Health-Related Food Taxes and Subsidies on Mortality from Diet-Related Disease in New Zealand: An Econometric-Epidemiologic Modelling Study.

    Directory of Open Access Journals (Sweden)

    Cliona Ni Mhurchu

    Full Text Available Health-related food taxes and subsidies may promote healthier diets and reduce mortality. Our aim was to estimate the effects of health-related food taxes and subsidies on deaths prevented or postponed (DPP in New Zealand.A macrosimulation model based on household expenditure data, demand elasticities and population impact fractions for 18 diet-related diseases was used to estimate effects of five tax and subsidy regimens. We used price elasticity values for 24 major commonly consumed food groups in New Zealand, and food expenditure data from national Household Economic Surveys. Changes in mortality from cardiovascular disease, cancer, diabetes and other diet-related diseases were estimated.A 20% subsidy on fruit and vegetables would result in 560 (95% uncertainty interval, 400 to 700 DPP each year (1.9% annual all-cause mortality. A 20% tax on major dietary sources of saturated fat would result in 1,500 (950 to 2,100 DPP (5.0%, and a 20% tax on major dietary sources of sodium would result in 2,000 (1300 to 2,700 DPP (6.8%. Combining taxes on saturated fat and sodium with a fruit and vegetable subsidy would result in 2,400 (1,800 to 3,000 DPP (8.1% mortality annually. A tax on major dietary sources of greenhouse gas emissions would generate 1,200 (750 to 1,700 DPP annually (4.0%. Effects were similar or greater for Maori and low-income households in relative terms.Health-related food taxes and subsidies could improve diets and reduce mortality from diet-related disease in New Zealand. Our study adds to the growing evidence base suggesting food pricing policies should improve population health and reduce inequalities, but there is still much work to be done to improve estimation of health impacts.

  6. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis.

    Science.gov (United States)

    Lal, Anita; Mantilla-Herrera, Ana Maria; Veerman, Lennert; Backholer, Kathryn; Sacks, Gary; Moodie, Marjory; Siahpush, Mohammad; Carter, Rob; Peeters, Anna

    2017-06-01

    A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011-12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged

  7. Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis

    Science.gov (United States)

    Mantilla-Herrera, Ana Maria; Veerman, Lennert; Backholer, Kathryn; Moodie, Marjory; Siahpush, Mohammad; Carter, Rob; Peeters, Anna

    2017-01-01

    Background A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Methods and findings Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011–12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. Conclusions This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs

  8. Public health impact and cost effectiveness of mass vaccination with live attenuated human rotavirus vaccine (RIX4414) in India: model based analysis.

    Science.gov (United States)

    Rose, Johnie; Hawthorn, Rachael L; Watts, Brook; Singer, Mendel E

    2009-09-25

    To examine the public health impact of mass vaccination with live attenuated human rotavirus vaccine (RIX4414) in a birth cohort in India, and to estimate the cost effectiveness and affordability of such a programme. Decision analytical Markov model encompassing all direct medical costs. Infection risk and severity depended on age, number of previous infections, and vaccination history; probabilities of use of inpatient and outpatient health services depended on symptom severity. Published clinical, epidemiological, and economic data. When possible, parameter estimates were based on data specific for India. Population Simulated Indian birth cohort followed for five years. Decrease in rotavirus gastroenteritis episodes (non-severe and severe), deaths, outpatient visits, and admission to hospital; incremental cost effectiveness ratio of vaccination expressed as net cost in 2007 rupees per life year saved. In the base case, vaccination prevented 28,943 (29.7%) symptomatic episodes, 6981 (38.2%) severe episodes, 164 deaths (41.0%), 7178 (33.3%) outpatient visits, and 812 (34.3%) admissions to hospital per 100,000 children. Vaccination cost 8023 rupees (about pound100, euro113, $165) per life year saved, less than India's per capita gross domestic product, a common criterion for cost effectiveness. The net programme cost would be equivalent to 11.6% of the 2006-7 budget of the Indian Department of Health and Family Welfare. Model results were most sensitive to variations in access to outpatient care for those with severe symptoms. If this parameter was increased to its upper limit, the incremental cost effectiveness ratio for vaccination still fell between one and three times the per capita gross domestic product, meeting the World Health Organization's criterion for "cost effective" interventions. Uncertainty analysis indicated a 94.7% probability that vaccination would be cost effective according to a criterion of one times per capita gross domestic product per life

  9. Effects of a School-Based Intervention on the Basis of Pender’s Health Promotion Model to Improve Physical Activity among High School Girls

    Directory of Open Access Journals (Sweden)

    P Teymouri

    2007-07-01

    Full Text Available Introduction & Objective: Participation in regular physical activity is associated with a variety of positive outcomes for young people. Physical activity (PA rates decline precipitously during the high school years and are consistently lower among adolescent girls than among adolescent boys. In order to stop or diverse this negative trend, there are necessary interventions based on various theories and models to promote physical activity in girls. Materials & Methods: This randomized control study evaluated the effectiveness of a 24-week exercise education program based on Pender’s Health Promotion model to improve cognitive and psychosocial factors associated with physical activity and to promote physical activity in adolescent girls (n =106. The program included educational sessions and tailored counseling. Results: There was an increase of 45 minutes for daily physical activity in the experimental group compared to their baseline. After intervention, the training group had a positive significant progression in stages along with significant improvements in self efficacy, enjoyment of physical activity, interpersonal influences, planning for physical activity, and also a decrease in perceived barriers to physical activity and competing preferences (p ≤ .0001-0.04. Conclusion: Findings of this study showed the positive effect of program on stage of change and potential determinants of the behavior of physical activity. The high proportion of the people in action and maintenance in experimental group compared to the baseline and the attainment of recommend criteria for physical activity are promising findings of school-based intervention based on Pender’s health promotion model.

  10. The effects of health promotion model-based educational program on self-care behaviors in patients undergoing coronary artery bypass grafting in Iran

    Science.gov (United States)

    Mohsenipouya, Hossein; Majlessi, Fereshteh; Ghafari, Rahman

    2018-01-01

    Background and aim Post-operative self-care behaviors, have positive effects on increase in adaptability, and reduce cardiac surgery patients’ disability. The present study is carried out aimed at determining the effect of education based on a health promotion model on the patients’ self-care behaviors after coronary artery bypass surgery. Methods This is a semi-experimental study carried out in Mazandaran (Iran) in 2016. Two hundred and twenty patients who participated in the study were selected using a simple random sampling method from a population of postoperative patients, and divided into control and experimental groups (110 patients in each) using block (AABB) randomization. Self-designed self-care questionnaires based on a health promotion model were distributed among the patients once before and three months after intervention. The data were analyzed by SPSS-22, Chi-Square tests, Mann-Whitney and ANCOVA at the significance level of ppromotion model can enhance self-care behaviors and reduce the number of admissions in patients after cardiac surgery. PMID:29588828

  11. A Health Production Model with Endogenous Retirement

    Science.gov (United States)

    Galama, Titus; Kapteyn, Arie; Fonseca, Raquel; Michaud, Pierre-Carl

    2012-01-01

    We formulate a stylized structural model of health, wealth accumulation and retirement decisions building on the human capital framework of health and derive analytic solutions for the time paths of consumption, health, health investment, savings and retirement. We argue that the literature has been unnecessarily restrictive in assuming that health is always at the “optimal” health level. Exploring the properties of corner solutions we find that advances in population health decrease the retirement age, while at the same time individuals retire when their health has deteriorated. This potentially explains why retirees point to deteriorating health as an important reason for early retirement, while retirement ages have continued to fall in the developed world, despite continued improvements in population health and mortality. In our model, workers with higher human capital invest more in health and because they stay healthier retire later than those with lower human capital whose health deteriorates faster. PMID:22888062

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

    Directory of Open Access Journals (Sweden)

    Nick Wilson

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

  13. Ozone health effects

    International Nuclear Information System (INIS)

    Easterly, C.

    1994-01-01

    Ozone is a principal component of photochemical air pollution endogenous to numerous metropolitan areas. It is primarily formed by the oxidation of NOx in the presence of sunlight and reactive organic compounds. Ozone is a highly active oxidizing agent capable of causing injury to the lung. Lung injury may take the form of irritant effects on the respiratory tract that impair pulmonary function and result in subjective symptoms of respiratory discomfort. These symptoms include, but are not limited to, cough and shortness of breath, and they can limit exercise performance. The effects of ozone observed in humans have been primarily limited to alterations in respiratory function, and a range of respiratory physiological parameters have been measured as a function of ozone exposure in adults and children. These affects have been observed under widely varying (clinical experimental and environmental settings) conditions

  14. The Effect of Education on Preventive Behaviors of Failure to Thrive in Mothers with Children Aged One to Five Years: Applied Health Belief Model

    Directory of Open Access Journals (Sweden)

    Mahtab Navabi

    2017-04-01

    Full Text Available Abstract Background: One of the common and important health problems is failure to thrive in childhood. The purpose of this study was to determine the effect of education on preventive behaviors of failure to thrive in mothers with children based on health belief model. Materials and Methods: This study is an interventional one in which 100 mothers with children one to five years involved (samples divided into two case and control groups, each of 50 sampling was done by a simple random method. For collecting information, a researcher-made questionnaire based on the health belief model and performance check list were used. Then, case group was trained for one month. 3 months after training, data were gathered and analyzed by Spss20 software. In addition to descriptive statistics, tests such as Chi-square, paired t-test and independent T-test were used. Results: The mean age of case and control was 29.98±5.51 and 25.35±5.30 years old, respectively. The average age of children was 23.31 ± 13.14 and 27.55 ± 14.01months, respectively. Before the intervention, no significant difference was seen between groups. The average score in case group before intervention was as: knowledge(31.87±14.24, perceived susceptibility(64.23±5.86, perceived severity(64.41±9.34, perceived benefits(61.75±6.79, perceived barriers(67.91±8.14, self-efficacy(68.00±7.87, cues to action(44.53±6.82 and action(70.00±9.77. However, after the intervention, significant differences between groups in all variables were obserred. Conclusion: According to the results, education based on health belief model is recommended for promoting preventive behaviors of failure to thrive.

  15. Acrolein health effects.

    Science.gov (United States)

    Faroon, O; Roney, N; Taylor, J; Ashizawa, A; Lumpkin, M H; Plewak, D J

    2008-08-01

    Acrolein is a chemical used as an intermediate reactive aldehyde in chemical industry. It is used for synthesis of many organic substances, methionine production, and methyl chloride refrigerant. The general population is exposed to acrolein via smoking, second-hand smoke, exposure to wood and plastic smoke. Firefighters and population living or working in areas with heavy automotive traffic may expose to higher level of acrolein via inhalation of smoke or automotive exhaust. Degradation of acrolein in all environmental media occurs rapidly, therefore, environmental accumulation is not expected. Acrolein degrade in 6A days when applied to surface water, and it has not been found as a contaminant in municipal drinking water. Acrolein vapor may cause eye, nasal and respiratory tract irritations in low level exposure. A decrease in breathing rate was reported by volunteers acutely exposed to 0.3A ppm of acrolein. At similar level, mild nasal epithelial dysplasia, necrosis, and focal basal cell metaplasia have been observed in rats. The acrolein effects on gastrointestinal mucosa in the animals include epithelial hyperplasia, ulceration, and hemorrhage. The severity of the effects is dose dependent. Acrolein induces the respiratory, ocular, and gastrointestinal irritations by inducing the release of peptides in nerve terminals innervating these systems. Levels of acrolein between 22 and 249 ppm for 10 min induced a dose-related decrease in substance P (a short-chain polypeptide that functions as a neurotransmitter or neuromodulator).

  16. Effectiveness of intensive healthcare waste management training model among health professionals at teaching hospitals of Pakistan: a quasi-experimental study.

    Science.gov (United States)

    Kumar, Ramesh; Somrongthong, Ratana; Shaikh, Babar Tasneem

    2015-02-28

    Infectious waste management has always remained a neglected public health problem in the developing countries, resulting in high burden of environmental pollution affecting general masses. Health workers are the key personnel who are responsible for the management of infectious waste at any hospital, however, their proper training and education is must for an optimal performance. This interventional study was conducted to assess the effectiveness of Intensive healthcare waste management (IHWM) training model at two tertiary care hospitals of Rawalpindi city, Pakistan. This study was quasi-experimental pre and post design with control and intervention groups. Out of 275 health care workers enrolled for the study, 138 workers were assigned for intervention group for 3 months trainings, hands-on practicum and reminders on infectious waste management; whereas 137 workers were assigned to the control hospital where routine activities on infectious health care waste management were performed. Pre and post intervention assessment was done for knowledge, attitude and practices (KAP); and was statistically analyzed. Bivariate and multivariate analysis, independent, paired and unpaired t-test, chi-square with p values, and mean of the responses were calculated. Overall the response rate was 92% at the end of intervention. During the baseline survey, 275 healthcare workers (HCW) included doctors, nurses, paramedics and sanitary workers, and after 3 months of intervention, 255 were reached out to complete the questionnaire. With regard to KAP at baseline, there were no significant differences between two groups at baseline, except for gender and department. However, in the post intervention survey, statistically significance difference (0.05) after 3 months. Study results suggest that IHWM training could be an effective intervention for improving knowledge, attitudes and practices among health workers regarding infectious waste management. Such training should become a

  17. A health economic model to assess the cost-effectiveness of OPTIFAST® for the treatment of obesity in USA.

    Science.gov (United States)

    Nuijten, Mark; Marczewska, Agnieszka; Araujo Torress, Krysmaru; Rasouli, Bahareh; Perugini, Moreno

    2018-04-20

    Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. High prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST ® is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of OPTIFAST ® program in the USA, as compared to "no intervention" and pharmacotherapy. An event-driven decision analytic model was used to estimate payer's cost-savings from reimbursement of the 1-year OPTIFAST ® program over 3 years in the USA. The analysis was performed for the broad population of obese persons (BMI >30 kg/m 2 ) undergoing the OPTIFAST ® program versus liraglutide 3 mg, naltrexone/bupropion and versus "no intervention". The model included risk of complications related to increased BMI. Data sources included published literature, clinical trials, official USA price/tariff lists and national population statistics. The primary perspective was that of a USA payer; costs provided in 2016 US dollars. OPTIFAST ® leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30-39.9 kg/m 2 ) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST ® program leads to a reduction of cost of obesity complications of USD 1,951 as compared to "no intervention" with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses show also substantial cost-savings in patients with class III obesity (BMI ≥40.0 kg/m 2 ) and patients with obesity (BMI 30-39.9 kg/m2) and type 2 diabetes versus all three previous comparators and bariatric surgery. Reimbursing OPTIFAST ® leads to meaningful cost

  18. A functional model for monitoring equity and effectiveness in purchasing health insurance premiums for the poor: evidence from Cambodia and the Lao PDR.

    Science.gov (United States)

    Annear, Peter Leslie; Bigdeli, Maryam; Jacobs, Bart

    2011-10-01

    To assess the impact on equity and effectiveness of introducing targeted subsidies for the poor into existing voluntary health insurance schemes in Low Income Countries with special reference to cross-subsidisation. A functional model was constructed using routine collected financial data to analyse changes in financial flows and resulting shifts in cross-subsidization between poor and non-poor. Data were collected from two sites, in Cambodia at Kampot operational health district and in the Lao People's Democratic Republic at Nambak district. Six key variables were identified as determining the financial flows between the subsidy and the insurance schemes and with health providers: population coverage, premium rate, facility contact rate, capitation rate, cost of treatment and changes in administration costs. Negative cross-subsidization was revealed where capitation was used as the payment mechanism and where utilisation rates of the poor were significantly below the non-poor. The same level of access for the poor could have been achieved with a lower Health Equity Fund subsidy if used as a direct reimbursement of user charges by the Health Equity Fund to the provider rather than through the Community Based Health Insurance scheme. Purchasing premiums for the poor under these conditions is more costly than direct reimbursement to the provider for the same level of service delivery. Negative cross-subsidization is a serious risk that must be managed appropriately and the benefits of a larger risk pool (cross-subsidization of the poor) are not evident. Benefits from combined coverage may accrue in the longer term with an expanded base of voluntary payers or when those with subsidized premiums are lifted out of poverty. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Applying the Health Belief Model to college students' health behavior

    Science.gov (United States)

    Kim, Hak-Seon; Ahn, Joo

    2012-01-01

    The purpose of this research was to investigate how university students' nutrition beliefs influence their health behavioral intention. This study used an online survey engine (Qulatrics.com) to collect data from college students. Out of 253 questionnaires collected, 251 questionnaires (99.2%) were used for the statistical analysis. Confirmatory Factor Analysis (CFA) revealed that six dimensions, "Nutrition Confidence," "Susceptibility," "Severity," "Barrier," "Benefit," "Behavioral Intention to Eat Healthy Food," and "Behavioral Intention to do Physical Activity," had construct validity; Cronbach's alpha coefficient and composite reliabilities were tested for item reliability. The results validate that objective nutrition knowledge was a good predictor of college students' nutrition confidence. The results also clearly showed that two direct measures were significant predictors of behavioral intentions as hypothesized. Perceived benefit of eating healthy food and perceived barrier for eat healthy food to had significant effects on Behavioral Intentions and was a valid measurement to use to determine Behavioral Intentions. These findings can enhance the extant literature on the universal applicability of the model and serve as useful references for further investigations of the validity of the model within other health care or foodservice settings and for other health behavioral categories. PMID:23346306

  20. Health Insurance, Medical Care, and Health Outcomes: A Model of Elderly Health Dynamics

    Science.gov (United States)

    Yang, Zhou; Gilleskie, Donna B.; Norton, Edward C.

    2009-01-01

    Prescription drug coverage creates a change in medical care consumption, beyond standard moral hazard, arising both from the differential cost-sharing and the relative effectiveness of different types of care. We model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health…

  1. 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

  2. Noise Pollution and Health Effects

    Directory of Open Access Journals (Sweden)

    Geravandi

    2015-01-01

    Full Text Available Background Noise pollution is of particular importance due to the physical and psychological effects on humans. Noise is a stressor that affects the autonomic nervous system and the endocrine system. Noise is also a threat to marine and terrestrial ecosystems. Health risks from noise are correlated with road traffic. In other words, noise health effects are the health consequences of elevated sound levels. Objectives This study aims to determine the effect of noise pollution (near roadways on health issues in Ahvaz, Iran. Materials and Methods In this cross-sectional study, equivalent sound pressure level were measured by sound level meters TES-1353 in 75 locations around 4 roadways, which had a high load of traffic in Ahvaz City during day time. During the study, 820 measurements were recorded at measuring stations, for 7 days per week with 1-hour interval between each measurement. Statistical analysis was carried out by SPSS software. Results According to the research findings, the equivalent sound pressure levels in all stations were 76.28 ± 3.12 dB (Mean ± SD. According to sound measurements and the survey questionnaire, noise pollution is higher than EPA (US Environmental Protection Agency and Iran standard level. Based on result of this study the worst noise health effects were the nervousness and sleep quality during 2012. Conclusions According to the results of this study, with increasing load of traffic, there is an increasing need for proper consideration plans to control noise pollution and prevent its effects.

  3. Modeling Per Capita State Health Expenditure Variat...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Modeling Per Capita State Health Expenditure Variation State-Level Characteristics Matter, published in Volume 3, Issue 4, of the Medicare and Medicaid Research...

  4. Shifting physician prescribing to a preferred histamine-2-receptor antagonist. Effects of a multifactorial intervention in a mixed-model health maintenance organization.

    Science.gov (United States)

    Brufsky, J W; Ross-Degnan, D; Calabrese, D; Gao, X; Soumerai, S B

    1998-03-01

    This study was undertaken to determine whether a program of education, therapeutic reevaluation of eligible patients, and performance feedback could shift prescribing to cimetidine from other histamine-2 receptor antagonists, which commonly are used in the management of ulcers and reflux, and reduce costs without increasing rates of ulcer-related hospital admissions. This study used an interrupted monthly time series with comparison series in a large mixed-model health maintenance organization. Physicians employed in health centers (staff model) and physicians in independent medical groups contracting to provide health maintenance organization services (group model) participated. The comparative percentage prescribed of specific histamine-2 receptor antagonists (market share), total histamine-2 receptor antagonist prescribing, cost per histamine-2 receptor antagonist prescription, and the rate of hospitalization for gastrointestinal illness were assessed. In the staff model, therapeutic reevaluation resulted in a sudden increase in market share of the preferred histamine-2 receptor antagonist cimetidine (+53.8%) and a sudden decrease in ranitidine (-44.7%) and famotidine (-4.8%); subsequently, cimetidine market share grew by 1.1% per month. In the group model, therapeutic reevaluation resulted in increased cimetidine market share (+9.7%) and decreased prescribing of other histamine-2 receptor antagonists (ranitidine -11.6%; famotidine -1.2%). Performance feedback did not result in further changes in prescribing in either setting. Use of omeprazole, an expensive alternative, essentially was unchanged by the interventions, as were overall histamine-2 receptor antagonist prescribing and hospital admissions for gastrointestinal illnesses. This intervention, which cost approximately $60,000 to implement, resulted in estimated annual savings in histamine-2 receptor antagonist expenditures of $1.06 million. Annual savings in histamine-2 receptor antagonist expenditures

  5. Developing a model for effects of climate change on human health and health-environment interactions: Heat stress in Austin, Texas - Urban Climate

    Science.gov (United States)

    Human health and well-being are and will be affected by climate change, both directly through changes in extreme weather events and indirectly through weather-induced changes in human and natural systems. Populations are vulnerable to these changes in varying degrees, depending ...

  6. Estimation of health effects (morbidity and mortality attributed to PM10 and PM2.5 exposure using an Air Quality model in Bukan city, from 2015-2016 exposure using air quality model

    Directory of Open Access Journals (Sweden)

    Bahram Kamarehie

    2017-08-01

    Full Text Available Background: Air Quality software is a useful tool for assessing the health risks associated with air pollutants. Quantifying the effects of exposure to air pollutants in terms of public health has become a critical component of policy discussion. The present study purposed to quantify the health effects of particulate matters on mortality and morbidity in a Bukan city hospital from 2015-2016. Methods: Information regarding coordinates, exposed population, number of stations used in profiling, mean and maximum concentrations (annual, winter, and summer, annual 98th percentile, baseline incidence (BI per 100 000 per year, and relative risk was needed for use with the software. Results: The average particulate matter concentration was higher in summer than in winter. The concentrations of PM10 in summer and winter were 84.37 and 74.86 μg m-3, respectively. The Air Quality model predicted that total mortality rates related to PM10 and PM2.5 were 33.3 and 49.8 deaths, respectively. As a result, 3.79% of the total mortality was due to PM10. In Bukan city, 2.004% of total deaths were due to cardiovascular mortality. The Air Quality model predicted that the deaths of 92.2 people were related to hospital admissions for respiratory disease. Conclusion: The continual evaluation of air quality data is necessary for investigating the effect of pollutants on human health.

  7. Effects of education based on the health belief model on screening behavior in high risk women for breast cancer, Tehran, Iran.

    Science.gov (United States)

    Hajian, Sepideh; Vakilian, Katayon; Najabadi, Khadijeh Mirzaii; Hosseini, Jalil; Mirzaei, Hamid Reza

    2011-01-01

    Breast cancer is the most common malignancy in women. Early diagnosis allows efficient treatment and increases survival, but the efficacy of breast self examination (BSE) is not sufficiently well established. The American Cancer Society aims to give women the opportunity to recognize the utility, limitations and adverse effects of breast cancer screening through education models based on psychological theories. With the Health Belief Model, people's health perceptions and attitudes influence their practices, for example with screening. The purpose of this randomized controlled clinical trial was to determine the effect of education based on this model on breast cancer screening in high risk Iranian women. Participants were women with a family history of breast cancer (mother, sister, and daughter). After explanation of the study objectives to participants, they were recruited on obtaining oral consent and each filled out the study questionnaire based on the Health Belief Model. Allocation was into two groups by computerized randomization, control and intervention, receiving education on breast cancer screening. Perceived susceptibility to and seriousness of breast cancer, perceived usefulness of and barriers to BSE, clinical breast examination, and mammography, and self-efficacy in the ability to perform these, were assessed, with comparison of scores for BSE practice before and after education and doing mammography and clinical examination by a physician in intervention and control group. The mean age was 37.8 ± 11.7 (range 19-60). The mean rank in the intervention group significantly differed before and after the education, but except for " perceived threat" and "perceived usefulness of breast self examination", we did not find any significant differences from the control group. After educational sessions, breast self examination and clinical examination practice rates were elevated. Health education based on well known psychological theories for breast cancer

  8. Modeling patients' acceptance of provider-delivered e-health.

    Science.gov (United States)

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  9. Health effects of ionizing radiation

    International Nuclear Information System (INIS)

    Radford, E.P.

    1980-01-01

    This presentation is restricted to the health effects of low doses of ionizing radiation. In general, these cumulative exposures are well below 100 rem, or about 50 times background or less. The two effects of interest in this dose range are genetic mutations and cancer production. The genetic effects will not be discussed in detail. The chief reason for the rise in risk estimates for cancer is the longer follow-up of exposed populations

  10. Evaluation of the Effectiveness of a First Aid Health Volunteers' Training Programme Using Kirkpatrick's Model: A Pilot Study

    Science.gov (United States)

    Vizeshfar, Fatemeh; Momennasab, Marzieh; Yektatalab, Shahrzad; Iman, Mohamad Taghi

    2018-01-01

    Objective: This study aimed to evaluate the effectiveness of a health volunteers' complementary training programme on first aid. Design: Quasi-experimental study. Setting: A comprehensive health centre in the southwest of Iran. Method: The study was conducted in the second half of 2015 with all 25 health volunteers in the Qamar Bani Hashem…

  11. A comparison of the cost-effectiveness of in vitro fertilization strategies and stimulated intrauterine insemination in a Canadian health economic model.

    Science.gov (United States)

    Bhatt, Taimur; Baibergenova, Akerke

    2008-05-01

    In vitro fertilization (IVF) with single embryo transfer (SET) has been proposed as a means of reducing multiple pregnancies associated with infertility treatment. All existing cost-effectiveness studies of IVF-SET have compared it with IVF with multiple embryo transfer but not with intrauterine insemination with gonadotropin stimulation (sIUI). We conducted a systematic review of studies of cost-effectiveness of IVF-SET versus IVF with double embryo transfer (DET). Further, we developed a health economy model that compared three strategies: (1) IVF-SET, (2) IVF-DET, and (3) sIUI. The decision analysis considered three cycles for each treatment option. IVF treatment was assumed to be a combination of cycles with transfer of fresh and frozen-thawed embryos. Probabilities used to populate the model were taken from published randomized clinical trials and observational studies. Cost estimates were based on average costs of associated procedures in Canada. The results of published studies on the cost-effectiveness of IVF-SET versus IVF-DET were not consistent. In our analysis, IVF-DET proved to be the most cost-effective strategy at $35,144/live birth, followed by sIUI at $66,960/live birth, and IVF-SET at $109,358/live birth. The results were sensitive both to the cost of IVF cycles and to the probability of live birth. This economic analysis showed that IVF-DET was the most cost-effective strategy of the options, and IVF-SET was the least cost-effective. The results in this model were insensitive to various probability inputs and to the costs associated with sIUI and IVF procedures.

  12. The effectiveness of health communication strategies in health education in Kushima, Japan.

    Science.gov (United States)

    Ebina, Ryoko; Kawasaki, Fumiko; Taniguchi, Izumi; Togari, Taisuke; Yamazaki, Yoshihiko; Sparks, Michael

    2010-03-01

    Japan's 2008 health policy focuses more than ever on health education for behaviour change and outcome measures for physical health status. This is at odds with contemporary health promotion and health education, which frame health as a resource for everyday life and indicate that the evaluation of interventions should measure broader aspects of health rather than just physical aspects. The application of a combination of different health communication models and theories allows for a customized approach, depending on the types of change that are being sought, and can lead to increased relevance as well as a better fit when it comes to evaluating the achievement of broad health promotion goals. This article explores the application of the Outcome Model for Health Promotion to a two-year health education intervention in Kushima, Japan. This model measures program effectiveness from four aspects: physical health outcomes; intermediate health outcomes; health promotion outcomes; and health promotion actions. A quantitative and qualitative longitudinal, mixed model study design and methods were used for the analysis. Data was taken from health exams, structured interviews, and participant observations collected from 67 participants at four times over two years. This intervention relied primarily on health education and communication to achieve mental and social health outcomes more significantly and faster than physical health outcomes. The importance of moving outcome measurement beyond direct health achievements is discussed in light of the relationships between physical, mental, and social health and its determinants, and our results.

  13. The Effect of an Educational Intervention Program on the Adoption of Low Back Pain Preventive Behaviors in Nurses: An Application of the Health Belief Model.

    Science.gov (United States)

    Sharafkhani, Naser; Khorsandi, Mahboobeh; Shamsi, Mohsen; Ranjbaran, Mehdi

    2016-02-01

    Study Design Randomized controlled trial. Objective The purpose of this study was to identify the effect of a theory-based educational intervention program on the level of knowledge and Health Belief Model (HBM) constructs among nurses in terms of the adoption of preventive behaviors. Methods This pretest/posttest quasi-experimental study was conducted on 100 nurses who were recruited through the multistage sampling method. The nurses were randomly assigned to intervention and control groups. The participants were evaluated before and 3 months after the educational intervention. A multidimensional questionnaire was prepared based on the theoretical structures of the HBM to collect the data. Data analysis was performed using descriptive and inferential statistics. Results There was no significant difference in the mean values of HBM constructs prior to the intervention between the intervention and control groups. However, after the administration of the educational program, the mean scores of knowledge and HBM constructs significantly increased in the intervention group when compared with the control group (p educational intervention based on the HBM was effective in improving the nurses' scores of knowledge and HBM constructs; therefore, theory-based health educational strategies are suggested as an effective alternative to traditional educational interventions.

  14. Statistical health-effects study

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1982-01-01

    The main purpose of this program is to analyze the mortality of Hanford workers and to determine the effects of radiation exposure in this population. A secondary purpose is to improve methodology for assessing health effects of chronic low-level exposure to harmful agents or substances, particularly in an occupational setting. In the past year we have updated our analyses, submitted papers for publication in the two areas of methodological research, and have interacted with Hanford Environmental Health Foundation staff to improve data collection procedures

  15. A dynamic population-based model for the development of work-related respiratory health effects among bakery workers.

    NARCIS (Netherlands)

    Warren, N.; Meijster, T.; Heederik, D.; Tielemans, E.

    2009-01-01

    OBJECTIVES: This paper presents a dynamic population-based model for the development of sensitisation and respiratory symptoms in bakery workers. The model simulates a population of individual workers longitudinally and tracks the development of work-related sensitisation and respiratory symptoms in

  16. A dynamic population-based model for the development of work-related respiratory health effects among bakery workers

    NARCIS (Netherlands)

    Warren, N.; Meijster, T.; Heederik, D.; Tielemans, E.

    2009-01-01

    Objectives: This paper presents a dynamic population-based model for the development of sensitisation and respiratory symptoms in bakery workers. The model simulates a population of individual workers longitudinally and tracks the development of work-related sensitisation and respiratory symptoms in

  17. Systematic review of integrated models of health care delivered at the primary-secondary interface: how effective is it and what determines effectiveness?

    Science.gov (United States)

    Mitchell, Geoffrey K; Burridge, Letitia; Zhang, Jianzhen; Donald, Maria; Scott, Ian A; Dart, Jared; Jackson, Claire L

    2015-01-01

    Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary-secondary care. Six elements were identified that were common to these models of integrated primary-secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable funding model. Compared with usual care, integrated primary-secondary care can improve elements of disease control and service delivery at a modestly increased cost, although the impact on clinical outcomes is limited. Future trials of integrated care should incorporate design elements likely to maximise effectiveness.

  18. A public health decision support system model using reasoning methods.

    Science.gov (United States)

    Mera, Maritza; González, Carolina; Blobel, Bernd

    2015-01-01

    Public health programs must be based on the real health needs of the population. However, the design of efficient and effective public health programs is subject to availability of information that can allow users to identify, at the right time, the health issues that require special attention. The objective of this paper is to propose a case-based reasoning model for the support of decision-making in public health. The model integrates a decision-making process and case-based reasoning, reusing past experiences for promptly identifying new population health priorities. A prototype implementation of the model was performed, deploying the case-based reasoning framework jColibri. The proposed model contributes to solve problems found today when designing public health programs in Colombia. Current programs are developed under uncertain environments, as the underlying analyses are carried out on the basis of outdated and unreliable data.

  19. An evaluation of Knowledge and Understanding Framework personality disorder awareness training: can a co-production model be effective in a local NHS mental health Trust?

    Science.gov (United States)

    Davies, Julie; Sampson, Mark; Beesley, Frank; Smith, Debra; Baldwin, Victoria

    2014-05-01

    5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Effects of a Nutrition Education Intervention Designed based on the Health Belief Model (HBM on Reducing the Consumption of Unhealthy Snacks in the Sixth Grade Primary School Girls

    Directory of Open Access Journals (Sweden)

    Azam Fathi

    2017-02-01

    Full Text Available BackgroundMalnutrition can threaten mental and physical development of children while healthy nutrition can improve mental and physical status of children. To select the best foods, children need nutrition education. This study aimed to determine the effect of nutrition education on reducing the consumption of unhealthy snacks in female primary school students in Qom- Iran.Materials and MethodsThis interventional study was conducted on 88 students in intervention and control groups who were selected via multistage random sampling method. The data was collected using a valid and reliable researcher-made questionnaire which was designed based on the health belief model (HBM. First four training sessions were held for the intervention group; two months later, data were collected again from both groups of students (intervention and control group. The collected data were analyzed by SPSS version 16.0 using descriptive statistics and independent and paired t-test.ResultsThe mean score of knowledge and performance of the intervention group, were 96.12 and 18.61 before the intervention which changed to 110.00 and 68.22 after the intervention. The results showed that before the intervention there was no statistically significant difference between the two groups in terms of mean scores of knowledge, and the constructs of the health belief model (P>0.05. After the intervention, the scores of all variables and the behavior of unhealthy snacks consumption were significantly increased in the intervention group (P

  1. The Effect of Educational Program Based on the Health Belief Model on Brucellosis Preventive Behaviors among Traditional Ranchers in Rural Areas of Hamadan Province

    Directory of Open Access Journals (Sweden)

    Zahra Eskandari

    2017-03-01

    Full Text Available Background and Objectives: Training brucellosis preventive behaviors is mandatory to reduce the incidence of this disease in at-risk groups. Thus, the aim of this study was to determine the effectiveness of an educational program based on Health Belief Model (HBM on brucellosis preventive behaviors among traditional ranchers in rural areas of Hamadan Province, Iran. Materials and Methods: This interventional study was performed with a pretest-posttest design and a control group in 2016. The participants were traditional ranchers of the villages of Hamadan Province, who are identified at high risk for brucellosis. In this study, 70 ranchers were randomly selected and divided into experimental and control groups. The data was collected using a questionnaire consisting of demographic information, knowledge, behavior checklist, and HBM constructs. The experimental group received the educational intervention during 4 sessions with film screening and the use of video and text messages. Data was analyzed using chi-square, Fisher’s exact test, independent t-test, and paired t-test in SPSS. Results: After the intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, and cues to action and prevention of brucellosis in the experimental group had significantly increased in comparison to the control group (P<0.001. Conclusions: Results of this study showed that the educational intervention based on the Health Belief Model could promote brucellosis preventive behaviors among traditional ranchers.

  2. Investigating the role of transportation models in epidemiologic studies of traffic related air pollution and health effects.

    Science.gov (United States)

    Shekarrizfard, Maryam; Valois, Marie-France; Goldberg, Mark S; Crouse, Dan; Ross, Nancy; Parent, Marie-Elise; Yasmin, Shamsunnahar; Hatzopoulou, Marianne

    2015-07-01

    In two earlier case-control studies conducted in Montreal, nitrogen dioxide (NO2), a marker for traffic-related air pollution was found to be associated with the incidence of postmenopausal breast cancer and prostate cancer. These studies relied on a land use regression model (LUR) for NO2 that is commonly used in epidemiologic studies for deriving estimates of traffic-related air pollution. Here, we investigate the use of a transportation model developed during the summer season to generate a measure of traffic emissions as an alternative to the LUR model. Our traffic model provides estimates of emissions of nitrogen oxides (NOx) at the level of individual roads, as does the LUR model. Our main objective was to compare the distribution of the spatial estimates of NOx computed from our transportation model to the distribution obtained from the LUR model. A secondary objective was to compare estimates of risk using these two exposure estimates. We observed that the correlation (spearman) between our two measures of exposure (NO2 and NOx) ranged from less than 0.3 to more than 0.9 across Montreal neighborhoods. The most important factor affecting the "agreement" between the two measures in a specific area was found to be the length of roads. Areas affected by a high level of traffic-related air pollution had a far better agreement between the two exposure measures. A comparison of odds ratios (ORs) obtained from NO2 and NOx used in two case-control studies of breast and prostate cancer, showed that the differences between the ORs associated with NO2 exposure vs NOx exposure differed by 5.2-8.8%. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Health Effects of Air Pollution.

    Science.gov (United States)

    Environmental Education Report and Newsletter, 1985

    1985-01-01

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

  4. Longitudinal health effects of disasters.

    NARCIS (Netherlands)

    IJzermans, C.J.; Donker, G.

    2003-01-01

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

  5. The Moderated Mediating Effect of Self-Efficacy on Exercise Among Older Adults in an Online Bone Health Intervention Study: A Parallel Process Latent Growth Curve Model.

    Science.gov (United States)

    Zhu, Shijun; Nahm, Eun-Shim; Resnick, Barbara; Friedmann, Erika; Brown, Clayton; Park, Jumin; Cheon, Jooyoung; Park, DoHwan

    2017-07-01

    This secondary data analyses of a longitudinal study assessed whether self-efficacy for exercise (SEE) mediated online intervention effects on exercise among older adults and whether age (50-64 vs. ≥65 years) moderated the mediation. Data were from an online bone health intervention study. Eight hundred sixty-six older adults (≥50 years) were randomized to three arms: Bone Power (n = 301), Bone Power Plus (n = 302), or Control (n = 263). Parallel process latent growth curve modeling (LGCM) was used to jointly model growths in SEE and in exercise and to assess the mediating effect of SEE on the effect of intervention on exercise. SEE was a significant mediator in 50- to 64-year-old adults (0.061, 95 BCI: 0.011, 0.163) but not in the ≥65 age group (-0.004, 95% BCI: -0.047, 0.025). Promotion of SEE is critical to improve exercise among 50- to 64-year-olds.

  6. Modeling cost-effectiveness and health gains of a "universal" versus "prioritized" hepatitis C virus treatment policy in a real-life cohort.

    Science.gov (United States)

    Kondili, Loreta A; Romano, Federica; Rolli, Francesca Romana; Ruggeri, Matteo; Rosato, Stefano; Brunetto, Maurizia Rossana; Zignego, Anna Linda; Ciancio, Alessia; Di Leo, Alfredo; Raimondo, Giovanni; Ferrari, Carlo; Taliani, Gloria; Borgia, Guglielmo; Santantonio, Teresa Antonia; Blanc, Pierluigi; Gaeta, Giovanni Battista; Gasbarrini, Antonio; Chessa, Luchino; Erne, Elke Maria; Villa, Erica; Ieluzzi, Donatella; Russo, Francesco Paolo; Andreone, Pietro; Vinci, Maria; Coppola, Carmine; Chemello, Liliana; Madonia, Salvatore; Verucchi, Gabriella; Persico, Marcello; Zuin, Massimo; Puoti, Massimo; Alberti, Alfredo; Nardone, Gerardo; Massari, Marco; Montalto, Giuseppe; Foti, Giuseppe; Rumi, Maria Grazia; Quaranta, Maria Giovanna; Cicchetti, Americo; Craxì, Antonio; Vella, Stefano

    2017-12-01

    We evaluated the cost-effectiveness of two alternative direct-acting antiviral (DAA) treatment policies in a real-life cohort of hepatitis C virus-infected patients: policy 1, "universal," treat all patients, regardless of fibrosis stage; policy 2, treat only "prioritized" patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and health care system perspective, was applied to the PITER cohort (representative of Italian hepatitis C virus-infected patients in care). Specifically, 8,125 patients naive to DAA treatment, without clinical, sociodemographic, or insurance restrictions, were used to evaluate the policies' cost-effectiveness. The patients' age and fibrosis stage, assumed DAA treatment cost of €15,000/patient, and the Italian liver disease costs were used to evaluate quality-adjusted life-years (QALY) and incremental cost-effectiveness ratios (ICER) of policy 1 versus policy 2. To generalize the results, a European scenario analysis was performed, resampling the study population, using the mean European country-specific health states costs and mean treatment cost of €30,000. For the Italian base-case analysis, the cost-effective ICER obtained using policy 1 was €8,775/QALY. ICERs remained cost-effective in 94%-97% of the 10,000 probabilistic simulations. For the European treatment scenario the ICER obtained using policy 1 was €19,541.75/QALY. ICER was sensitive to variations in DAA costs, in the utility value of patients in fibrosis stages F0-F3 post-sustained virological response, and in the transition probabilities from F0 to F3. The ICERs decrease with decreasing DAA prices, becoming cost-saving for the base price (€15,000) discounts of at least 75% applied in patients with F0-F2 fibrosis. Extending hepatitis C virus treatment to patients in any fibrosis stage improves health outcomes and is cost-effective; cost-effectiveness significantly increases

  7. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.

    Science.gov (United States)

    Eaton, Jeffrey W; Menzies, Nicolas A; Stover, John; Cambiano, Valentina; Chindelevitch, Leonid; Cori, Anne; Hontelez, Jan A C; Humair, Salal; Kerr, Cliff C; Klein, Daniel J; Mishra, Sharmistha; Mitchell, Kate M; Nichols, Brooke E; Vickerman, Peter; Bakker, Roel; Bärnighausen, Till; Bershteyn, Anna; Bloom, David E; Boily, Marie-Claude; Chang, Stewart T; Cohen, Ted; Dodd, Peter J; Fraser, Christophe; Gopalappa, Chaitra; Lundgren, Jens; Martin, Natasha K; Mikkelsen, Evelinn; Mountain, Elisa; Pham, Quang D; Pickles, Michael; Phillips, Andrew; Platt, Lucy; Pretorius, Carel; Prudden, Holly J; Salomon, Joshua A; van de Vijver, David A M C; de Vlas, Sake J; Wagner, Bradley G; White, Richard G; Wilson, David P; Zhang, Lei; Blandford, John; Meyer-Rath, Gesine; Remme, Michelle; Revill, Paul; Sangrujee, Nalinee; Terris-Prestholt, Fern; Doherty, Meg; Shaffer, Nathan; Easterbrook, Philippa J; Hirnschall, Gottfried; Hallett, Timothy B

    2014-01-01

    New WHO guidelines recommend initiation of antiretroviral therapy for HIV-positive adults with CD4 counts of 500 cells per μL or less, a higher threshold than was previously recommended. Country decision makers have to decide whether to further expand eligibility for antiretroviral therapy accordingly. We aimed to assess the potential health benefits, costs, and cost-effectiveness of various eligibility criteria for adult antiretroviral therapy and expanded treatment coverage. We used several independent mathematical models in four settings-South Africa (generalised epidemic, moderate antiretroviral therapy coverage), Zambia (generalised epidemic, high antiretroviral therapy coverage), India (concentrated epidemic, moderate antiretroviral therapy coverage), and Vietnam (concentrated epidemic, low antiretroviral therapy coverage)-to assess the potential health benefits, costs, and cost-effectiveness of various eligibility criteria for adult antiretroviral therapy under scenarios of existing and expanded treatment coverage, with results projected over 20 years. Analyses assessed the extension of eligibility to include individuals with CD4 counts of 500 cells per μL or less, or all HIV-positive adults, compared with the previous (2010) recommendation of initiation with CD4 counts of 350 cells per μL or less. We assessed costs from a health-system perspective, and calculated the incremental cost (in US$) per disability-adjusted life-year (DALY) averted to compare competing strategies. Strategies were regarded very cost effective if the cost per DALY averted was less than the country's 2012 per-head gross domestic product (GDP; South Africa: $8040; Zambia: $1425; India: $1489; Vietnam: $1407) and cost effective if the cost per DALY averted was less than three times the per-head GDP. In South Africa, the cost per DALY averted of extending eligibility for antiretroviral therapy to adult patients with CD4 counts of 500 cells per μL or less ranged from $237 to $1691 per

  8. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model.

    Science.gov (United States)

    Vreman, Rick A; Goodell, Alex J; Rodriguez, Luis A; Porco, Travis C; Lustig, Robert H; Kahn, James G

    2017-08-03

    Excessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary heart disease (CHD) and other elements of the metabolic syndrome. Recent studies have shown that non-alcoholic fatty liver disease (NAFLD) is a critical pathway to metabolic syndrome. This model assesses the health and economic benefits of interventions aimed at reducing intake of added sugars. Using data from US National Health Surveys and current literature, we simulated an open cohort, for the period 2015-2035. We constructed a microsimulation model with Markov chains for NAFLD (including steatosis, non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC)), body mass index, T2D and CHD. We assessed reductions in population disease prevalence, disease-attributable disability-adjusted life years (DALYs) and costs, with interventions that reduce added sugars consumption by either 20% or 50%. The model estimated that a 20% reduction in added sugars intake will reduce prevalence of hepatic steatosis, NASH, cirrhosis, HCC, obesity, T2D and CHD. Incidence of T2D and CHD would be expected to decrease by 19.9 (95% CI 12.8 to 27.0) and 9.4 (95% CI 3.1 to 15.8) cases per 100 000 people after 20 years, respectively. A 20% reduction in consumption is also projected to annually avert 0.767 million (M) DALYs (95% CI 0.757M to 0.777M) and a total of US$10.3 billion (B) (95% CI 10.2B to 10.4B) in discounted direct medical costs by 2035. These effects increased proportionally when added sugars intake were reduced by 50%. The decrease in incidence and prevalence of disease is similar to results in other models, but averted costs and DALYs were higher, mainly due to inclusion of NAFLD and CHD. The model suggests that efforts to reduce consumption of added sugars may result in significant public health and economic benefits. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

  9. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model

    Science.gov (United States)

    Vreman, Rick A; Goodell, Alex J; Rodriguez, Luis A; Porco, Travis C; Lustig, Robert H; Kahn, James G

    2017-01-01

    Objectives Excessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary heart disease (CHD) and other elements of the metabolic syndrome. Recent studies have shown that non-alcoholic fatty liver disease (NAFLD) is a critical pathway to metabolic syndrome. This model assesses the health and economic benefits of interventions aimed at reducing intake of added sugars. Methods Using data from US National Health Surveys and current literature, we simulated an open cohort, for the period 2015–2035. We constructed a microsimulation model with Markov chains for NAFLD (including steatosis, non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC)), body mass index, T2D and CHD. We assessed reductions in population disease prevalence, disease-attributable disability-adjusted life years (DALYs) and costs, with interventions that reduce added sugars consumption by either 20% or 50%. Findings The model estimated that a 20% reduction in added sugars intake will reduce prevalence of hepatic steatosis, NASH, cirrhosis, HCC, obesity, T2D and CHD. Incidence of T2D and CHD would be expected to decrease by 19.9 (95% CI 12.8 to 27.0) and 9.4 (95% CI 3.1 to 15.8) cases per 100 000 people after 20 years, respectively. A 20% reduction in consumption is also projected to annually avert 0.767 million (M) DALYs (95% CI 0.757M to 0.777M) and a total of US$10.3 billion (B) (95% CI 10.2B to 10.4B) in discounted direct medical costs by 2035. These effects increased proportionally when added sugars intake were reduced by 50%. Conclusions The decrease in incidence and prevalence of disease is similar to results in other models, but averted costs and DALYs were higher, mainly due to inclusion of NAFLD and CHD. The model suggests that efforts to reduce consumption of added sugars may result in significant public health and economic benefits. PMID:28775179

  10. Effect of Bundled Payments and Health Care Reform as Alternative Payment Models in Total Joint Arthroplasty: A Clinical Review.

    Science.gov (United States)

    Siddiqi, Ahmed; White, Peter B; Mistry, Jaydev B; Gwam, Chukwuweike U; Nace, James; Mont, Michael A; Delanois, Ronald E

    2017-08-01

    In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models. A literature search was performed using PubMed and the CMMSIC to explore different APMs and clinical results after implementation. All studies that were not in English or unrelated to the topic were excluded. Preliminary results of bundled payment models have shown reduced costs in total joint arthroplasty largely by reducing hospital length of stay, decreasing readmission rates, as well as reducing the number of patients sent to in-patient rehabilitation facilities. In order to refine episode of care bundles, CMMSIC has also developed other initiatives such as the Comprehensive Care for Joint Replacement (CJR) pathway and Surgical Hip and Femur Fracture (SHFFT). Despite the unknown future of the Affordable Care Act, BPCI, and CJR, preliminary results of alternative models have shown promise to reduce costs and improve quality of care. Moving into the future, surgeon control of the BPCI and CJR bundle should be investigated to further improve patient care and maximize financial compensation. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Health effects of unemployment benefit program generosity.

    Science.gov (United States)

    Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

    2015-02-01

    We assessed the impact of unemployment benefit programs on the health of the unemployed. We linked US state law data on maximum allowable unemployment benefit levels between 1985 and 2008 to individual self-rated health for heads of households in the Panel Study of Income Dynamics and implemented state and year fixed-effect models. Unemployment was associated with increased risk of reporting poor health among men in both linear probability (b=0.0794; 95% confidence interval [CI]=0.0623, 0.0965) and logistic models (odds ratio=2.777; 95% CI=2.294, 3.362), but this effect is lower when the generosity of state unemployment benefits is high (b for interaction between unemployment and benefits=-0.124; 95% CI=-0.197, -0.0523). A 63% increase in benefits completely offsets the impact of unemployment on self-reported health. Results suggest that unemployment benefits may significantly alleviate the adverse health effects of unemployment among men.

  12. A Comparative Analysis of Some Policy Options to Reduce Rationing in the UK’s NHS: Lessons from a General Equilibrium Model Incorporating Positive Health Effects

    NARCIS (Netherlands)

    Rutten, M.M.; Reed, G.

    2009-01-01

    This paper seeks to determine the macro-economic impacts of changes in health care provision. The resource allocation issues have been explored in theory, by applying the Rybczynski theorem, and empirically, using a computable general equilibrium (CGE) model for the UK with a detailed health

  13. The Effectiveness of a Cohort Model as a Predictor of Grade Point Average and Graduation Status of Pre-Health Sciences Students in a Public Community College

    Science.gov (United States)

    Brandon, Elvis Nash

    2017-01-01

    There is a college completion crisis in the United States. In today's competitive job market, health sciences students cannot afford to fail in their educational attainment. The purpose of this study was to determine if participation in the cohort model is a predictor of the success of public community college pre-health sciences students.…

  14. Development of a health information technology acceptance model using consumers' health behavior intention.

    Science.gov (United States)

    Kim, Jeongeun; Park, Hyeoun-Ae

    2012-10-01

    For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers' intention and behavior is needed to develop and implement effective and efficient strategies. To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers' behavioral intention of using HIT. This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model's explanatory power and to make it more applicable to health consumers' behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers' use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers' attitude and behavioral intention. Health consumers' health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. An extended TAM in the HIT arena was found to be valid to describe health consumers' behavioral intention. We categorized the concepts in

  15. The Effect of Health Education based on Health Belief Model on Preventive Actions of Synthetic Drugs Dependence in Male Students of Kerman, Iran

    Directory of Open Access Journals (Sweden)

    Seyed Saeed Mazloomy Mahmoodabad

    2017-06-01

    Conclusion: Findings indicated that by increase of HBM components' average scores, the average score of synthetic drug dependence preventive actions increased too. Therefore, results of the research confirm the effect and efficiency of HBM in making preventive actions of drug dependence. 

  16. Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation.

    Science.gov (United States)

    Cambiano, Valentina; Miners, Alec; Dunn, David; McCormack, Sheena; Ong, Koh Jun; Gill, O Noel; Nardone, Anthony; Desai, Monica; Field, Nigel; Hart, Graham; Delpech, Valerie; Cairns, Gus; Rodger, Alison; Phillips, Andrew N

    2018-01-01

    In the UK, HIV incidence among men who have sex with men (MSM) has remained high for several years, despite widespread use of antiretroviral therapy and high rates of virological suppression. Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in preventing further infections in MSM, but its cost-effectiveness is uncertain. In this modelling study and economic evaluation, we calibrated a dynamic, individual-based stochastic model, the HIV Synthesis Model, to multiple data sources (surveillance data provided by Public Health England and data from a large, nationally representative survey, Natsal-3) on HIV among MSM in the UK. We did a probabilistic sensitivity analysis (sampling 22 key parameters) along with a range of univariate sensitivity analyses to evaluate the introduction of a PrEP programme with sexual event-based use of emtricitabine and tenofovir for MSM who had condomless anal sexual intercourse in the previous 3 months, a negative HIV test at baseline, and a negative HIV test in the preceding year. The main model outcomes were the number of HIV infections, quality-adjusted life-years (QALYs), and costs. Introduction of such a PrEP programme, with around 4000 MSM initiated on PrEP by the end of the first year and almost 40 000 by the end of the 15th year, would result in a total cost saving (£1·0 billion discounted), avert 25% of HIV infections (42% of which would be directly because of PrEP), and lead to a gain of 40 000 discounted QALYs over an 80-year time horizon. This result was particularly sensitive to the time horizon chosen, the cost of antiretroviral drugs (for treatment and PrEP), and the underlying trend in condomless sex. This analysis suggests that the introduction of a PrEP programme for MSM in the UK is cost-effective and possibly cost-saving in the long term. A reduction in the cost of antiretroviral drugs (including the drugs used for PrEP) would substantially shorten the time for cost savings to be realised

  17. Health effects from long-range transported contaminants in Arctic top predators: An integrated review based on studies of polar bears and relevant model species.

    Science.gov (United States)

    Sonne, Christian

    2010-07-01

    weight, respectively. Furthermore, PFC concentrations, at which population effect levels could occur, are likely to be reached around year 2012 for the East Greenland polar bear subpopulation if current increasing temporal trends continue. Such proposed reproductive population effects were supported by physiological based pharmacokinetic (PBPK) modelling of critical body residues (CBR) with risk quotients >or=1 for SigmaPCB, dieldrin, SigmaPFC and SigmaOHC (organohalogen contaminant). The estimated daily TEQ for East Greenland polar bears and East Greenland sledge dogs were 32-281-folds above WHO SigmaTEQ guidelines for humans. Compared to human tolerable daily intake (TDI), these were exceeded for PCBs, dieldrin, chlordanes and SigmaHCH in East Greenland polar bears. Comparisons like these should be done with caution, but together with the CBR modelling and T-score estimations, these were the only available tools for polar bear risk evaluation. In conclusion, polar bears seem to be susceptible to contaminant induced stress that may have an overall sub-clinical impact on their health and population status via impacts on their immune and reproductive systems. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Projection models for health-effects assessment in populations exposed to radioactive and nonradioactive pollutants. Volume III. SPAHR interactive package guide

    International Nuclear Information System (INIS)

    Collins, J.J.

    1982-09-01

    The Simulation Package for the Analysis of Health Risk (SPAHR) is a computer software package based upon a demographic model for health risk projectons. The model extends several health risk projection models by making realistic assumptions about the population at risk, adn thus represents a distinct improvement over previous models. Complete documentation for use of SPAHR is contained in this five-volume publication. The demographic model in SPAHR estimates population response to environmental toxic exposures. Latency of response, changing dose level over time, competing risks from other causes of death, and population structure can be incorporated into SPAHR to project health risks. Risks are measured by morbid years, number of deaths, and loss of life expectancy. Comparisons of estimates of excess deaths demonstrate that previous health risk projection models may have underestimated excess deaths by a factor of from 2 to 10, depending on the pollutant and the exposure scenario. The software supporting the use of the demographic model is designed to be user oriented. Complex risk projections are made by responding to a series of prompts generated by the package. The flexibility and ease of use of SPAHR make it an important contribution to existing models and software packages. This manual outlines the use of the interactive capabilities of SPAHR. SPAHR is an integrated system of computer programs designed for simulating numerous health risk scenarios using the techniques of demographic modeling. This system of computer programs has been designed to be very flexible so as to allow the user to simulate a large variety of scenarios. It provides the user with an integrated package for projecting the impacts on human health of exposure to various hazards, particularly those resulting from the effluents related to energy production

  19. Electronic cigarettes: human health effects

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-01-01

    Objective With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Methods Literature searches were conducted through September 2013 using multiple electronic databases. Results Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Conclusions Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data. PMID:24732161

  20. Electronic cigarettes: human health effects.

    Science.gov (United States)

    Callahan-Lyon, Priscilla

    2014-05-01

    With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Literature searches were conducted through September 2013 using multiple electronic databases. Forty-four articles are included in this analysis. E-cigarette aerosols may contain propylene glycol, glycerol, flavourings, other chemicals and, usually, nicotine. Aerosolised propylene glycol and glycerol produce mouth and throat irritation and dry cough. No data on the effects of flavouring inhalation were identified. Data on short-term health effects are limited and there are no adequate data on long-term effects. Aerosol exposure may be associated with respiratory function impairment, and serum cotinine levels are similar to those in traditional cigarette smokers. The high nicotine concentrations of some products increase exposure risks for non-users, particularly children. The dangers of secondhand and thirdhand aerosol exposure have not been thoroughly evaluated. Scientific evidence regarding the human health effects of e-cigarettes is limited. While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive. Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking. No e-cigarette has been approved by FDA as a cessation aid. Environmental concerns and issues regarding non-user exposure exist. The health impact of e-cigarettes, for users and the public, cannot be determined with currently available data.

  1. Evaluation of the Effectiveness of Nutritional Education based on Health Belief Model on Self-Esteem and BMI of Overweight and at Risk of Overweight Adolescent Girls

    Directory of Open Access Journals (Sweden)

    Leili Rabiei

    2017-08-01

    Full Text Available Background Due to significant increases in the prevalence of overweight and obesity in adolescents in developed countries, much attention has been focused on this issue. This study aimed to determine the effectiveness of nutritional education based on Health Belief Model (HBM on self-esteem and body mass index (BMI of overweight and at risk of overweight adolescent girls. Materials and Methods: The study subjects consist of 140 female students recruited from two high schools, who were randomly allocated to the intervention (n=70 and control (n=70 groups. The data collection instrument included sections on socio-demographic status, transportation method, physical status, and knowledge and attitudes of the students towards nutrition, which was designed according to HBM. As the intervention, model-based educational program was implemented through six 60-minute sessions, focusing on the overweight and at-risk students. Results were compared in the beginning, and three months after the intervention to find the possible impacts. Results: Average score of model structures and self-esteem of students in both groups had no significant difference at baseline, but immediately after the intervention and 3 months after treatment, the mean component scores were significantly higher in intervention group than controls (P

  2. Effects of Application of Social Marketing Theory and the Health Belief Model in Promoting Cervical Cancer Screening among Targeted Women in Sisaket Province, Thailand.

    Science.gov (United States)

    Wichachai, Suparp; Songserm, Nopparat; Akakul, Theerawut; Kuasiri, Chanapong

    2016-01-01

    Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 3060 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample ttest and independent ttest were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (x=4.09; S.D. =0.30), than in the control group (x=3.82; S.D. =0.20) with statistical significance (psocial marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

  3. Global Health Innovation Technology Models

    Directory of Open Access Journals (Sweden)

    Kimberly Harding

    2016-04-01

    Full Text Available Chronic technology and business process disparities between High Income, Low Middle Income and Low Income (HIC, LMIC, LIC research collaborators directly prevent the growth of sustainable Global Health innova‐ tion for infectious and rare diseases. There is a need for an Open Source-Open Science Architecture Framework to bridge this divide. We are proposing such a framework for consideration by the Global Health community, by utiliz‐ ing a hybrid approach of integrating agnostic Open Source technology and healthcare interoperability standards and Total Quality Management principles. We will validate this architecture framework through our programme called Project Orchid. Project Orchid is a conceptual Clinical Intelligence Exchange and Virtual Innovation platform utilizing this approach to support clinical innovation efforts for multi-national collaboration that can be locally sustainable for LIC and LMIC research cohorts. The goal is to enable LIC and LMIC research organizations to acceler‐ ate their clinical trial process maturity in the field of drug discovery, population health innovation initiatives and public domain knowledge networks. When sponsored, this concept will be tested by 12 confirmed clinical research and public health organizations in six countries. The potential impact of this platform is reduced drug discovery and public health innovation lag time and improved clinical trial interventions, due to reliable clinical intelligence and bio-surveillance across all phases of the clinical innovation process.

  4. Effects of Self-care Health Behaviors on Quality of Life Mediated by Cardiovascular Risk Factors Among Individuals with Coronary Artery Disease: A Structural Equation Modeling Approach

    Directory of Open Access Journals (Sweden)

    Sukhee Ahn, RN, PhD

    2016-06-01

    Conclusions: The findings indicate that self-efficacy, self-care health behaviors, and modifiable risk factors play an important role in QOL in adults with coronary artery disease. Patients could be more confident in performing self-care health behaviors, leading to a better QOL, by more effectively managing their cardiovascular risk factors. Nursing strategies to improve QOL in this population should include motivating them to perform self-care health behaviors.

  5. Air Pollution Exposure Modeling for Health Studies | Science ...

    Science.gov (United States)

    Dr. Michael Breen is leading the development of air pollution exposure models, integrated with novel personal sensor technologies, to improve exposure and risk assessments for individuals in health studies. He is co-investigator for multiple health studies assessing the exposure and effects of air pollutants. These health studies include participants with asthma, diabetes, and coronary artery disease living in various U.S. cities. He has developed, evaluated, and applied novel exposure modeling and time-activity tools, which includes the Exposure Model for Individuals (EMI), GPS-based Microenvironment Tracker (MicroTrac) and Exposure Tracker models. At this seminar, Dr. Breen will present the development and application of these models to predict individual-level personal exposures to particulate matter (PM) for two health studies in central North Carolina. These health studies examine the association between PM and adverse health outcomes for susceptible individuals. During Dr. Breen’s visit, he will also have the opportunity to establish additional collaborations with researchers at Harvard University that may benefit from the use of exposure models for cohort health studies. These research projects that link air pollution exposure with adverse health outcomes benefit EPA by developing model-predicted exposure-dose metrics for individuals in health studies to improve the understanding of exposure-response behavior of air pollutants, and to reduce participant

  6. Long-term particulate matter modeling for health effect studies in California - Part 2: Concentrations and sources of ultrafine organic aerosols

    Science.gov (United States)

    Hu, Jianlin; Jathar, Shantanu; Zhang, Hongliang; Ying, Qi; Chen, Shu-Hua; Cappa, Christopher D.; Kleeman, Michael J.

    2017-04-01

    Organic aerosol (OA) is a major constituent of ultrafine particulate matter (PM0. 1). Recent epidemiological studies have identified associations between PM0. 1 OA and premature mortality and low birth weight. In this study, the source-oriented UCD/CIT model was used to simulate the concentrations and sources of primary organic aerosols (POA) and secondary organic aerosols (SOA) in PM0. 1 in California for a 9-year (2000-2008) modeling period with 4 km horizontal resolution to provide more insights about PM0. 1 OA for health effect studies. As a related quality control, predicted monthly average concentrations of fine particulate matter (PM2. 5) total organic carbon at six major urban sites had mean fractional bias of -0.31 to 0.19 and mean fractional errors of 0.4 to 0.59. The predicted ratio of PM2. 5 SOA / OA was lower than estimates derived from chemical mass balance (CMB) calculations by a factor of 2-3, which suggests the potential effects of processes such as POA volatility, additional SOA formation mechanism, and missing sources. OA in PM0. 1, the focus size fraction of this study, is dominated by POA. Wood smoke is found to be the single biggest source of PM0. 1 OA in winter in California, while meat cooking, mobile emissions (gasoline and diesel engines), and other anthropogenic sources (mainly solvent usage and waste disposal) are the most important sources in summer. Biogenic emissions are predicted to be the largest PM0. 1 SOA source, followed by mobile sources and other anthropogenic sources, but these rankings are sensitive to the SOA model used in the calculation. Air pollution control programs aiming to reduce the PM0. 1 OA concentrations should consider controlling solvent usage, waste disposal, and mobile emissions in California, but these findings should be revisited after the latest science is incorporated into the SOA exposure calculations. The spatial distributions of SOA associated with different sources are not sensitive to the choice of

  7. Modeling Medical Services with Mobile Health Applications

    Directory of Open Access Journals (Sweden)

    Zhenfei Wang

    2018-01-01

    Full Text Available The rapid development of mobile health technology (m-Health provides unprecedented opportunities for improving health services. As the bridge between doctors and patients, mobile health applications enable patients to communicate with doctors through their smartphones, which is becoming more and more popular among people. To evaluate the influence of m-Health applications on the medical service market, we propose a medical service equilibrium model. The model can balance the supply of doctors and demand of patients and reflect possible options for both doctors and patients with or without m-Health applications in the medical service market. In the meantime, we analyze the behavior of patients and the activities of doctors to minimize patients’ full costs of healthcare and doctors’ futility. Then, we provide a resolution algorithm through mathematical reasoning. Lastly, based on artificially generated dataset, experiments are conducted to evaluate the medical services of m-Health applications.

  8. Simulation Models for Socioeconomic Inequalities in Health: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Niko Speybroeck

    2013-11-01

    Full Text Available Background: The emergence and evolution of socioeconomic inequalities in health involves multiple factors interacting with each other at different levels. Simulation models are suitable for studying such complex and dynamic systems and have the ability to test the impact of policy interventions in silico. Objective: To explore how simulation models were used in the field of socioeconomic inequalities in health. Methods: An electronic search of studies assessing socioeconomic inequalities in health using a simulation model was conducted. Characteristics of the simulation models were extracted and distinct simulation approaches were identified. As an illustration, a simple agent-based model of the emergence of socioeconomic differences in alcohol abuse was developed. Results: We found 61 studies published between 1989 and 2013. Ten different simulation approaches were identified. The agent-based model illustration showed that multilevel, reciprocal and indirect effects of social determinants on health can be modeled flexibly. Discussion and Conclusions: Based on the review, we discuss the utility of using simulation models for studying health inequalities, and refer to good modeling practices for developing such models. The review and the simulation model example suggest that the use of simulation models may enhance the understanding and debate about existing and new socioeconomic inequalities of health frameworks.

  9. Electronic cigarettes: human health effects

    OpenAIRE

    Callahan-Lyon, Priscilla

    2014-01-01

    Objective With the rapid increase in use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigarettes), users and non-users are exposed to the aerosol and product constituents. This is a review of published data on the human health effects of exposure to e-cigarettes and their components. Methods Literature searches were conducted through September 2013 using multiple electronic databases. Results Forty-four articles are included in this analysis. E-cigarette ae...

  10. Effectiveness evaluation of the Positive Family Support intervention: A three-tiered public health delivery model for middle schools.

    Science.gov (United States)

    Smolkowski, Keith; Seeley, John R; Gau, Jeffery M; Dishion, Tom J; Stormshak, Elizabeth A; Moore, Kevin J; Falkenstein, Corrina A; Fosco, Gregory M; Garbacz, S Andrew

    2017-06-01

    This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems. Implementation, however, was hampered by several challenges, including school funding cuts, lack of staff time to provide parenting supports, and staff turnover. Given that preventive interventions are generally cost effective, it is critical that researchers continue their efforts to refine these interventions and find ways to support schools' implementation of evidence-based programs that can reduce problem behavior. This article is part of a special issue "Parental Engagement in School-Based Interventions". Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  11. The Effectiveness of an Educational Intervention Based on the Health Belief Model in the Empowerment of Stockbreeders Against High-Risk Behaviors Associated with Brucellosis

    Directory of Open Access Journals (Sweden)

    Vahid Babaei

    2014-12-01

    Full Text Available Background and Objectives: Brucellosis is among the most common zoonotic diseases. Educational programs can be effective in the prevention of this disease in humans. The present study was conducted to assess the effectiveness of an educational intervention based on the Health Belief Model (HBM in the empowerment of stockbreeders against high risk behaviors associated with brucellosis in Charuymaq county, East Azerbaijan. Materials and Methods: The present quasi-experimental study was conducted in 2014 in Charuymaq county. A total of 200 people selected through stratified random sampling participated in the study. Data were collected using a researcher-designed questionnaire including items on participants' demographic information, knowledge and the HBM constructs. Training sessions were then designed and held for the intervention group. Three months after the intervention was held, data were collected from both groups and then analyzed using descriptive statistics including the Mann-Whitney U test and the Wilcoxon test. Results: The mean scores obtained for knowledge, HBM constructs (perceived susceptibility, severity, barriers and benefits and self-efficacy and brucellosis preventive behaviors showed no significant differences between the two groups before the intervention however, after the educational intervention, significant differences were observed between the mean scores obtained by the intervention group and the control group (P<0.05. Conclusion: The cooperation of charismatic individuals with intervention programs and the use of education theories can be more effective in modifying high-risk behaviors these programs should therefore be widely implemented across the country.

  12. Statistical health-effects study

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  13. An integrated Bayesian model for estimating the long-term health effects of air pollution by fusing modelled and measured pollution data: A case study of nitrogen dioxide concentrations in Scotland.

    Science.gov (United States)

    Huang, Guowen; Lee, Duncan; Scott, Marian

    2015-01-01

    The long-term health effects of air pollution can be estimated using a spatio-temporal ecological study, where the disease data are counts of hospital admissions from populations in small areal units at yearly intervals. Spatially representative pollution concentrations for each areal unit are typically estimated by applying Kriging to data from a sparse monitoring network, or by computing averages over grid level concentrations from an atmospheric dispersion model. We propose a novel fusion model for estimating spatially aggregated pollution concentrations using both the modelled and monitored data, and relate these concentrations to respiratory disease in a new study in Scotland between 2007 and 2011. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. The Culture-Work-Health Model and Work Stress.

    Science.gov (United States)

    Peterson, Michael; Wilson, John F.

    2002-01-01

    Examines the role of organizational culture in the etiology of workplace stress through the framework of the Culture-Work- Health model. A review of relevant business and health literature indicates that culture is an important component of work stress and may be a key to creating effective organizational stress interventions. (SM)

  15. Cost-effectiveness of national mandatory screening of all admissions to English National Health Service hospitals for meticillin-resistant Staphylococcus aureus: a mathematical modelling study.

    Science.gov (United States)

    Robotham, Julie V; Deeny, Sarah R; Fuller, Chris; Hopkins, Susan; Cookson, Barry; Stone, Sheldon

    2016-03-01

    In December, 2010, National Health Service (NHS) England introduced national mandatory screening of all admissions for meticillin-resistant Staphylococcus aureus (MRSA). We aimed to assess the effectiveness and cost-effectiveness of this policy, from a regional or national health-care decision makers' perspective, compared with alternative screening strategies. We used an individual-based dynamic transmission model parameterised with national MRSA audit data to assess the effectiveness and cost-effectiveness of admission screening of patients in English NHS hospitals compared with five alternative strategies (including no screening, checklist-activated screening, and high-risk specialty-based screening), accompanied by patient isolation and decolonisation, over a 5 year time horizon. We evaluated strategies for different NHS hospital types (acute, teaching, and specialist), MRSA prevalence, and transmission potentials using probabilistic sensitivity analyses. Compared with no screening, mean cost per quality-adjusted life-year (QALY) of screening all admissions was £89,000-148,000 (range £68,000-222,000), and this strategy was consistently more costly and less effective than alternatives for all hospital types. At a £30,000/QALY willingness-to-pay threshold and current prevalence, only the no-screening strategy was cost effective. The next best strategies were, in acute and teaching hospitals, targeting of high-risk specialty admissions (30-40% chance of cost-effectiveness; mean incremental cost-effectiveness ratios [ICERs] £45,200 [range £35,300-61,400] and £48,000/QALY [£34,600-74,800], respectively) and, in specialist hospitals, screening these patients plus risk-factor-based screening of low-risk specialties (a roughly 20% chance of cost-effectiveness; mean ICER £62,600/QALY [£48,000-89,400]). As prevalence and transmission increased, targeting of high-risk specialties became the optimum strategy at the NHS willingness-to-pay threshold (£30,000/QALY

  16. Game Maturity Model for Health Care.

    Science.gov (United States)

    de Boer, Jan C; Adriani, Paul; van Houwelingen, Jan Willem; Geerts, A

    2016-04-01

    This article introduces the Game Maturity Model for the healthcare industry as an extension to the general Game Maturity Model and describes the usage by two case studies of applied health games. The Game Maturity Model for healthcare provides a practical and value-adding method to assess existing games and to determine strategic considerations for application of applied health games. Our forecast is that within 5 years the use and development of applied games will have a role in our daily lives and the way we organize health care that will be similar to the role social media has today.

  17. HEALTH AND ENVIRONMENTAL EFFECTS DOCUMENT ...

    Science.gov (United States)

    Health and Environmental Effects Documents (HEEDS) are prepared for the Office of Solid Waste and Emergency Response (OSWER). This document series is intended to support listings under the Resource Conservation and Recovery Act (RCRA) as well as to provide health-related limits and goals for emergency and remedial actions under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA). Both published literature and information obtained from Agency Program Office files are evaluated as they pertain to potential human health, aquatic life and environmental effects of hazardous waste constituents. Several quantitative estimates are presented provided sufficient data are available. For systemic toxicants, these include Reference Doses (RfDs) for chronic and subchronic exposures for both the inhalation and oral exposures. In the case of suspected carcinogens, RfDs may not be estimated. Instead, a carcinogenic potency factor, or q1*, is provided. These potency estimates are derived for both oral and inhalation exposures where possible. In addition, unit risk estimates for air and drinking water are presented based on inhalation and oral data, respectively. Reportable quantities (RQs) based on both chronic toxicity and carcinogenicity are derived. The RQ is used to determine the quantity of a hazardous substance for which notification is required in the event of a release as specified under CERCLA.

  18. A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network.

    Science.gov (United States)

    Devine, Emily Beth; Alfonso-Cristancho, Rafael; Devlin, Allison; Edwards, Todd C; Farrokhi, Ellen T; Kessler, Larry; Lavallee, Danielle C; Patrick, Donald L; Sullivan, Sean D; Tarczy-Hornoch, Peter; Yanez, N David; Flum, David R

    2013-08-01

    To describe the inaugural comparative effectiveness research (CER) cohort study of Washington State's Comparative Effectiveness Research Translation Network (CERTAIN), which compares invasive with noninvasive treatments for peripheral artery disease, and to focus on the patient centeredness of this cohort study by describing it within the context of a newly published conceptual framework for patient-centered outcomes research (PCOR). The peripheral artery disease study was selected because of clinician-identified uncertainty in treatment selection and differences in desired outcomes between patients and clinicians. Patient centeredness is achieved through the "Patient Voices Project," a CERTAIN initiative through which patient-reported outcome (PRO) instruments are administered for research and clinical purposes, and a study-specific patient advisory group where patients are meaningfully engaged throughout the life cycle of the study. A clinician-led research advisory panel follows in parallel. Primary outcomes are PRO instruments that measure function, health-related quality of life, and symptoms, the latter developed with input from the patients. Input from the patient advisory group led to revised retention procedures, which now focus on short-term (3-6 months) follow-up. The research advisory panel is piloting a point-of-care, patient assessment checklist, thereby returning study results to practice. The cohort study is aligned with the tenets of one of the new conceptual frameworks for conducting PCOR. The CERTAIN's inaugural cohort study may serve as a useful model for conducting PCOR and creating a learning health care network. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. A generalized measurement model to quantify health: the multi-attribute preference response model.

    Science.gov (United States)

    Krabbe, Paul F M

    2013-01-01

    After 40 years of deriving metric values for health status or health-related quality of life, the effective quantification of subjective health outcomes is still a challenge. Here, two of the best measurement tools, the discrete choice and the Rasch model, are combined to create a new model for deriving health values. First, existing techniques to value health states are briefly discussed followed by a reflection on the recent revival of interest in patients' experience with regard to their possible role in health measurement. Subsequently, three basic principles for valid health measurement are reviewed, namely unidimensionality, interval level, and invariance. In the main section, the basic operation of measurement is then discussed in the framework of probabilistic discrete choice analysis (random utility model) and the psychometric Rasch model. It is then shown how combining the main features of these two models yields an integrated measurement model, called the multi-attribute preference response (MAPR) model, which is introduced here. This new model transforms subjective individual rank data into a metric scale using responses from patients who have experienced certain health states. Its measurement mechanism largely prevents biases such as adaptation and coping. Several extensions of the MAPR model are presented. The MAPR model can be applied to a wide range of research problems. If extended with the self-selection of relevant health domains for the individual patient, this model will be more valid than existing valuation techniques.

  20. Potent health effects of pomegranate

    Directory of Open Access Journals (Sweden)

    Aida Zarfeshany

    2014-01-01

    Full Text Available Accumulating data clearly claimed that Punica granatum L. (pomegranate has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions.

  1. Potent health effects of pomegranate

    Science.gov (United States)

    Zarfeshany, Aida; Asgary, Sedigheh; Javanmard, Shaghayegh Haghjoo

    2014-01-01

    Accumulating data clearly claimed that Punica granatum L. (pomegranate) has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions. PMID:24800189

  2. The Long-Term Safety, Public Health Impact, and Cost-Effectiveness of Routine Vaccination with a Recombinant, Live-Attenuated Dengue Vaccine (Dengvaxia): A Model Comparison Study.

    Science.gov (United States)

    Flasche, Stefan; Jit, Mark; Rodríguez-Barraquer, Isabel; Coudeville, Laurent; Recker, Mario; Koelle, Katia; Milne, George; Hladish, Thomas J; Perkins, T Alex; Cummings, Derek A T; Dorigatti, Ilaria; Laydon, Daniel J; España, Guido; Kelso, Joel; Longini, Ira; Lourenco, Jose; Pearson, Carl A B; Reiner, Robert C; Mier-Y-Terán-Romero, Luis; Vannice, Kirsten; Ferguson, Neil

    2016-11-01

    Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9). These predictions were conducted for the World Health Organization to inform their recommendations on optimal use of this vaccine. The models adopted, with small variations, a parsimonious vaccine mode of action that was able to reproduce quantitative features of the observed trial data. The adopted mode of action assumed that vaccination, similarly to natural infection, induces transient, heterologous protection and, further, establishes a long-lasting immunogenic memory, which determines disease severity of subsequent infections. The default vaccination policy considered was routine vaccination of 9-y-old children in a three-dose schedule at 80% coverage. The outcomes examined were the impact of vaccination on infections, symptomatic dengue, hospitalised dengue, deaths, and cost-effectiveness over a 30-y postvaccination period. Case definitions were chosen in accordance with the Phase III trials. All models predicted that in settings with moderate to high dengue endemicity (SP9 ≥ 50%), the default vaccination policy would reduce the burden of dengue disease for the population by 6%-25% (all simulations: -3%-34%) and in high-transmission settings (SP9 ≥ 70%) by 13%-25% (all simulations: 10%- 34%). These endemicity levels are representative of the participating sites in

  3. The Long-Term Safety, Public Health Impact, and Cost-Effectiveness of Routine Vaccination with a Recombinant, Live-Attenuated Dengue Vaccine (Dengvaxia: A Model Comparison Study.

    Directory of Open Access Journals (Sweden)

    Stefan Flasche

    2016-11-01

    Full Text Available Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9. These predictions were conducted for the World Health Organization to inform their recommendations on optimal use of this vaccine.The models adopted, with small variations, a parsimonious vaccine mode of action that was able to reproduce quantitative features of the observed trial data. The adopted mode of action assumed that vaccination, similarly to natural infection, induces transient, heterologous protection and, further, establishes a long-lasting immunogenic memory, which determines disease severity of subsequent infections. The default vaccination policy considered was routine vaccination of 9-y-old children in a three-dose schedule at 80% coverage. The outcomes examined were the impact of vaccination on infections, symptomatic dengue, hospitalised dengue, deaths, and cost-effectiveness over a 30-y postvaccination period. Case definitions were chosen in accordance with the Phase III trials. All models predicted that in settings with moderate to high dengue endemicity (SP9 ≥ 50%, the default vaccination policy would reduce the burden of dengue disease for the population by 6%-25% (all simulations: -3%-34% and in high-transmission settings (SP9 ≥ 70% by 13%-25% (all simulations: 10%- 34%. These endemicity levels are representative of the

  4. Effect of Nutrition Education Program on the Recommended Weight Gain in during Pregnancy Application of Health Belief Model: A Randomaized Cilinical Trial

    Directory of Open Access Journals (Sweden)

    Mohebi M.

    2012-04-01

    Full Text Available Background and Objectives: Nutrition in pregnancy has an important role in fetus and mother health, and also in the pregnancy outcome. One of the significant changes related to nutrition is weight gain of pregnant women as one of the influencing indicators which is measured by Body Mass Index (BMI. This study was conducted to determine nutritional education effect upon pregnancy weight gain in pregnant women on the basis of health belief model (HBM in Gonabad, Iran.Methods: This is a quasi-experimental randomized and controlled study on 110 pregnant women referring to health centers in Gonabad, Iran. They were divided into experimental and control groups who participated in the study, in the year of 2009. The data of two groups were collected by reliable and valid questionnaires during the first part of pregnancy care in pre-test stage. Then, two educational sessions were held for the experimental group. Post test was done for both groups in the last stage of pregnancy care, and the data were analyzed by paired T, T independent, the correlation coefficient, Mann-Whitney, and Chi-square. A p<0.05 was considered to be significant.Results: No significant differences were found between the education, parity, abortion, jobs and the mean age of the two groups. After the intervention, the mean score of knowledge, perceived susceptibility, severity, threat, benefits and barriers and nutritional behavior in the experimental group, significantly changed in the control group (p<0.01. Moreover, statistical analyses showed a significant difference between the two groups in gaining recommended weight in pregnancy.Conclusion: While 77.78% of the experimental group members achieved recommend MBI, just 32.29% of those in the control group had a gain in this criterion. This study proved that HBM application in nutritional education was successfully effective to gain recommended weight in pregnancy, so that increasing suitable weight gain reached maximum and un

  5. Public health component in building information modeling

    Science.gov (United States)

    Trufanov, A. I.; Rossodivita, A.; Tikhomirov, A. A.; Berestneva, O. G.; Marukhina, O. V.

    2018-05-01

    A building information modelling (BIM) conception has established itself as an effective and practical approach to plan, design, construct, and manage buildings and infrastructure. Analysis of the governance literature has shown that the BIM-developed tools do not take fully into account the growing demands from ecology and health fields. In this connection, it is possible to offer an optimal way of adapting such tools to the necessary consideration of the sanitary and hygienic specifications of materials used in construction industry. It is proposed to do it through the introduction of assessments that meet the requirements of national sanitary standards. This approach was demonstrated in the case study of Revit® program.

  6. Effect of battery longevity on costs and health outcomes associated with cardiac implantable electronic devices: a Markov model-based Monte Carlo simulation.

    Science.gov (United States)

    Schmier, Jordana K; Lau, Edmund C; Patel, Jasmine D; Klenk, Juergen A; Greenspon, Arnold J

    2017-11-01

    The effects of device and patient characteristics on health and economic outcomes in patients with cardiac implantable electronic devices (CIEDs) are unclear. Modeling can estimate costs and outcomes for patients with CIEDs under a variety of scenarios, varying battery longevity, comorbidities, and care settings. The objective of this analysis was to compare changes in patient outcomes and payer costs attributable to increases in battery life of implantable cardiac defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D). We developed a Monte Carlo Markov model simulation to follow patients through primary implant, postoperative maintenance, generator replacement, and revision states. Patients were simulated in 3-month increments for 15 years or until death. Key variables included Charlson Comorbidity Index, CIED type, legacy versus extended battery longevity, mortality rates (procedure and all-cause), infection and non-infectious complication rates, and care settings. Costs included procedure-related (facility and professional), maintenance, and infections and non-infectious complications, all derived from Medicare data (2004-2014, 5% sample). Outcomes included counts of battery replacements, revisions, infections and non-infectious complications, and discounted (3%) costs and life years. An increase in battery longevity in ICDs yielded reductions in numbers of revisions (by 23%), battery changes (by 44%), infections (by 23%), non-infectious complications (by 10%), and total costs per patient (by 9%). Analogous reductions for CRT-Ds were 23% (revisions), 32% (battery changes), 22% (infections), 8% (complications), and 10% (costs). Based on modeling results, as battery longevity increases, patients experience fewer adverse outcomes and healthcare costs are reduced. Understanding the magnitude of the cost benefit of extended battery life can inform budgeting and planning decisions by healthcare providers and insurers.

  7. Health effects of biomass exposure

    International Nuclear Information System (INIS)

    Rastogi, S.K.; Husain, Tanveer

    1993-01-01

    Biomass fuels such as coal, wood, crop residues, kerosene oil and dung-cakes meet the energy needs in the household sector in India and other developing countries. Crop residues and dung-cakes are largely used in rural areas, whereas wood forms the major source of fuel in urban as well as rural areas. Combustion of these fuels produces various kinds of poisonous gases such as CO, smoke, nitrogen dioxide, polycyclic aromatic hydrocarbons and respirable particulates. These gases are released in the domestic environment and they pollute the indoor air. The women and children are the one who suffer most from this air pollution. This results into a variety of health problems principally pertaining to respiratory system among the women and children. Studies on this aspect are reviewed. They point towards the positive relationship between biomass smoke and various health effects, particularly respiratory diseases. Need for research on the ways to prevent pollution due to biomass and resultant health hazards is emphasised. (M.G.B.). 25 refs., 2 tabs

  8. Work Ability: using structural equation modeling to assess the effects of aging, health and work on the population of Brazilian municipal employees.

    Science.gov (United States)

    Alcântara, Marcus A; Sampaio, Rosana F; Assunção, Ada Ávila; Silva, Fabiana C Martins

    2014-01-01

    The Work Ability Model has a holistic structure that incorporates individual characteristics, work-related factors and life outside of work. The model has been explored in the context of Finland but still needs to be applied in other countries. The aim of this study was to examine the relationships between age, health, work and work ability in a sample of Brazilian municipal employees. A sample of 5,646 workers answered a web-survey questionnaire that collected information about socio-demographics, health, work characteristics and work ability. Structural equation modeling (SEM) was used to examine the simultaneous relationships between the variables that comprise the Work Ability Model. The sample was predominantly female (68.0%), between 30 and 49 years old (60.0%) and highly educated (66.0%). SEM produced good fit indexes that supported the Work Ability Model. Age was positively related to work ability and negatively related to health. Health and work characteristics positively influenced work ability. The results produced additional support for the conceptualization of work ability as a complex and dynamic phenomenon: a system composed of an individual and various elements of his/her work interact in time and space in a nonlinear way.

  9. Health effects of low doses at low dose rates: dose-response relationship modeling in a cohort of workers of the nuclear industry

    International Nuclear Information System (INIS)

    Metz-Flamant, Camille

    2011-01-01

    The aim of this thesis is to contribute to a better understanding of the health effects of chronic external low doses of ionising radiation. This work is based on the French cohort of CEA-AREVA NC nuclear workers. The mains stages of this thesis were (1) conducting a review of epidemiological studies on nuclear workers, (2) completing the database and performing a descriptive analysis of the cohort, (3) quantifying risk by different statistical methods and (4) modelling the exposure-time-risk relationship. The cohort includes monitored workers employed more than one year between 1950 and 1994 at CEA or AREVA NC companies. Individual annual external exposure, history of work, vital status and causes of death were reconstructed for each worker. Standardized mortality ratios using French national mortality rates as external reference were computed. Exposure-risk analysis was conducted in the cohort using the linear excess relative risk model, based on both Poisson regression and Cox model. Time dependent modifying factors were investigated by adding an interaction term in the model or by using exposure time windows. The cohort includes 36, 769 workers, followed-up until age 60 in average. During the 1968- 2004 period, 5, 443 deaths, 2, 213 cancers, 62 leukemia and 1, 314 cardiovascular diseases were recorded. Among the 57% exposed workers, the mean cumulative dose was 21.5 milli-sieverts (mSv). A strong Healthy Worker Effect is observed in the cohort. Significant elevated risks of pleura cancer and melanoma deaths were observed in the cohort but not associated with dose. No significant association was observed with solid cancers, lung cancer and cardiovascular diseases. A significant dose-response relationship was observed for leukemia excluding chronic lymphatic leukemia, mainly for doses received less than 15 years before and for yearly dose rates higher than 10 mSv. This PhD work contributes to the evaluation of risks associated to chronic external radiation

  10. Reviewing model application to support animal health decision making.

    Science.gov (United States)

    Singer, Alexander; Salman, Mo; Thulke, Hans-Hermann

    2011-04-01

    Animal health is of societal importance as it affects human welfare, and anthropogenic interests shape decision making to assure animal health. Scientific advice to support decision making is manifold. Modelling, as one piece of the scientific toolbox, is appreciated for its ability to describe and structure data, to give insight in complex processes and to predict future outcome. In this paper we study the application of scientific modelling to support practical animal health decisions. We reviewed the 35 animal health related scientific opinions adopted by the Animal Health and Animal Welfare Panel of the European Food Safety Authority (EFSA). Thirteen of these documents were based on the application of models. The review took two viewpoints, the decision maker's need and the modeller's approach. In the reviewed material three types of modelling questions were addressed by four specific model types. The correspondence between tasks and models underpinned the importance of the modelling question in triggering the modelling approach. End point quantifications were the dominating request from decision makers, implying that prediction of risk is a major need. However, due to knowledge gaps corresponding modelling studies often shed away from providing exact numbers. Instead, comparative scenario analyses were performed, furthering the understanding of the decision problem and effects of alternative management options. In conclusion, the most adequate scientific support for decision making - including available modelling capacity - might be expected if the required advice is clearly stated. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Simulation modeling for the health care manager.

    Science.gov (United States)

    Kennedy, Michael H

    2009-01-01

    This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

  12. Function Model for Community Health Service Information

    Science.gov (United States)

    Yang, Peng; Pan, Feng; Liu, Danhong; Xu, Yongyong

    In order to construct a function model of community health service (CHS) information for development of CHS information management system, Integration Definition for Function Modeling (IDEF0), an IEEE standard which is extended from Structured Analysis and Design(SADT) and now is a widely used function modeling method, was used to classifying its information from top to bottom. The contents of every level of the model were described and coded. Then function model for CHS information, which includes 4 super-classes, 15 classes and 28 sub-classed of business function, 43 business processes and 168 business activities, was established. This model can facilitate information management system development and workflow refinement.

  13. Six challenges in modelling for public health policy.

    Science.gov (United States)

    Metcalf, C J E; Edmunds, W J; Lessler, J

    2015-03-01

    The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014). Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Six challenges in modelling for public health policy

    Directory of Open Access Journals (Sweden)

    C.J.E. Metcalf

    2015-03-01

    Full Text Available The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014. Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges.

  15. The Effects of Stigma on Determinants of Mental Health Help-Seeking Behaviors Among Male College Students: An Application of the Information-Motivation-Behavioral Skills Model.

    Science.gov (United States)

    DeBate, Rita DiGioacchino; Gatto, Amy; Rafal, Gregor

    2018-05-01

    Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample ( n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation ( r = .363, p < .01), information and behavioral skills ( r = .166, p < .01), and motivation and behavioral skills ( r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.

  16. Health care management modelling: a process perspective

    NARCIS (Netherlands)

    Vissers, J.M.H.

    1998-01-01

    Modelling-based health care management ought to become just as popular as evidence based medicine. Making managerial decisions based on evidence by modelling efforts is certainly a step forward. Examples can be given of many successful applications in different areas of decision making: disease

  17. Health effects of exhaust particles

    Energy Technology Data Exchange (ETDEWEB)

    Pihlava, T.; Uuppo, M.; Niemi, S.

    2013-11-01

    This report introduces general information about diesel particles and their health effects. The purpose of this report is to introduce particulate matter pollution and present some recent studies made regarding the health effects of particulate matter. The aim is not to go very deeply into the science, but instead to keep the text understandable for the average layman. Particulate matter is a complex mixture of extremely small particles and liquid droplets. These small particles are made up of a number of components that include for example acids, such as nitrates and sulphates, as well as organic chemicals, metals and dust particles from the soil. Particulate matter comes from several sources, such as transportation emissions, industrial emissions, forest fires, cigarette smoke, volcanic ash and climate variations. Particles are divided into coarse particles with diameters less than 10 ..m, fine particles with diameters smaller than 2.5 ..m and ultra-fine particles with diameters less than 0.1 ..m. The particulate matter in diesel exhaust gas is a highly complex mixture of organic, inorganic, solid, volatile and partly volatile compounds. Many of these particles do not form until they reach the air. Many carcinogenic compounds have been found in diesel exhaust gas and it is considered carcinogenic to humans. Particulate matter can cause several health effects, such as premature death in persons with heart or lung disease, cancer, nonfatal heart attacks, irregular heartbeat, aggravated asthma, decreased lung function and an increase in respiratory symptoms, such as irritation of the airways, coughing or difficulty breathing. It is estimated that in Finland about 1300 people die prematurely due to particles and the economic loss in the EU due to the health effects of particles can be calculated in the billions. Ultra-fine particles are considered to be the most harmful to human health. Ultrafine particles usually make the most of their quantity and surface area

  18. The Relationship between Spiritual Health and other Dimensions of Health: Presentation of a Model

    Directory of Open Access Journals (Sweden)

    Akram Heidari

    2016-06-01

    Full Text Available Attitudes to humankind will have different effects on health service delivery. Health might used to be intended to provide physical health in the past; today, however, many researchers and clinicians consider the concept health to be beyond physical health. In support of this claim, it is enough to indicate that the bio-psycho-social model has for years been held by scientific communities to be a fully admitted model. However, the missing ring in this model, as suggested by many, is the spiritual health. In recent years, the relationship between spirituality and clinical interventions with a comprehensive focus on health has been under increasing scrutiny. Although different models have been presented for investigation of the relationship between spiritual health and other dimensions, the fundamental challenge in this regard is the actual place of spiritual health compared with other dimensions. In this article, attempts are made to address the position and weight of spiritual health from the Islam’s point of view.

  19. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    2004-01-01

    This Practical Radiation Technical Manual is one of a series which has been designed to provide guidance on radiological protection for employers, Radiation Protection Officers, managers and other technically competent persons who have a responsibility to ensure the safety of employees working with ionizing radiation. The Manual may be used with the appropriate IAEA Practical Radiation Safety Manuals to provide adequate training, instruction or information on health effects and medical surveillance for all employees engaged in work with ionizing radiation. Sources of ionizing radiations have a large number of applications in the workplace. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not harmful. Some applications involve sources that could deliver more significant radiation doses, particularly when poor methods are practised or an accident occurs. The radiations cannot be seen, felt or sensed by the human body in any way and excessive exposures may cause detriment to the health of a worker in a way that is not immediately apparent. When the symptoms occur, weeks or possibly years later, an untrained worker or inexperienced medical staff probably cannot recognize the effects to be due to the radiation exposure. This Manual explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit if it forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

  20. Evaluating the effectiveness of health care teams.

    Science.gov (United States)

    Mickan, Sharon M

    2005-05-01

    While it is recognised that effective health care teams are associated with quality patient care, the literature is comparatively sparse in defining the outcomes of effective teamwork. This literature review of the range of organisational, team and individual benefits of teamwork complements an earlier article which summarised the antecedent conditions for (input) and team processes (throughput) of effective teams. This article summarises the evidence for a range of outcome measures of effective teams. Organisational benefits of teamwork include reduced hospitalisation time and costs, reduced unanticipated admissions, better accessibility for patients, and improved coordination of care. Team benefits include efficient use of health care services, enhanced communication and professional diversity. Patients report benefits of enhanced satisfaction, acceptance of treatment and improved health outcomes. Finally, team members report enhanced job satisfaction, greater role clarity and enhanced well-being. Due to the inherent complexity of teamwork, a constituency model of team evaluation is supported where key stakeholders identify and measure the intended benefits of a team.

  1. Health effects of indoor odorants.

    Science.gov (United States)

    Cone, J E; Shusterman, D

    1991-11-01

    People assess the quality of the air indoors primarily on the basis of its odors and on their perception of associated health risk. The major current contributors to indoor odorants are human occupant odors (body odor), environmental tobacco smoke, volatile building materials, bio-odorants (particularly mold and animal-derived materials), air fresheners, deodorants, and perfumes. These are most often present as complex mixtures, making measurement of the total odorant problem difficult. There is no current method of measuring human body odor, other than by human panel studies of expert judges of air quality. Human body odors have been quantitated in terms of the "olf" which is the amount of air pollution produced by the average person. Another quantitative unit of odorants is the "decipol," which is the perceived level of pollution produced by the average human ventilated by 10 L/sec of unpolluted air or its equivalent level of dissatisfaction from nonhuman air pollutants. The standard regulatory approach, focusing on individual constituents or chemicals, is not likely to be successful in adequately controlling odorants in indoor air. Besides the current approach of setting minimum ventilation standards to prevent health effects due to indoor air pollution, a standard based on the olf or decipol unit might be more efficacious as well as simpler to measure.

  2. The salutogenic model of health in health promotion research.

    Science.gov (United States)

    Mittelmark, Maurice B; Bull, Torill

    2013-06-01

    Despite health promotion's enthusiasm for the salutogenic model of health, researchers have paid little attention to Antonovsky's central ideas about the ease/dis-ease continuum, defined in terms of 'breakdown' (the severity of pain and functional limitations, and the degree medical care is called for, irrespective of specific diseases). Rather, salutogenesis research has a strong focus on how sense of coherence relates to a wide range of specific diseases and illness endpoints. We address two questions: Why has Antonovsky's health concept failed to stimulate research on breakdown, and how can the present emphasis on disease be complemented by an emphasis on positive well-being in the salutogenic model? We show that (i) the breakdown concept of health as specified by Antonovsky is circular in definition, (ii) it is not measured on the 'required' ease/dis-ease continuum, (iii) it is not measureable by any validated or reliability-tested assessment tool, and (iv) it has not so much been rejected by health promotion, as it has not been considered at all. We show that Antonovsky came to view breakdown as but one aspect of well-being. He was open to the idea of well-being as something more positive than the absence of pain, suffering and need for medical care. We suggest ways to move salutogenesis research in the direction of well-being in its positive sense.

  3. The Health Equity Promotion Model: Reconceptualization of Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Disparities

    Science.gov (United States)

    Fredriksen-Goldsen, Karen I.; Simoni, Jane M.; Kim, Hyun-Jun; Lehavot, Keren; Walters, Karina L.; Yang, Joyce; Hoy-Ellis, Charles P.

    2015-01-01

    National health initiatives emphasize the importance of eliminating health disparities among historically disadvantaged populations. Yet, few studies have examined the range of health outcomes among lesbian, gay, bisexual, and transgender (LGBT) people. To stimulate more inclusive research in the area, we present the Health Equity Promotion Model—a framework oriented toward LGBT people reaching their full mental and physical health potential that considers both positive and adverse health-related circumstances. The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioral, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. By explicating the important role of agency and resilience as well as the deleterious effect of social structures on health outcomes, it supports policy and social justice to advance health and well-being in these communities. Important directions for future research as well as implications for health-promotion interventions and policies are offered. PMID:25545433

  4. Training effectiveness evaluation model

    International Nuclear Information System (INIS)

    Penrose, J.B.

    1993-01-01

    NAESCO's Training Effectiveness Evaluation Model (TEEM) integrates existing evaluation procedures with new procedures. The new procedures are designed to measure training impact on organizational productivity. TEEM seeks to enhance organizational productivity through proactive training focused on operation results. These results can be identified and measured by establishing and tracking performance indicators. Relating training to organizational productivity is not easy. TEEM is a team process. It offers strategies to assess more effectively organizational costs and benefits of training. TEEM is one organization's attempt to refine, manage and extend its training evaluation program

  5. Pulmonary health effects of agriculture.

    Science.gov (United States)

    Nordgren, Tara M; Bailey, Kristina L

    2016-03-01

    Occupational exposures in the agricultural industry are associated with numerous lung diseases, including chronic obstructive pulmonary disease, asthma, hypersensitivity pneumonitis, lung cancer, and interstitial lung diseases. Efforts are ongoing to ascertain contributing factors to these negative respiratory outcomes and improve monitoring of environmental factors leading to disease. In this review, recently published studies investigating the deleterious effects of occupational exposures in the agricultural industry are discussed. Occupational exposures to numerous agricultural environment aerosols, including pesticides, fungi, and bacteria are associated with impaired respiratory function and disease. Increases in certain farming practices, including mushroom and greenhouse farming, present new occupational exposure concerns. Improved detection methods may provide opportunities to better monitor safe exposure levels to known lung irritants. In the agricultural industry, occupational exposures to organic and inorganic aerosols lead to increased risk for lung disease among workers. Increased awareness of respiratory risks and improved monitoring of agricultural environments are necessary to limit pulmonary health risks to exposed populations.

  6. The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

    Science.gov (United States)

    Webb, Lucy

    2012-07-01

    This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

  7. The effect of health shocks on smoking and obesity.

    Science.gov (United States)

    Sundmacher, Leonie

    2012-08-01

    To investigate whether negative changes in their own health (i.e. health shocks) or in that of a smoking or obese household member, lead smokers to quit smoking and obese individuals to lose weight. The study is informed by economic models ('rational addiction' and 'demand for health' models) which offer hypotheses on the relationship between health shocks and health-related behaviour. Each hypothesis was tested applying a discrete-time hazard model with random effects using up to ten waves of the German Socioeconomic Panel (GSOEP) and statistics on cigarette, food and beverage prices provided by the Federal Statistical Office. Health shocks had a significant positive impact on the probability that smokers quit during the same year in which they experienced the health shock. Health shocks of a smoking household member between year t-2 and t-1 also motivated smoking cessation, although statistical evidence for this was weaker. Health shocks experienced by obese individuals or their household members had, on the other hand, no significant effect on weight loss, as measured by changes in Body Mass Index (BMI). The results of the study suggest that smokers are aware of the risks associated with tobacco consumption, know about effective strategies to quit smoking, and are willing to quit for health-related reasons. In contrast, there was no evidence for changes in health-related behaviour among obese individuals after a health shock.

  8. 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

  9. 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.

  10. Disaster Reintegration Model: A Qualitative Analysis on Developing Korean Disaster Mental Health Support Model

    Directory of Open Access Journals (Sweden)

    Yun-Jung Choi

    2018-02-01

    Full Text Available This study sought to describe the mental health problems experienced by Korean disaster survivors, using a qualitative research method to provide empirical resources for effective disaster mental health support in Korea. Participants were 16 adults or elderly adults who experienced one or more disasters at least 12 months ago recruited via theoretical sampling. Participants underwent in-depth individual interviews on their disaster experiences, which were recorded and transcribed for qualitative analysis, which followed Strauss and Corbin’s (1998 Grounded theory. After open coding, participants’ experiences were categorized into 130 codes, 43 sub-categories and 17 categories. The categories were further analyzed in a paradigm model, conditional model and the Disaster Reintegration Model, which proposed potentially effective mental health recovery strategies for disaster survivors, health providers and administrators. To provide effective assistance for mental health recovery of disaster survivors, both personal and public resilience should be promoted while considering both cultural and spiritual elements.

  11. Ecotoxicological effects extrapolation models

    Energy Technology Data Exchange (ETDEWEB)

    Suter, G.W. II

    1996-09-01

    One of the central problems of ecological risk assessment is modeling the relationship between test endpoints (numerical summaries of the results of toxicity tests) and assessment endpoints (formal expressions of the properties of the environment that are to be protected). For example, one may wish to estimate the reduction in species richness of fishes in a stream reach exposed to an effluent and have only a fathead minnow 96 hr LC50 as an effects metric. The problem is to extrapolate from what is known (the fathead minnow LC50) to what matters to the decision maker, the loss of fish species. Models used for this purpose may be termed Effects Extrapolation Models (EEMs) or Activity-Activity Relationships (AARs), by analogy to Structure-Activity Relationships (SARs). These models have been previously reviewed in Ch. 7 and 9 of and by an OECD workshop. This paper updates those reviews and attempts to further clarify the issues involved in the development and use of EEMs. Although there is some overlap, this paper does not repeat those reviews and the reader is referred to the previous reviews for a more complete historical perspective, and for treatment of additional extrapolation issues.

  12. Health promotion: An effective tool for global health

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar

    2012-01-01

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

  13. [Health for refugees - the Bremen model].

    Science.gov (United States)

    Mohammadzadeh, Zahra; Jung, Felicitas; Lelgemann, Monika

    2016-05-01

    The Bremen model recognizes that refugee health care has to go beyond merely checking for the prevalence of contagious diseases. Elementary health care offered in the reception centre and transitory facilities is based on voluntary acceptance by the refugees. At the same time, legal requirements for the medical reception of refugees are observed. In addition, doctors performing the initial medical examination are enabled to cover acute care on the spot. During the preliminary phase of immigration refugees are allowed to see a doctor in their facility repeatedly. After a certain time, they are provided with a health card permitting limited access to regular care outside of their facility. The current rise of refugee numbers affects the situation of Bremen health care for adult as well as juvenile refugees. In spite of the increase, health care standards are maintained by means of the health card. From 2011 to 2014, "Factors influencing health status and contact with health services" averaged 29.6 % in the health check data. Diseases of the respiratory system (18.1 %) and "symptoms, signs and abnormal findings not elsewhere classified" (16.9 %) ranked second and third, respectively. Diseases of the digestive system (6.1 %) of the musculoskeletal system (6 %) and of the skin and subcutaneous tissue (3.6 %) followed. Infectious diseases such as HIV infections, hepatitis or tuberculosis were seldom.

  14. [Dependent relative: Effects on family health].

    Science.gov (United States)

    Estrada Fernández, M Eugenia; Gil Lacruz, Ana I; Gil Lacruz, Marta; Viñas López, Antonio

    2018-01-01

    The purpose of this work is to analyse the effects on informal caregiver's health and lifestyle when living with a dependent person at home. A comparison will be made between this situation and other situations involving commitment of time and energy, taking into account gender and age differences in each stage of the life cycle. Cross-sectional study analysing secondary data. The method used for collecting information is the computer assisted personal interview carried out in selected homes by the Ministry of Health, Social Services and Equality. The study included 19,351 participants aged over 25 years who completed the 2011-2012 Spanish National Health Survey. This research is based on demographic information obtained from a Spanish National Health Survey (2011/12). Using an empirical framework, the Logit model was select and the data reported as odds ratio. The estimations were repeated independently by sub-groups of age and gender. The study showed that the health of people who share their lives with a dependent person is worse than those who do not have any dependent person at home (they are 5 times at higher risk of developing health problems). The study found that being a woman, advance age, low educational level and does not work, also has an influence. Being a caregiver reduces the likelihood of maintaining a healthy lifestyle through physical exercise, relaxation, or eating a balanced diet. Living with a dependent person reduces the likelihood of maintaining healthy lifestyles and worsens the state of health of family members. Significant differences in gender and age were found. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. A Conceptual Model to Assess Stress-Associated Health Effects of Multiple Ecosystem Services Degraded by Disaster Events in the Gulf of Mexico and Elsewhere

    Science.gov (United States)

    Few conceptual frameworks attempt to connect disaster-associated environmental injuries to impacts on ecosystem services (the benefits humans derive from nature) and thence to both psychological and physiological human health effects. To our knowledge, this study is one of the fi...

  16. Twelve-month effects of the Groningen active living model (GALM) on physical activity, health and fitness outcomes in sedentary and underactive older adults aged 55-65

    NARCIS (Netherlands)

    de Jong, Johan; Lemmink, Koen A. P. M.; King, Abby C.; Huisman, Mark; Stevens, Martin

    Objective: To determine the effects on energy expenditure, health and fitness outcomes after 12 months of GALM. Methods: Subjects from matched neighbourhoods were assigned to an intervention (IG) (n = 79) or a waiting-list control group (CG) (n = 102). During the 12 months the IG attended two series

  17. Six-month effects of the Groningen active living model (GALM) on physical activity, health and fitness outcomes in sedentary and underactive older adults aged 55–65

    NARCIS (Netherlands)

    de Jong, Johan; Lemmink, Koen; Stevens, Martin; de Greef, Mathieu; Rispens, Piet; King, Abby C.; Mulder, Theo

    2006-01-01

    Objective: To determine the effects on energy expenditure, health and fitness outcomes in sedentary older adults aged 55–65 after 6-month participation in the GALM program. Methods: In three Dutch communities, subjects from matched neighbourhoods were assigned to an intervention (n = 79) or a

  18. Six-month effects of the Groningen active living model (GALM) on physical activity, health and fitness outcomes in sedentary and underactive older adults aged 55-65

    NARCIS (Netherlands)

    de Jong, Johan; Lemmink, Koen A. P. M.; Stevens, Martin; de Greef, Mathieu H. G.; Rispens, Pieter; King, Abby C.; Mulder, Theo

    Objective: To determine the effects on energy expenditure, health and fitness outcomes in sedentary older adults aged 55-65 after 6-month participation in the GALM program. Methods: In three Dutch communities, subjects from matched neighbourhoods were assigned to an intervention (n = 79) or a

  19. An integrated model of decision-making in health contexts: the role of science education in health education

    Science.gov (United States)

    Arnold, Julia C.

    2018-03-01

    Health education is to foster health literacy, informed decision-making and to promote health behaviour. To date, there are several models that seek to explain health behaviour (e.g. the Theory of Planned Behaviour or the Health Belief Model). These models include motivational factors (expectancies and values) that play a role in decision-making in health contexts. In this theoretical paper, it is argued that none of these models makes consequent use of expectancy-value pairs. It is further argued that in order to make these models fruitful for science education and for informed decision-making, models should systematically incorporate knowledge as part of the decision-making process. To fill this gap, this theoretical paper introduces The Integrated Model of Decision-Making in Health Contexts. This model includes three types of knowledge (system health knowledge, action-related health knowledge and effectiveness health knowledge) as influencing factors for motivational factors (perceived health threat, attitude towards health action, attitude towards health outcome and subjective norm) that are formed of expectancy-value pairs and lead to decisions. The model's potential for health education in science education as well as research implications is discussed.

  20. The Effect of Educational Intervention Based on Health Belief Model and Social Support on Promoting Skin Cancer Preventive Behaviors in a Sample of Iranian Farmers.

    Science.gov (United States)

    Jeihooni, Ali Khani; Rakhshani, Tayebeh

    2018-01-08

    Skin cancer is one of the most common cancers in Iran. Farmers are exposed to the sun's ultraviolet radiation due to their job and are susceptible to skin cancer. The aim of this study is to survey the effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in farmers of Fasa City, Fars province, Iran. In this quasi-experimental study, 200 farmers (100 in experimental group and 100 in control group) in Fasa City, Fars, Iran, were selected in 2017. The educational intervention for the experimental group consisted of eight training sessions (introduction to skin cancer, risk factors, complications, benefits and barriers to proper use of sunscreen, UV sunglasses and physical protection, self-efficacy in applying preventive behaviors, role of social support). A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self-efficacy and cues to action), and social support was used to measure skin cancer preventive behaviors before, 3 months after the intervention, and 6 months later. Data were analyzed using SPSS-22 via chi-squared, independent samples t test, Mann-Whitney, and repeated measures ANOVA at a significance level of 0.5. The mean age of the farmers was 42.21 ± 10.52 years in the experimental group and 44.28 ± 10.16 years in the control group. Three months after the intervention and 6 months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, cues to action, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and social support in adoption of skin cancer preventive behaviors in 3 and 6 months post intervention in farmers. Hence, these models can act as a

  1. Health Effects of Petroleum Coke

    Science.gov (United States)

    Significant quantities of fugitive dust from pet coke storage and handling operations present a health risk. EPA’s research suggests that petcoke does not pose a different health risk than similar-sized particulate matter (PM10).

  2. Applications of system dynamics modelling to support health policy.

    Science.gov (United States)

    Atkinson, Jo-An M; Wells, Robert; Page, Andrew; Dominello, Amanda; Haines, Mary; Wilson, Andrew

    2015-07-09

    The value of systems science modelling methods in the health sector is increasingly being recognised. Of particular promise is the potential of these methods to improve operational aspects of healthcare capacity and delivery, analyse policy options for health system reform and guide investments to address complex public health problems. Because it lends itself to a participatory approach, system dynamics modelling has been a particularly appealing method that aims to align stakeholder understanding of the underlying causes of a problem and achieve consensus for action. The aim of this review is to determine the effectiveness of system dynamics modelling for health policy, and explore the range and nature of its application. A systematic search was conducted to identify articles published up to April 2015 from the PubMed, Web of Knowledge, Embase, ScienceDirect and Google Scholar databases. The grey literature was also searched. Papers eligible for inclusion were those that described applications of system dynamics modelling to support health policy at any level of government. Six papers were identified, comprising eight case studies of the application of system dynamics modelling to support health policy. No analytic studies were found that examined the effectiveness of this type of modelling. Only three examples engaged multidisciplinary stakeholders in collective model building. Stakeholder participation in model building reportedly facilitated development of a common 'mental map' of the health problem, resulting in consensus about optimal policy strategy and garnering support for collaborative action. The paucity of relevant papers indicates that, although the volume of descriptive literature advocating the value of system dynamics modelling is considerable, its practical application to inform health policy making is yet to be routinely applied and rigorously evaluated. Advances in software are allowing the participatory model building approach to be extended to

  3. Health effects of ionizing radiation

    International Nuclear Information System (INIS)

    Pathak, B.

    1989-12-01

    Ionizing radiation is energy that travels through space as electromagnetic waves or a stream of fast moving particles. In the workplace, the sources of ionizing radiation are radioactive substances, nuclear power plants, x-ray machines and nuclear devices used in medicine, research and industry. Commonly encountered types of radiation are alpha particles, beta particles and gamma rays. Alpha particles have very little penetrating power and pose a risk only when the radioactive substance is deposited inside the body. Beta particles are more penetrating than alpha particles and can penetrate the outer body tissues causing damage to the skin and the eyes. Gamma rays are highly penetrating and can cause radiation damage to the whole body. The probability of radiation-induced disease depends on the accumulated amount of radiation dose. The main health effects of ionizing radiation are cancers in exposed persons and genetic disorders in the children, grandchildren and subsequent generations of the exposed parents. The fetus is highly sensitive to radiation-induced abnormalities. At high doses, radiation can cause cataracts in the eyes. There is no firm evidence that ionizing radiation causes premature aging. Radiation-induced sterility is highly unlikely for occupational doses. The data on the combined effect of ionizing radiation and other cancer-causing physical and chemical agents are inconclusive

  4. Understanding Business Models in Health Care.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-05-01

    The increasing focus on the costs of care is forcing health care organizations to critically look at their basic set of processes and activities, to determine what type of value they can deliver. A business model describes the resources, processes, and cost assumptions that an organization makes that will lead to the delivery of a unique value proposition to a customer. As health care organizations are beginning to transform their structure in preparation for a value-based delivery system, understanding business model theory can help in the redesign process.

  5. The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy.

    Science.gov (United States)

    Hsu, WanChen; Chiang, ChiaHsun; Yang, ShuChing

    2014-12-12

    College students' health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual's health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated. This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU. The Health Behavior Scale is a 12-item instrument developed to measure college students' eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants' health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects. The study found that perceptions of better health status (t520=2.14-6.12, PeHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth literacy played an intermediary role in the association between individual factors and health behaviors (Sobel test=2.09-2.72, PeHealth

  6. Children’s Environmental Health Faculty Champions Initiative: A Successful Model for Integrating Environmental Health into Pediatric Health Care

    Science.gov (United States)

    Rogers, Bonnie; McCurdy, Leyla Erk; Slavin, Katie; Grubb, Kimberly; Roberts, James R.

    2009-01-01

    Background Pediatric medical and nursing education lack the environmental health content needed to properly prepare health care professionals to prevent, recognize, manage, and treat environmental exposure–related diseases. The need for improvements in health care professionals’ environmental health knowledge has been expressed by leading institutions. However, few studies have evaluated the effectiveness of programs that incorporate pediatric environmental health (PEH) into curricula and practice. Objective We evaluated the effectiveness of the National Environmental Education Foundation’s (NEEF) Children’s Environmental Health Faculty Champions Initiative, which is designed to build environmental health capacity among pediatric health care professionals. Methods Twenty-eight pediatric health care professionals participated in a train-the-trainer workshop, in which they were educated to train other health care professionals in PEH and integrate identified PEH competencies into medical and nursing practice and curricula. We evaluated the program using a workshop evaluation tool, action plan, pre- and posttests, baseline and progress assessments, and telephone interviews. Results During the 12 months following the workshop, the faculty champions’ average pretest score of 52% was significantly elevated (p < 0.0001) to 65.5% on the first posttest and to 71.5% on the second posttest, showing an increase and retention of environmental health knowledge. Faculty champions trained 1,559 health care professionals in PEH, exceeding the goal of 280 health care professionals trained. Ninety percent of faculty champions reported that PEH had been integrated into the curricula at their institution. Conclusion The initiative was highly effective in achieving its goal of building environmental health capacity among health care professionals. The faculty champions model is a successful method and can be replicated in other arenas. PMID:19478972

  7. Diesel exhaust emissions : health effects

    Energy Technology Data Exchange (ETDEWEB)

    Grenier, M. [Natural Resources Canada, Sudbury, ON (Canada). CANMET Mining and Mineral Sciences Laboratories

    2009-07-01

    Despite modern day ventilation, underground miners are exposed to diesel particulate matter (DPM) composed of elemental carbon, organic carbon, sulphates, metals and ashes. Diesel exhaust contains over 40 air contaminants that have been recognized as toxic, carcinogenic or reproductive and developmental hazards. Nearly all components of diesel exhaust interact with the human body at the bloodstream or tissue level. This presentation discussed the following 4 potential levels of threat posed by the physical and chemical nature of diesel exhaust: (1) cancer of the lungs and bladder, (2) toxins that affect the nervous, endocrine, reproductive and immune system as well as the liver and kidneys, (3) fine particulate matter that can cause premature death and an increase in respiratory illness, and (4) nitrogen oxides that contribute to increased ozone and smog. Non-cancer health effects from short-term exposure include acute irritation and respiratory symptoms. This presentation also referred to cancer risk assessments of diesel exhaust by national, state, and world health organizations. Particulate exposure standards for Canada, Quebec, Ontario and the United States were listed along with the percentage of DPM samples in excess of various exposure limits in 2008 according to Canadian underground mine data. DPM concentration levels in mines are in the range that environmental agencies would consider high for general population exposure. Solutions for underground mines include pollution control at the source; use of modern engines with certification for underground mining; emissions based maintenance; exhaust treatment; use of clean or alternative fuels such as hydrogen; regular sampling and monitoring; ventilation; training and technology transfer; and regulations. tabs., figs.

  8. Health effects of toxicants: Online knowledge support

    Science.gov (United States)

    Judson, Richard; de Marcellus, Sally; de Knecht, Joop; Leinala, Eeva

    2016-01-01

    Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Information is structured in a variety of formats, including traditional databases, portals, prediction models, and decision making support tools. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations. PMID:26506572

  9. Health effects of toxicants: Online knowledge support.

    Science.gov (United States)

    Wexler, Philip; Judson, Richard; de Marcellus, Sally; de Knecht, Joop; Leinala, Eeva

    2016-01-15

    Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Information is structured in a variety of formats, including traditional databases, portals, prediction models, and decision making support tools. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations. Published by Elsevier Inc.

  10. eHealth literacy issues, constructs, models, and methods for health information technology design and evaluation

    Directory of Open Access Journals (Sweden)

    Helen Monkman

    2015-12-01

    Full Text Available The concept of eHealth literacy is beginning to be recognized as a being of key importance in the design and adoption of effective and efficient health information systems and applications targeted to lay people and patients. Indeed, many systems such as patient portals and personal health records have not been adopted due to a mismatch between the level of eHealth literacy demanded by a system and the level of eHealth literacy possessed by end users. The purpose of this paper is to present an overview of important concepts related to eHealth literacy, as well as how the notion of eHealth literacy can be applied to improve the design and adoption of consumer health information systems. This paper begins with describing the importance of eHealth literacy with respect to design of health applications for the general public paired with examples of consumer health information systems whose limited success and adoption has been attributed to the lack of consideration for eHealth literacy. This is followed by definitions of what eHealth literacy is and how it emerged from the related concept of health literacy. A model for conceptualizing the importance of aligning consumers’ eHealth literacy skills and the demands systems place on their skills is then described. Next, current tools for assessing consumers’ eHealth literacy levels are outlined, followed by an approach to systematically incorporating eHealth literacy in the deriving requirements for new systems is presented. Finally, a discussion of evolving approaches for incorporating eHealth literacy into usability engineering methods is presented.

  11. Health and environmental effects of nuclear weapons

    International Nuclear Information System (INIS)

    1993-01-01

    This report briefly reviews previous WHO work on the health consequences of nuclear war and concentrates on current information about the effects of nuclear weapons on health, and related environmental problems. 15 refs

  12. Health effects estimation code development for accident consequence analysis

    International Nuclear Information System (INIS)

    Togawa, O.; Homma, T.

    1992-01-01

    As part of a computer code system for nuclear reactor accident consequence analysis, two computer codes have been developed for estimating health effects expected to occur following an accident. Health effects models used in the codes are based on the models of NUREG/CR-4214 and are revised for the Japanese population on the basis of the data from the reassessment of the radiation dosimetry and information derived from epidemiological studies on atomic bomb survivors of Hiroshima and Nagasaki. The health effects models include early and continuing effects, late somatic effects and genetic effects. The values of some model parameters are revised for early mortality. The models are modified for predicting late somatic effects such as leukemia and various kinds of cancers. The models for genetic effects are the same as those of NUREG. In order to test the performance of one of these codes, it is applied to the U.S. and Japanese populations. This paper provides descriptions of health effects models used in the two codes and gives comparisons of the mortality risks from each type of cancer for the two populations. (author)

  13. Health Externalities and Heat savings in Energy System Modelling

    DEFF Research Database (Denmark)

    Zvingilaite, Erika

    Energy consumption and production can cause air pollution with global impact, such as CO2, and local/regional air pollutants, such as SO2, NOx and PM2.5, as a result of fuel combustion. Use of fossil fuels leads to global CO2 emissions and causes global warming effects, regardless place or height......-related external costs can be internalised, for instance, in energy system modelling. External costs of global warming and human health damage can be of comparable magnitude.However, in contrast to global CO2 impacts, air pollution damage to human health depends on a number of factors, related to location...... and included in an energy system optimisation model. The performed analysis of the Danish heat and power sector concludes that accounting for spatial variation of health damage costs in heat and power system optimisation model has an effect on the optimal technology mix and distribution of energy plants among...

  14. People Create Health: Effective Health Promotion is a Creative Process

    OpenAIRE

    Cloninger, C. Robert; Cloninger, Kevin M.

    2013-01-01

    Effective health promotion involves the creative cultivation of physical, mental, social, and spiritual well-being. Efforts at health promotion produce weak and inconsistent benefits when it does not engage people to express their own goals and values. Likewise, health promotion has been ineffective when it relies only on instruction about facts regarding a healthy lifestyle, or focuses on reduction of disease rather than the cultivation of well-being. Meta-analysis of longitudinal studies an...

  15. A Participatory Model for Multi-Document Health Information Summarisation

    Directory of Open Access Journals (Sweden)

    Dinithi Nallaperuma

    2017-03-01

    Full Text Available Increasing availability and access to health information has been a paradigm shift in healthcare provision as it empowers both patients and practitioners alike. Besides awareness, significant time savings and process efficiencies can be achieved through effective summarisation of healthcare information. Relevance and accuracy are key concerns when generating summaries for such documents. Despite advances in automated summarisation approaches, the role of participation has not been explored. In this paper, we propose a new model for multi-document health information summarisation that takes into account the role of participation. The updated IS user participation theory was extended to explicate these roles. The proposed model integrates both extractive and abstractive summarisation processes with continuous participatory inputs to each phase. The model was implemented as a client-server application and evaluated by both domain experts and health information consumers. Results from the evaluation phase indicates the model is successful in generating relevant and accurate summaries for diverse audiences.

  16. Effects of nuclear war on health and health services

    International Nuclear Information System (INIS)

    1990-01-01

    This report reviews the findings since 1987 in the field of research related to the possible impact of nuclear war and nuclear explosions on health and health services. An annex contains the finding and conclusions of a 1989 United Nations study on the climatic and other effects of nuclear war. 1 tab

  17. Hybrid Modeling Improves Health and Performance Monitoring

    Science.gov (United States)

    2007-01-01

    Scientific Monitoring Inc. was awarded a Phase I Small Business Innovation Research (SBIR) project by NASA's Dryden Flight Research Center to create a new, simplified health-monitoring approach for flight vehicles and flight equipment. The project developed a hybrid physical model concept that provided a structured approach to simplifying complex design models for use in health monitoring, allowing the output or performance of the equipment to be compared to what the design models predicted, so that deterioration or impending failure could be detected before there would be an impact on the equipment's operational capability. Based on the original modeling technology, Scientific Monitoring released I-Trend, a commercial health- and performance-monitoring software product named for its intelligent trending, diagnostics, and prognostics capabilities, as part of the company's complete ICEMS (Intelligent Condition-based Equipment Management System) suite of monitoring and advanced alerting software. I-Trend uses the hybrid physical model to better characterize the nature of health or performance alarms that result in "no fault found" false alarms. Additionally, the use of physical principles helps I-Trend identify problems sooner. I-Trend technology is currently in use in several commercial aviation programs, and the U.S. Air Force recently tapped Scientific Monitoring to develop next-generation engine health-management software for monitoring its fleet of jet engines. Scientific Monitoring has continued the original NASA work, this time under a Phase III SBIR contract with a joint NASA-Pratt & Whitney aviation security program on propulsion-controlled aircraft under missile-damaged aircraft conditions.

  18. 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.

  19. Reflecting the real value of health care resources in modelling and cost-effectiveness studies-The example of viral load informed differentiated care.

    Science.gov (United States)

    Revill, Paul; Walker, Simon; Cambiano, Valentina; Phillips, Andrew; Sculpher, Mark J

    2018-01-01

    The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter's value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. The findings have

  20. Reflecting the real value of health care resources in modelling and cost-effectiveness studies—The example of viral load informed differentiated care

    Science.gov (United States)

    Walker, Simon; Cambiano, Valentina; Phillips, Andrew; Sculpher, Mark J.

    2018-01-01

    Background The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. Key issues for economic evaluation The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter’s value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest

  1. Health effects of ionising radiation

    International Nuclear Information System (INIS)

    Mohammadi, S.

    2000-01-01

    Human and animal studies have shown an increased incidence of cancer and malformation due to radioactive materials and external radiation. The biological effects of radiation on tissues are the occurrence of morphological and functional changes in the body. The critical parts of the body are those tissues or organs which when irradiated, are likely to influence the health of the individual or its offspring. The probability of these changes depends on the radiation dose. There are two main types of damage due to radiation dose. Radiation Sickness with well-defined symptoms like cancer and inherited disorders which can appear after several years. A second type of damage, namely Acute Radiation Sickness results after exposure of the whole or parts of the body to high doses of radiation greater than 1 Gy. There are safety standards for the amount of dose equivalent that is taken as acceptable. The International Commission on Radiological Protection (ICRP) has given norms in which natural and medical causes were not included. These are given as recommended values (1966) and proposed values (2000), both in mSv/yr: population at large: 1.7 and 0.4; members of the public: 5 and 2; and radiologic workers: 50 and 20, respectively. Taking into account the increased number of reactor accidents, the question is how safe is our safety standards? Even when one is able to connect a quantitative risk with a radiation dose, there are three fundamental principles which we should obey in dealing with risks from radiation. These are: (1) Avoid any risk. (2) The risk should be related to the possible benefit. (3) Any dose below the politically agreed limits is acceptable

  2. Does job burnout mediate negative effects of job demands on mental and physical health in a group of teachers? Testing the energetic process of Job Demands-Resources model.

    Science.gov (United States)

    Baka, Łukasz

    2015-01-01

    The aim of the study was to investigate the direct and indirect - mediated by job burnout - effects of job demands on mental and physical health problems. The Job Demands-Resources model was the theoretical framework of the study. Three job demands were taken into account - interpersonal conflicts at work, organizational constraints and workload. Indicators of mental and physical health problems included depression and physical symptoms, respectively. Three hundred and sixteen Polish teachers from 8 schools participated in the study. The hypotheses were tested with the use of tools measuring job demands (Interpersonal Conflicts at Work, Organizational Constraints, Quantitative Workload), job burnout (the Oldenburg Burnout Inventory), depression (the Beck Hopelessness Scale), and physical symptoms (the Physical Symptoms Inventory). The regression analysis with bootstrapping, using the PROCESS macros of Hayes was applied. The results support the hypotheses partially. The indirect effect and to some extent the direct effect of job demands turned out to be statistically important. The negative impact of 3 job demands on mental (hypothesis 1 - H1) and physical (hypothesis 2 - H2) health were mediated by the increasing job burnout. Only organizational constraints were directly associated with mental (and not physical) health. The results partially support the notion of the Job Demands-Resources model and provide further insight into processes leading to the low well-being of teachers in the workplace. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  3. Effect of Health Care Professionals' Continuing Education ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...

  4. Managing Dog Waste: Campaign Insights from the Health Belief Model

    Science.gov (United States)

    Typhina, Eli; Yan, Changmin

    2014-01-01

    Aiming to help municipalities develop effective education and outreach campaigns to reduce stormwater pollutants, such as pet waste, this study applied the Health Belief Model (HBM) to identify perceptions of dog waste and corresponding collection behaviors from dog owners living in a small U.S. city. Results of 455 online survey responses…

  5. Current models of positive mental health

    Directory of Open Access Journals (Sweden)

    Stanojević Dragana Z.

    2012-01-01

    Full Text Available The concept of positive mental health represents not merely the absence of mental disease but presence of high level of happiness and well-being. In this paper we mentioned shortly the earliest concept of mental health, presented by Marie Jahoda in the mid-twentieth century. After that, we described two traditions in understanding and researching of subjective well-being: hedonic and eudaimonic approach. First approach focuses on investigation of positive affects and happiness as emotional and life satisfaction as cognitive component of subjective well-being. Second tradition emphasizes potentials and competences that person develops to the highest level, in personal and social area. Both psychological and social well-being are core concept of positive mental health psychology, designated together as positive functioning. The psychological well-being comprises six dimensions: self-acceptance, positive relations with others, environmental mastery, autonomy, purpose of life and personal growth. Social well-being consists of five dimensions: social integration, social acceptance, social contribution, social actualization and social coherence. By integrating hedonic and eudaimonic well-being as well as absence of mental disease, Corey Keyes introduced concept of complete mental health. People with complete mental health have reported absence of disease during past year and presence of high level of emotional, psychological and social well-being (flourishing. People with incomplete mental health have also reported absence of mental disease but low level of positive functioning (languishing. Keyes thought there are people with complete and incomplete mental illness; both groups report presence of mental disease, but second group has high level of positive functioning. Models of positive mental health are widely used in research studies as well as in programs for prevention and promotion of mental health. .

  6. Business Models for Successfully Maintaining Games for Health.

    Science.gov (United States)

    Baranowski, Moderator Tom; Isaac, Participants Fikry; Ashford, Chris; Goldman, Ron; Lenihan, David J; Poole, Brent; Buday, Richard; van Rijswijk, Jurriaan

    2013-04-01

    Videogames for health provide innovative, exciting, and possibly highly effective new media for helping players change their behaviors or otherwise benefit their health. Getting the right videogames into the hands of players who can benefit most in a way that pays for the continued innovation and creation of such games is a current challenge. Entertainment videogame companies, which create games primarily to enhance players' enjoyment, have used the general business marketplace (e.g., online stores, walk-in stores, app stores) to deliver their products directly to consumers and earn enough capital to invest in making new products. No one believes, however, that enough kids or adults would use the general business marketplace to purchase games for health in sufficient volume to provide the down payment for the innovation and creation of new games for health. A successful business model is critical to the financial future of games for health. We asked members of our Editorial Board who are in health-related companies (Fikry Isaac, MD, MPH), in several game development companies (Chris Ashford, Ron Goldman, David J. Lenihan, Brent Poole, and Richard Buday, FAIA), and the head of the Games for Health Europe Foundation (Jurriaan van Rijswijk, MSc) to address questions in a roundtable about the current and possible future business models for games for health.

  7. Modeling of Food and Nutrition Surveillance in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Santuzza Arreguy Silva VITORINO

    Full Text Available ABSTRACT Objective: To describe the modeling stages of food and nutrition surveillance in the Primary Health Care of the Unified Health Care System, considering its activities, objectives, and goals Methods: Document analysis and semi-structured interviews were used for identifying the components, describe the intervention, and identify potential assessment users. Results: The results include identification of the objectives and goals of the intervention, the required inputs, activities, and expected effects. The intervention was then modeled based on these data. The use of the theoretical logic model optimizes times, resources, definition of the indicators that require monitoring, and the aspects that require assessment, identifying more clearly the contribution of the intervention to the results Conclusion: Modeling enabled the description of food and nutrition surveillance based on its components and may guide the development of viable plans to monitor food and nutrition surveillance actions so that modeling can be established as a local intersectoral planning instrument.

  8. The Moderating Effect of Health-Improving Workplace Environment on Promoting Physical Activity in White-Collar Employees: A Multi-Site Longitudinal Study Using Multi-Level Structural Equation Modeling.

    Science.gov (United States)

    Watanabe, Kazuhiro; Otsuka, Yasumasa; Shimazu, Akihito; Kawakami, Norito

    2016-02-01

    This longitudinal study aimed to investigate the moderating effect of health-improving workplace environment on relationships between physical activity, self-efficacy, and psychological distress. Data were collected from 16 worksites and 129 employees at two time-points. Health-improving workplace environment was measured using the Japanese version of the Environmental Assessment Tool. Physical activity, self-efficacy, and psychological distress were also measured. Multi-level structural equation modeling was used to investigate the moderating effect of health-improving workplace environment on relationships between psychological distress, self-efficacy, and physical activity. Psychological distress was negatively associated with physical activity via low self-efficacy. Physical activity was negatively related to psychological distress. Physical activity/fitness facilities in the work environment exaggerated the positive relationship between self-efficacy and physical activity. Physical activity/fitness facilities in the workplace may promote employees' physical activity.

  9. The Environmental Science and Health Effects Program

    International Nuclear Information System (INIS)

    Michael Gurevich; Doug Lawson; Joe Mauderly

    2000-01-01

    The goal of the Environmental Science and Health Effect Program is to conduct policy-relevant research that will help us understand atmospheric impacts and potential health effects that may be caused by the use of petroleum-based fuels and alternative transportation fuels from mobile sources

  10. The Environmental Science and Health Effects Program

    Energy Technology Data Exchange (ETDEWEB)

    Michael Gurevich; Doug Lawson; Joe Mauderly

    2000-04-10

    The goal of the Environmental Science and Health Effect Program is to conduct policy-relevant research that will help us understand atmospheric impacts and potential health effects that may be caused by the use of petroleum-based fuels and alternative transportation fuels from mobile sources.

  11. Leadership models in health care - a case for servant leadership.

    Science.gov (United States)

    Trastek, Victor F; Hamilton, Neil W; Niles, Emily E

    2014-03-01

    Our current health care system is broken and unsustainable. Patients desire the highest quality care, and it needs to cost less. To regain public trust, the health care system must change and adapt to the current needs of patients. The diverse group of stakeholders in the health care system creates challenges for improving the value of care. Health care providers are in the best position to determine effective ways of improving the value of care. To create change, health care providers must learn how to effectively lead patients, those within health care organizations, and other stakeholders. This article presents servant leadership as the best model for health care organizations because it focuses on the strength of the team, developing trust and serving the needs of patients. As servant leaders, health care providers may be best equipped to make changes in the organization and in the provider-patient relationship to improve the value of care for patients. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  12. The capacity-load model of non-communicable disease risk: understanding the effects of child malnutrition, ethnicity and the social determinants of health.

    Science.gov (United States)

    Wells, Jonathan C K

    2018-05-01

    The capacity-load model is a conceptual model developed to improve understanding of the life-course aetiology of non-communicable diseases (NCDs) and their ecological and societal risk factors. The model addresses continuous associations of both (a) nutrition and growth patterns in early life and (b) lifestyle factors at older ages with NCD risk. Metabolic capacity refers to physiological traits strongly contingent on early nutrition and growth during the first 1000 days, which promote the long-term capacity for homeostasis in the context of fuel metabolism and cardiovascular health. Metabolic load refers to components of nutritional status and lifestyle that challenge homeostasis. The higher the load, and the lower the capacity, the greater the NCD risk. The model therefore helps understand dose-response associations of both early development and later phenotype with NCD risk. Infancy represents a critical developmental period, during which slow growth can constrain metabolic capacity, whereas rapid weight gain may elevate metabolic load. Severe acute malnutrition in early childhood (stunting, wasting) may continue to deplete metabolic capacity, and confer elevated susceptibility to NCDs in the long term. The model can be applied to associations of NCD risk with socio-economic position (SEP): lower SEP is generally associated with lower capacity but often also with elevated load. The model can also help explain ethnic differences in NCD risk, as both early growth patterns and later body composition differ systematically between ethnic groups. Recent work has begun to clarify the role of organ development in metabolic capacity, which may further contribute to ethnic differences in NCD risk.

  13. Population health improvement: a community health business model that engages partners in all sectors.

    Science.gov (United States)

    Kindig, David A; Isham, George

    2014-01-01

    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  14. Health Effects of Environmental Pollution.

    Science.gov (United States)

    Environmental Protection Agency, Washington, DC.

    This booklet notes that for a long time the American people were willing to pay any price for progress. Now may refuse to accept an environment that menaces their health and lowers their enjoyment of life. They are embracing a new environmental consciousness, a broader vision of reality, a more profound sense of their place in nature. Among the…

  15. Implementation strategies for collaborative primary care-mental health models.

    Science.gov (United States)

    Franx, Gerdien; Dixon, Lisa; Wensing, Michel; Pincus, Harold

    2013-09-01

    Extensive research exists that collaborative primary care-mental health models can improve care and outcomes for patients. These programs are currently being implemented throughout the United States and beyond. The purpose of this study is to review the literature and to generate an overview of strategies currently used to implement such models in daily practice. Six overlapping strategies to implement collaborative primary care-mental health models were described in 18 selected studies. We identified interactive educational strategies, quality improvement change processes, technological support tools, stakeholder engagement in the design and execution of implementation plans, organizational changes in terms of expanding the task of nurses and financial strategies such as additional collaboration fees and pay for performance incentives. Considering the overwhelming evidence about the effectiveness of primary care-mental health models, there is a lack of good studies focusing on their implementation strategies. In practice, these strategies are multifaceted and locally defined, as a result of intensive and required stakeholder engagement. Although many barriers still exist, the implementation of collaborative models could have a chance to succeed in the United States, where new service delivery and payment models, such as the Patient-Centered Medical Home, the Health Home and the Accountable Care Organization, are being promoted.

  16. On models of health assistance and the program of family health of the Brazilian Health Department

    Directory of Open Access Journals (Sweden)

    Claudia Hausman Silveira

    2008-08-01

    Full Text Available The article makes reference to the three models that have inspired the construction of the Program of Family Health in Brazil (Cuban, English and Canadian, observing their differences and similarities and comparing them with the Brazilian case. Therefore, an associative line is also constructed between the Only System of Health (SUS and the necessity of a practice which allows the functioning of its lines of direction and organization principles. Thus, we reach the conclusion that the Program of Family Health in Brazil, for its multi professional work proposal in interdisciplinary teams, in accordance with the SUS, can help keep the law of health in the Country. Key-words: SUS; Program of Family Health; Interdisciplinary; Medical care model; Sanitary practice

  17. Public Health Activist Skills Pyramid: A Model for Implementing Health in All Policies.

    Science.gov (United States)

    Damari, Behzad; Ehsani Chimeh, Elham

    2017-01-01

    Affecting public health for society requires various competencies. In fact, the prerequisite for the implementation of health in all policies should be effectiveness of public health activists (PHAs) in these competencies. This study aims to determine the competencies of the activists in public health. The present qualitative study reviewed the literature and adopted qualitative methods like content analysis, stakeholder interviews, and conducted focus group discussions with related experts. In each stage, the required competencies were extracted through drawing the main action processes of a PHA. Thereafter, the authors reached an ultimately best-suited working model by classifying and approving extracted competencies. The competencies comprise a pyramid set of three main categories of basic, specialized/professional, and individual updating competencies. Personal management, communication, teamwork, project management, ability to apply principles and concepts of public health, anatomy, physiology, and pathology in the organizations of the society should be included in the basic category. Specialized skills should include ability to plan, public participation, intersectoral collaboration, social marketing, working with the media/media friendly attitude, advocacy, research management and knowledge translation, evaluation of health programs, network establishment and management, deployment and institutionalization, operational research, empowerment and consultation, and protocol and service pack design. Last but not least, individual updating is defined as being informed of the latest scientific articles and reports about health and its situation in different countries as well as determinants that affect health. Implementation of this pyramid requires design and establishment of specific centers for transferring effective public health competencies. This pyramid has also functional use for the revision of educational curriculums in all health study fields. Moreover

  18. The Health Effects of Motorization

    OpenAIRE

    Millett, Christopher; Agrawal, Sutapa; Sullivan, Ruth; Vaz, Mario; Kurpad, Anura; Bharathi, A. V.; Prabhakaran, Dorairaj; Reddy, Kolli Srinath; Kinra, Sanjay; Smith, George Davey; Ebrahim, Shah

    2013-01-01

    Editors' Summary Background Noncommunicable diseases (NCDs) and obesity (excessive body fat) are major threats to global health. Every year, more than 36 million people (including 29 million in LMICs) die from NCDs?nearly two-thirds of the world's annual deaths. Cardiovascular diseases (conditions that affect the heart and the circulation), diabetes, cancer, and respiratory diseases are responsible for most NCD-related deaths. Obesity is a risk factor for all these NCDs and the global prevale...

  19. From Family Violence Exposure to Violent Offending: Examining Effects of Race and Mental Health in a Moderated Mediation Model Among Confined Male Juveniles.

    Science.gov (United States)

    Fix, Rebecca L; Alexander, Apryl A; Burkhart, Barry R

    2017-09-01

    Depression, substance use, and impulsivity have been linked to family violence exposure and to the development of violent offending during adolescence. Additionally, the indirect effects associated with these factors may not generalize across different racial/ethnic adolescent populations. The present study tested whether race/ethnicity moderated the mediated relationship between family violence exposure and violent offending, with depression, substance use, and impulsivity as mediators. A sample of 1,359 male adolescents was obtained from a juvenile correctional program. Between-racial/ethnic group comparisons were generally consistent with previous findings. The overall moderated mediation model was significant in predicting violence for both racial/ethnic groups. Different factors influenced violent offending among African Americans and European Americans in the tested model. Furthermore, race/ethnicity moderated the relationship between family violence exposure and impulsivity and substance use. Implications and future directions resolving issues are discussed concerning whether race/ethnicity should be included as a moderator in models of violence.

  20. Effect of occupational mobility and health status on life satisfaction of Chinese residents of different occupations: logistic diagonal mobility models analysis of cross-sectional data on eight Chinese provinces

    Science.gov (United States)

    2014-01-01

    Background Life satisfaction research in China is in development, requiring new perspectives for enrichment. In China, occupational mobility is accompanied by changes in economic liberalization and the emergence of occupational stratification. On the whole, however, occupational mobility has rarely been used as an independent variable. Health status is always used as the observed or dependent variable in studies of the phenomenon and its influencing factors. A research gap still exists for enriching this field. Methods The data used in this study were obtained from the China Health and Nutrition Survey (CHNS). The study included nine provinces in China. The survey was conducted from 1989 to 2009.Every survey involved approximately 4400 families or 19,000 individual samples and parts of community data. Results First, we built a 5 × 5 social mobility table and calculated life satisfaction of Chinese residents of different occupations in each table. Second, gender, age, marital status, education level, annual income and hukou, health status, occupational mobility were used as independent variables. Lastly, we used logistic diagonal mobility models to analyze the relationship between life satisfaction and the variables. Model 1 was the basic model, which consisted of the standard model and controlled variables and excluded drift variables. Model 2 was the total model, which consisted of all variables of interest in this study. Model 3 was the screening model, which excluded the insignificant drift effect index in Model 2. Conclusion From the perspective of the analysis of controlled variables, health conditions, direction, and distance of occupational mobility significantly affected life satisfaction of Chinese residents of different occupations. (1) From the perspective of health status, respondents who have not been sick or injured had better life satisfaction than those who had been sick or injured. (2) From the perspective of occupational mobility direction

  1. Effect of occupational mobility and health status on life satisfaction of Chinese residents of different occupations: logistic diagonal mobility models analysis of cross-sectional data on eight Chinese provinces.

    Science.gov (United States)

    Liang, Ying; Lu, Peiyi

    2014-02-08

    Life satisfaction research in China is in development, requiring new perspectives for enrichment. In China, occupational mobility is accompanied by changes in economic liberalization and the emergence of occupational stratification. On the whole, however, occupational mobility has rarely been used as an independent variable. Health status is always used as the observed or dependent variable in studies of the phenomenon and its influencing factors. A research gap still exists for enriching this field. The data used in this study were obtained from the China Health and Nutrition Survey (CHNS). The study included nine provinces in China. The survey was conducted from 1989 to 2009.Every survey involved approximately 4400 families or 19,000 individual samples and parts of community data. First, we built a 5 × 5 social mobility table and calculated life satisfaction of Chinese residents of different occupations in each table. Second, gender, age, marital status, education level, annual income and hukou, health status, occupational mobility were used as independent variables. Lastly, we used logistic diagonal mobility models to analyze the relationship between life satisfaction and the variables. Model 1 was the basic model, which consisted of the standard model and controlled variables and excluded drift variables. Model 2 was the total model, which consisted of all variables of interest in this study. Model 3 was the screening model, which excluded the insignificant drift effect index in Model 2. From the perspective of the analysis of controlled variables, health conditions, direction, and distance of occupational mobility significantly affected life satisfaction of Chinese residents of different occupations. (1) From the perspective of health status, respondents who have not been sick or injured had better life satisfaction than those who had been sick or injured. (2) From the perspective of occupational mobility direction, the coefficients of occupational

  2. Effect of Dynamic Meditation on Mental Health.

    Science.gov (United States)

    Iqbal, Naved; Singh, Archana; Aleem, Sheema

    2016-02-01

    Although traditional meditation has been found to be effective in improving physical and mental health of subjects, there was a paucity of research of the effect of active or dynamic meditation on these variables. Therefore, the present study was aimed at studying the effect of dynamic meditation on mental health of the subjects. Total sample of the present study comprised 60 subjects, 30 each in experimental and control group. Subjects in experimental group were given 21-day training in dynamic meditation. Mental health of the experimental and control group subjects was measured in pre- and post-condition with the help of Mental Health Inventory developed by Jagadish and Srivastava (Mental Health inventory, Manovaigyanik Parikshan Sansthan, Varanasi, 1983). Obtained data were analyzed with the help of ANCOVA. In post-condition, experimental group scored better than control group on integration of personality, autonomy and environmental mastery. Effect sizes of dynamic meditation on these dimensions of mental health were large. However, experimental group and control group did not differ significantly on positive self-evaluation, perception of reality and group-oriented attitude dimensions of mental health in post-condition. Overall, dynamic meditation training was effective in improving mental health of the subjects.

  3. Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy

    DEFF Research Database (Denmark)

    Kayser, Lars; Kushniruk, Andre; Osborne, Richard H

    2015-01-01

    BACKGROUND: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often...... the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...

  4. Judicialization of Health: A Perspective of Effectiveness

    Directory of Open Access Journals (Sweden)

    Claudia Mota Estabel

    2015-12-01

    Full Text Available This work is scoped to synthesize the legalization of the right to health, and offer a perspective for shaping effectiveness. Using the inductive method and based on research literature and case law, at first a brief history of the right to health will be presented as well as some of the principles relating to fundamental precept. Per second, from a normative and jurisprudential approach, the right will be presented to health in the judiciary perspective, focused on the instruments already used (court decisions, the number of demands that concern the health issue, and public policies adopted by the judiciary both in its own sphere as administratively. Finally, emphasis shall be the various issues in the legal health procedure regarding the joint responsibility of federal entities and guidelines for proper conformation of the right to health, the effect of promoting citizenship and social justice.

  5. Effects of nutrition on oral health

    OpenAIRE

    G A Agbelusi

    2010-01-01

    Nutrition represents a summation of intake, absorption, storage and utilization of foods by the tissues. Oral tissues are one of the most sensitive indicators of nutritional state of the body. Nutritional deficiencies are associated with changes in the integrity (health and appearance) of the oral structures/ tissues and these changes are frequently the first clinical signs of deficiency. Nutrition affects oral health and oral health affects nutrition. The effects of malnutrition can be s...

  6. World Organisation for Animal Health: strengthening Veterinary Services for effective One Health collaboration.

    Science.gov (United States)

    Corning, S

    2014-08-01

    To effectively reduce health risks at the animal-human-ecosystems interface, a One Health strategy is crucially important to create strong national and regional animal health systems that are well coordinated with strong public health systems. Animal diseases, particularly those caused by new and emerging zoonotic pathogens, must be effectively controlled at their source to reduce their potentially devastating impact upon both animal and human health. As the international organisation responsible for developing standards, guidelines and recommendations for animal health, the World Organisation for Animal Health (OIE) plays an important role in minimising animal and public health risks attributable to zoonoses and other animal diseases, which can have severe consequences for global food safety and security. National Veterinary Services, which implement OIE animal health and welfare standards and other measures, are the first line of defence against these diseases, and must have the capacity to meet the core requirements necessary for their diagnosis and control. The OIE works collaboratively with the World Health Organization and Food and Agriculture Organization of the United Nations to improve the ability of national animal and public health systems to respond to current and emerging animal health risks with public health consequences. In addition to improving and aligning national laboratory capacities in high-risk areas, the OIE collaborates on One Health-oriented projects for key diseases, establishing model frameworks which can be applied to manage other existing and emerging priority diseases. This article reviews the role and activities of the OIE in strengthening the national Veterinary Services of its Member Countries for a more effective and sustainable One Health collaboration.

  7. Health effects of energy development

    International Nuclear Information System (INIS)

    Myers, D.K.; Newcombe, H.B.

    1980-01-01

    Our accumulated technology has added roughly 50 years to the average life span of a human being in North America. Most of this increase in life span has occurred within the last 100 years. Cheap and safe supplies of energy are required for the industrial prosperity that has made this possible. The best estimates available all indicate that nuclear power and natural gas are the safest forms of contemporary energy production. The largest potential radiation hazard to which we are currently exposed appears to derive from our houses; increased attention by public health authorities to the control of this particular hazard may be warranted. (Auth)

  8. Developing explanatory models of health inequalities in childhood dental caries

    DEFF Research Database (Denmark)

    Pine, Cynthia M; Adair, Pauline M; Petersen, Poul Erik

    2004-01-01

    OBJECTIVE: Long-term aim is to determine optimum interventions to reduce dental caries in children in disadvantaged communities and minimise the effects of exclusion from health care systems, of ethnic diversity, and health inequalities. DESIGN: Generation of initial explanatory models, study...... in developing and delivering this multi-centre study. Experience gained will support the development of substantive trials and longitudinal studies to address the considerable international health disparity of childhood dental caries....... protocol and development of two standardised measures. First, to investigate how parental attitudes may impact on their children's oral health-related behaviours and second, to assess how dentists' attitudes may impact on the provision of dental care. SUBJECTS: Core research team, lead methodologists, 44...

  9. Health and environmental effects of nuclear weapons

    International Nuclear Information System (INIS)

    1995-08-01

    Since 1981 WHO has been studying and reporting on the effects of nuclear war on health and health services. This report provides information on the subject and refers to earlier related work of WHO. It forms the basis for a request from WHO to the International Court of Justice regarding the legality of the use of nuclear weapons. 15 refs

  10. Health effects estimation for contaminated properties

    International Nuclear Information System (INIS)

    Marks, S.; Denham, D.H.; Cross, F.T.; Kennedy, W.E. Jr.

    1984-05-01

    As part of an overall remedial action program to evaluate the need for and institute actions designed to minimize health hazards from inactive tailings piles and from displaced tailings, methods for estimating health effects from tailings were developed and applied to the Salt Lake City area. 2 references, 2 tables

  11. Physical Health Effects of Intimate Partner Abuse

    Science.gov (United States)

    Sillito, Carrie LeFevre

    2012-01-01

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

  12. Biophysical models of radiobiological effects

    International Nuclear Information System (INIS)

    Obaturov, G.M.

    1984-01-01

    Models of radiation effect on biological structures and objects are presented. Physical and molecular models based on target theory and DNA or chromosome injuries, respectively, and reparation ''saturation'' theory, are considered

  13. [Effectiveness of support for asbestos health consultation in health centers].

    Science.gov (United States)

    Nagamatsu, Yasuko

    2011-09-01

    In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

  14. Health effects of biofuel exhaust

    OpenAIRE

    Vugt, M.A.T.M. van; Mulderij, M.; Usta, M.; Kadijk, G.; Kooter, I.M.; Krul, C.A.M.

    2009-01-01

    Alternatives to fossil fuels receive a lot of attention. In particular, oil derived of specific crops forms a promising fuel. In order to warrant global expectance of such novel fuels, safety issues associated with combustion of these fuels needs to be assessed. Although only a few public reports exist, recently potential toxic effects associated with biofuels has been published. Here, we report the analysis of a comprehensive study, comparing the toxic effects of conventional diesel, biodies...

  15. Quantal health effects of three toxic agents combined

    International Nuclear Information System (INIS)

    Seiler, F.A.

    1988-01-01

    Quantal health effects such as cancer, correlated with the combined action of three toxic agents, are considered. Data on the combined effects of two agents are scarce and no such data exist for three toxicants, yet concerns have arisen about simultaneous exposure of radiation workers to three different agents. Using models developed from the analysis of health effects involving two toxicants, equations for the combined effects of three agents are derived from a more general formalism. An application of practical interest is the incidence of cancer of the esophagus and its correlation with concurrent exposures to alcohol, tobacco, and either low- or high-LET radiation. (author)

  16. Health effects of vegan diets.

    Science.gov (United States)

    Craig, Winston J

    2009-05-01

    Recently, vegetarian diets have experienced an increase in popularity. A vegetarian diet is associated with many health benefits because of its higher content of fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemicals and a fat content that is more unsaturated. Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegan include vitamins B-12 and D, calcium, and long-chain n-3 (omega-3) fatty acids. Unless vegans regularly consume foods that are fortified with these nutrients, appropriate supplements should be consumed. In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals.

  17. The Effects of Noise on Health

    National Research Council Canada - National Science Library

    Harris, Charles

    1997-01-01

    .... This is followed by a discussion of noise induced physiological changes, noise as a stress, and on some specialized topics on the effects of impulsive acoustic stimuli, on effects on sleep, and on hearing and health effects of people living under military training routes.

  18. Health Effects of Ozone and Particle Pollution

    Science.gov (United States)

    ... this page: Health Effects of Ozone and Particle Pollution Two types of air pollution dominate in the ... So what are ozone and particle pollution? Ozone Pollution It may be hard to imagine that pollution ...

  19. Health effects and bioavailability of dietary flavonols

    NARCIS (Netherlands)

    Hollman, P.C.H.; Katan, M.B.

    1999-01-01

    Flavonoids are polyphenolic compounds that are ubiquitously present in foods of plant origin. Flavonoids are categorised into flavonols, flavones, catechins, flavanones, anthocyanidins, and isoflavonoids. They may have beneficial health effects because of their antioxidant properties and their

  20. Physiological Basis for Prompt Health Effects

    International Nuclear Information System (INIS)

    VINCENT, Andrew

    2006-01-01

    As input to design considerations precluding worker radiological exposure that could lead to an acute health effect from a postulated accident condition, an assessment of the short term health effects was performed. To assure that the impact of the accident scenario on the individual is appropriately considered, both external and internal exposures are included in the evaluation. The focus of this evaluation was to develop a quantitative basis from which to consider the level of exposure postulated in an accident that could lead to a defined physiological impact for short term health effects. This paper does not assess latent health effects of radiological exposure associated with normal operations or emergency response guidelines as these are clearly articulated in existing regulations and ICRP documents. The intent of this paper is to facilitate a dialogue on the appropriate meaning of currently undefined terms such as ''significant'' exposure and ''high-hazard material'' in DSA development

  1. Work stress and health effects among university personnel.

    Science.gov (United States)

    Donders, N C G M; van der Gulden, J W J; Furer, J W; Tax, B; Roscam Abbing, E W

    2003-10-01

    (1) To investigate the contribution of job characteristics and personal characteristics to the explanation of health effects among university personnel; (2) to investigate the differences between scientific personnel (SP) and non-scientific personnel (NSP); (3) to investigate whether health effects occurred one after another. The well being at work of employees at a Dutch university (n=2,522) was investigated by means of a questionnaire. A model was constructed in which several job and personal characteristics were set out against health effects. The latter were assumed to occur in phases: decreased "job satisfaction" as an early effect, followed by increased "tension" and "emotional exhaustion", and possibly also by increased "perceived health complaints". The contribution of job and personal characteristics to the explanation of health effects was investigated by means of linear regression analysis, with separate analyses for SP and NSP. Positive job characteristics, especially professional expertise and work variety, contributed to the explanation of "job satisfaction". The major contributors to "tension" and "emotional exhaustion" were negative characteristics, such as work pressure. Besides the negative aspects, the major contributors to the explanation of "perceived health complaints" were sex, age and other health effects. In NSP, social support contributed to the explanation of "tension" and "emotional exhaustion", but not in SP. The explained variance of "job satisfaction" by the positive job characteristics in NSP was much higher than that in SP. To investigate whether health effects occurred one after another, we considered explained variance. Explained variance in "job satisfaction" was much higher than in "perceived health complaints". "Emotional exhaustion" and "tension" were in between. Contrary to expectations, decision latitude and social support played only minor roles. Also, the differences between SP and NSP were smaller than expected. As

  2. The cost-effectiveness and public health benefit of nalmefene added to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels: a Markov model.

    Science.gov (United States)

    Laramée, Philippe; Brodtkorb, Thor-Henrik; Rahhali, Nora; Knight, Chris; Barbosa, Carolina; François, Clément; Toumi, Mondher; Daeppen, Jean-Bernard; Rehm, Jürgen

    2014-09-16

    To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels (DRLs) as defined by the WHO, and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases, injuries and deaths. Decision modelling using Markov chains compared costs and effects over 5 years. The analysis was from the perspective of the National Health Service (NHS) in England and Wales. The model considered the licensed population for nalmefene, specifically adults with both alcohol dependence and high/very high DRLs, who do not require immediate detoxification and who continue to have high/very high DRLs after initial assessment. We modelled treatment effect using data from three clinical trials for nalmefene (ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941)). Baseline characteristics of the model population, treatment resource utilisation and utilities were from these trials. We estimated the number of alcohol-attributable events occurring at different levels of alcohol consumption based on published epidemiological risk-relation studies. Health-related costs were from UK sources. We measured incremental cost per quality-adjusted life year (QALY) gained and number of alcohol-attributable harmful events avoided. Nalmefene in combination with psychosocial support had an incremental cost-effectiveness ratio (ICER) of £5204 per QALY gained, and was therefore cost-effective at the £20,000 per QALY gained decision threshold. Sensitivity analyses showed that the conclusion was robust. Nalmefene plus psychosocial support led to the avoidance of 7179 alcohol-attributable diseases/injuries and 309 deaths per 100,000 patients compared to psychosocial support alone over the course of 5 years. Nalmefene can be seen as a cost-effective treatment for alcohol dependence, with substantial public

  3. The cost-effectiveness and public health benefit of nalmefene added to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels: a Markov model

    Science.gov (United States)

    Laramée, Philippe; Brodtkorb, Thor-Henrik; Rahhali, Nora; Knight, Chris; Barbosa, Carolina; François, Clément; Toumi, Mondher; Daeppen, Jean-Bernard; Rehm, Jürgen

    2014-01-01

    Objectives To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels (DRLs) as defined by the WHO, and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases, injuries and deaths. Design Decision modelling using Markov chains compared costs and effects over 5 years. Setting The analysis was from the perspective of the National Health Service (NHS) in England and Wales. Participants The model considered the licensed population for nalmefene, specifically adults with both alcohol dependence and high/very high DRLs, who do not require immediate detoxification and who continue to have high/very high DRLs after initial assessment. Data sources We modelled treatment effect using data from three clinical trials for nalmefene (ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941)). Baseline characteristics of the model population, treatment resource utilisation and utilities were from these trials. We estimated the number of alcohol-attributable events occurring at different levels of alcohol consumption based on published epidemiological risk-relation studies. Health-related costs were from UK sources. Main outcome measures We measured incremental cost per quality-adjusted life year (QALY) gained and number of alcohol-attributable harmful events avoided. Results Nalmefene in combination with psychosocial support had an incremental cost-effectiveness ratio (ICER) of £5204 per QALY gained, and was therefore cost-effective at the £20 000 per QALY gained decision threshold. Sensitivity analyses showed that the conclusion was robust. Nalmefene plus psychosocial support led to the avoidance of 7179 alcohol-attributable diseases/injuries and 309 deaths per 100 000 patients compared to psychosocial support alone over the course of 5 years. Conclusions

  4. Safeguards system effectiveness modeling

    International Nuclear Information System (INIS)

    Bennett, H.A.; Boozer, D.D.; Chapman, L.D.; Daniel, S.L.; Engi, D.; Hulme, B.L.; Varnado, G.B.

    1976-01-01

    A general methodology for the comparative evaluation of physical protection system effectiveness at nuclear facilities is presently under development. The approach is applicable to problems of sabotage or theft at fuel cycle facilities. The overall methodology and the primary analytic techniques used to assess system effectiveness are briefly outlined

  5. Safeguards system effectiveness modeling

    International Nuclear Information System (INIS)

    Boozer, D.D.; Hulme, B.L.; Daniel, S.L.; Varnado, G.B.; Bennett, H.A.; Chapman, L.D.; Engi, D.

    1976-09-01

    A general methodology for the comparative evaluation of physical protection system effectiveness at nuclear facilities is presently under development. The approach is applicable to problems of sabotage or theft at fuel cycle facilities. In this paper, the overall methodology and the primary analytic techniques used to assess system effectiveness are briefly outlined

  6. Safeguards system effectiveness modeling

    International Nuclear Information System (INIS)

    Bennett, H.A.; Boozer, D.D.; Chapman, L.D.; Daniel, S.L.; Engi, D.; Hulme, B.L.; Varnado, G.B.

    1976-01-01

    A general methodology for the comparative evaluation of physical protection system effectiveness at nuclear facilities is presently under development. The approach is applicable to problems of sabotage or theft at fuel cycle facilities. In this paper, the overall methodology and the primary analytic techniques used to assess system effectiveness are briefly outlined

  7. Access to effective health care

    DEFF Research Database (Denmark)

    Høy, Bente

    2015-01-01

    Access to effective healthcare is in particular challenging for vulnerable and socially disadvantaged patients. Patients with chronic conditions are over-represented in these lower socioeconomic (LSES) groups. No generic review integrating the evidence on Self-Management support interventions in ...

  8. Health Effects of Sleep Deprivation,

    Science.gov (United States)

    1990-06-01

    of an inordinate sleep loss (as hunger and thirst prevent us from going too long without food and water). Because of this, it takes great personal...drug-refractory depression. Neuropsychology 13:111-116, 1985. 82. Dowd PJ: Sleep deprivation effects on the vestibular habituation process. J Apply

  9. Managing structural uncertainty in health economic decision models: a discrepancy approach

    OpenAIRE

    Strong, M.; Oakley, J.; Chilcott, J.

    2012-01-01

    Healthcare resource allocation decisions are commonly informed by computer model predictions of population mean costs and health effects. It is common to quantify the uncertainty in the prediction due to uncertain model inputs, but methods for quantifying uncertainty due to inadequacies in model structure are less well developed. We introduce an example of a model that aims to predict the costs and health effects of a physical activity promoting intervention. Our goal is to develop a framewor...

  10. Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health

    Science.gov (United States)

    Trinkoff, A.M.; Storr, C.L.; Wilson, M.L.; Gurses, A.P.

    2015-01-01

    Summary Background To our knowledge, no evidence is available on health care professionals’ use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses’ personal use of ePHRs using a modified technology acceptance model. Objectives To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses’ own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers’ use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use. Methods A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect. Results Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses’ own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses. Conclusions Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their

  11. Biophysical models of radiobiological effects

    International Nuclear Information System (INIS)

    Obaturov, G.M.

    1987-01-01

    Radiobiological effect models at different organization levels, developed by the author, are presented. Classification and analysis of concepts and biophysical models at molecular, genetic and cellular levels, developed by Soviet and foreign authors in comparison to inherent models, are conducted from the viewpoint of system approach to radiobiological processes and of modelling principles. Models are compared with each other, limits of their applicability and drawbacks are determined. Evaluation of the model truthfulness is conducted according to a number of criteria, ways of further investigations and experimental examination of some models are proposed

  12. Effect of a Multidisciplinary Outpatient Model of Care on Health Outcomes in Older Patients with Multimorbidity: A Retrospective Case Control Study.

    Directory of Open Access Journals (Sweden)

    Sepehr Shakib

    Full Text Available To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital.A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital. Controls were matched in a 4:1 ratio with cases for age, gender, index admission diagnosis and length of stay.Non-elective readmission rates, total readmission length of stay and overall survival.A total of 252 cases and 1008 control patients were included in the study. Despite the patients referred to the multidisciplinary model of care had slightly more comorbid conditions, significantly higher total length of hospital stay in the previous 12 months and increased prevalence of diabetes and heart failure by comparison to those who received usual care, they had significantly improved survival (adjusted hazard ratio 0.70 95% CI 0.51-0.96, p = 0.029 and no excess in the number of hospitalisations observed.Following discharge from hospital, holistic multidisciplinary outpatient management is associated with improved survival in older patients with multimorbidity. The findings of this study warrant further examination in randomised and cost-effectiveness trials.

  13. Multivariate determinants of self-management in Health Care: assessing Health Empowerment Model by comparison between structural equation and graphical models approaches

    Directory of Open Access Journals (Sweden)

    Filippo Trentini

    2015-03-01

    Full Text Available Backgroung. In public health one debated issue is related to consequences of improper self-management in health care.  Some theoretical models have been proposed in Health Communication theory which highlight how components such general literacy and specific knowledge of the disease might be very important for effective actions in healthcare system.  Methods. This  paper aims at investigating the consistency of Health Empowerment Model by means of both graphical models approach, which is a “data driven” method and a Structural Equation Modeling (SEM approach, which is instead “theory driven”, showing the different information pattern that can be revealed in a health care research context.The analyzed dataset provides data on the relationship between the Health Empowerment Model constructs and the behavioral and health status in 263 chronic low back pain (cLBP patients. We used the graphical models approach to evaluate the dependence structure in a “blind” way, thus learning the structure from the data.Results. From the estimation results dependence structure confirms links design assumed in SEM approach directly from researchers, thus validating the hypotheses which generated the Health Empowerment Model constructs.Conclusions. This models comparison helps in avoiding confirmation bias. In Structural Equation Modeling, we used SPSS AMOS 21 software. Graphical modeling algorithms were implemented in a R software environment.

  14. Health effects and medical surveillance

    International Nuclear Information System (INIS)

    1998-01-01

    Source of ionizing radiations have innumerable applications in the work place. Usually, even where the work is performed safely, the employees involved inevitably receive small, regular exposures to radiation that are not manifestly harmful. This Module explains how ionizing radiations can interact with and affect human tissues, the various factors that influence the outcome and the detrimental effects that may result. The medical surveillance that is appropriate for those working with radiation sources, depending on the degree of hazard of the work, is described. The Manual will be of most benefit it if forms part of more comprehensive training or is supplemented by the advice of a medically qualified expert. Where medical surveillance is appropriate for radiation employees, the services of a qualified doctor, occupational physician or other trained medical staff will be required

  15. Industrial wind turbines and adverse health effects.

    Science.gov (United States)

    Jeffery, Roy D; Krogh, Carmen M E; Horner, Brett

    2014-01-01

    Some people living in the environs of industrial wind turbines (IWTs) report experiencing adverse health and socioeconomic effects. This review considers the hypothesis that annoyance from audible IWTs is the cause of these adverse health effects. We searched PubMed and Google Scholar for articles published since 2000 that included the terms "wind turbine health," "wind turbine infrasound," "wind turbine annoyance," "noise annoyance" or "low frequency noise" in the title or abstract. Industrial wind turbines produce sound that is perceived to be more annoying than other sources of sound. Reported effects from exposure to IWTs are consistent with well-known stress effects from persistent unwanted sound. If placed too close to residents, IWTs can negatively affect the physical, mental and social well-being of people. There is sufficient evidence to support the conclusion that noise from audible IWTs is a potential cause of health effects. Inaudible low-frequency noise and infrasound from IWTs cannot be ruled out as plausible causes of health effects.

  16. Valuing Health Effect on Air Pollution : WTP Approach Using CVM

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Yoo; Um, Mi Jung [Seoul National University, Seoul (Korea); Kwak, Seung Jun [Korea University, Seoul (Korea)

    1998-09-01

    Cost-benefit is required for improving air quality efficiently. Benefit in connection with air quality has influence on health effects, a barrier to administration, aesthetic value, and material loss. Among these, health effects are occupying most of them. In this study, the economic value by the people in Seoul was estimated about symptoms of eye irritation, heartburn, and asthma among health effects relating to air pollution by using conditional value measurement (CVM). As a result, 2,580 won/day for eye irritation, 9,000 won/day for heartburn, and 55,400 won/day for asthma were measured. Moreover, in the case of carrying out several CV questions in one survey, it was found out that the estimated results of single variation model and dual variation model were different. (author). 21 refs., 7 tabs.

  17. Poor housing quality: Prevalence and health effects.

    Science.gov (United States)

    Baker, Emma; Lester, Laurence H; Bentley, Rebecca; Beer, Andrew

    2016-01-01

    Housing is a central component of productive, healthy, and meaningful lives, and a principle social determinant of health and well-being. Surprisingly, though, evidence on the ways that housing influences health in Australia is poorly developed. This stems largely from the fact that the majority of the population are accommodated in good quality housing. The dominance of a "good housing paradigm" means that households living in poor quality and unhealthy housing are doubly disadvantaged-by the quality of their housing and because policy makers in Australia do not acknowledge the health effects of housing. In this article, we examine the relationship between health outcomes and quality of housing. We base our analysis on data from the Household Income and Labour Dynamics in Australia (HILDA) survey, a panel dataset that is representative across Australia. We find a sizeable, policy-important, and to date under-acknowledged cohort of Australians whose health is influenced by poor-condition dwellings.

  18. Health effects of coal technologies: research needs

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    In this 1977 Environmental Message, President Carter directed the establishment of a joint program to identify the health and environmental problems associated with advanced energy technologies and to review the adequacy of present research programs. In response to the President's directive, representatives of three agencies formed the Federal Interagency Committee on the Health and Environmental Effects of Energy Technologies. This report was prepared by the Health Effects Working Group on Coal Technologies for the Committee. In this report, the major health-related problems associated with conventional coal mining, storage, transportation, and combustion, and with chemical coal cleaning, in situ gasification, fluidized bed combustion, magnetohydrodynamic combustion, cocombustion of coal-oil mixtures, and cocombustion of coal with municipal solid waste are identified. The report also contains recommended research required to address the identified problems.

  19. Parenting Stress, Mental Health, Dyadic Adjustment: A Structural Equation Model

    Directory of Open Access Journals (Sweden)

    Luca Rollè

    2017-05-01

    Full Text Available Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms, and dyadic adjustment among first-time parents.Method: We studied 268 parents (134 couples of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment.Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers.Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

  20. The Effect of Working Hours on Health

    OpenAIRE

    Berniell, Maria Ines; Bietenbeck, Jan

    2017-01-01

    Does working time causally affect workers' health? We study this question in the context of a French reform which reduced the standard workweek from 39 to 35 hours, at constant earnings. Our empirical analysis exploits variation in the adoption of this shorter workweek across employers, which is mainly driven by institutional features of the reform and thus exogenous to workers' health. Difference-in-differences and lagged dependent variable regressions reveal a negative effect of working hou...

  1. Building a regional health equity movement: the grantmaking model of a local health department.

    Science.gov (United States)

    Baril, Nashira; Patterson, Meghan; Boen, Courtney; Gowler, Rebekah; Norman, Nancy

    2011-01-01

    The Boston Public Health Commission's Center for Health Equity and Social Justice provides grant funding, training, and technical assistance to 15 organizations and coalitions across New England to develop, implement, and evaluate community-based policy and systems change strategies that address social determinants of health and reduce racial and ethnic health inequities. This article describes Boston Public Health Commission's health equity framework, theory of change regarding the elimination of racial and ethnic health inequities, and current grantmaking model. To conclude, the authors evaluate the grant model and offer lessons learned from providing multiyear regional grants to promote health equity.

  2. Short-term effect of two education methods on oral health among hearing impairment children

    Directory of Open Access Journals (Sweden)

    Shiva Pouradeli

    2016-12-01

    CONCLUSION: Both video and dental model effectively improve the oral health of children with HI in short term. Continuous school-based oral health education programs, particularly for HI children, need to be considered.

  3. The Union Health Center: a working model of clinical care linked to preventive occupational health services.

    Science.gov (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

    1997-03-01

    As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success

  4. Health literacy and public health: A systematic review and integration of definitions and models

    LENUS (Irish Health Repository)

    Sorensen, Kristine

    2012-01-25

    Abstract Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

  5. A cost-effectiveness analysis of celecoxib compared with diclofenac in the treatment of pain in osteoarthritis (OA) within the Swedish health system using an adaptation of the NICE OA model.

    Science.gov (United States)

    Brereton, Nicholas; Pennington, Becky; Ekelund, Mats; Akehurst, Ronald

    2014-09-01

    Celecoxib for the treatment of pain resulting from osteoarthritis (OA) was reviewed by the Tandvårds- och läkemedelsförmånsverket-Dental and Pharmaceutical Benefits Board (TLV) in Sweden in late 2010. This study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus a PPI in a Swedish setting. The National Institute for Health and Care Excellence (NICE) in the UK developed a health economic model as part of their 2008 assessment of treatments for OA. In this analysis, the model was reconstructed and adapted to a Swedish perspective. Drug costs were updated using the TLV database. Adverse event costs were calculated using the regional price list of Southern Sweden and the standard treatment guidelines from the county council of Stockholm. Costs for treating cardiovascular (CV) events were taken from the Swedish DRG codes and the literature. Over a patient's lifetime treatment with celecoxib plus a PPI was associated with a quality-adjusted life year (QALY) gain of 0.006 per patient when compared to diclofenac plus a PPI. There was an increase in discounted costs of 529 kr per patient, which resulted in an incremental cost-effectiveness ratio (ICER) of 82,313 kr ($12,141). Sensitivity analysis showed that treatment was more cost effective in patients with an increased risk of bleeding or gastrointestinal (GI) complications. The results suggest that celecoxib plus a PPI is a cost effective treatment for OA when compared to diclofenac plus a PPI. Treatment is shown to be more cost effective in Sweden for patients with a high risk of bleeding or GI complications. It was in this population that the TLV gave a positive recommendation. There are known limitations on efficacy in the original NICE model.

  6. Development of an enhanced health-economic model and cost-effectiveness analysis of tiotropium + olodaterol Respimat® fixed-dose combination for chronic obstructive pulmonary disease patients in Italy.

    Science.gov (United States)

    Selya-Hammer, Carl; Gonzalez-Rojas Guix, Nuria; Baldwin, Michael; Ternouth, Andrew; Miravitlles, Marc; Rutten-van Mölken, Maureen; Goosens, Lucas M A; Buyukkaramikli, Nasuh; Acciai, Valentina

    2016-10-01

    The objective of this study was to compare the cost-effectiveness of the fixed-dose combination (FDC) of tiotropium + olodaterol Respimat(®) FDC with tiotropium alone for patients with chronic obstructive pulmonary disease (COPD) in the Italian health care setting using a newly developed patient-level Markov model that reflects the current understanding of the disease. While previously published models have largely been based around a cohort approach using a Markov structure and GOLD stage stratification, an individual-level Markov approach was selected for the new model. Using patient-level data from the twin TOnado trials assessing Tiotropium + olodaterol Respimat(®) FDC versus tiotropium, outcomes were modelled based on the trough forced expiratory volume (tFEV1) of over 1000 patients in each treatment arm, tracked individually at trial visits through the 52-week trial period, and after the trial period it was assumed to decline at a constant rate based on disease stage. Exacerbation risk was estimated based on a random-effects logistic regression analysis of exacerbations in UPLIFT. Mortality by age and disease stage was estimated from an analysis of TIOSPIR trial data. Cost of bronchodilators and other medications, routine management, and costs of treatment for moderate and severe exacerbations for the Italian setting were included. A cost-effectiveness analysis was conducted over a 15-year time horizon from the perspective of the Italian National Health Service. Aggregating total costs and quality-adjusted life years (QALYs) for each treatment cohort over 15 years and comparing tiotropium + olodaterol Respimat(®) FDC with tiotropium alone, resulted in mean incremental costs per patient of €1167 and an incremental cost-effectiveness ratio (ICER) of €7518 per additional QALY with tiotropium + olodaterol Respimat(®) FDC. The lung function outcomes observed for tiotropium + olodaterol Respimat(®) FDC in TOnado drove the results in terms of slightly

  7. Quantal health effects for a combination of several toxic agents

    Energy Technology Data Exchange (ETDEWEB)

    Seiler, F A

    1988-12-01

    Quantal health effects caused by the combined action of a number of toxic agents are modeled using the information available for each toxicant acting in isolation. Two basic models are used; one assumes no interaction, the other postulates a separable kind of interaction in which each agent contributes an enhancement factor independent of all other agents. These two models provide yardsticks by which to measure synergisms and antagonisms in the interaction between the effects of toxic agents. Equations are given in approximations for small and large values of the risk. (author)

  8. Quantal health effects for a combination of several toxic agents

    International Nuclear Information System (INIS)

    Seiler, F.A.

    1988-01-01

    Quantal health effects caused by the combined action of a number of toxic agents are modeled using the information available for each toxicant acting in isolation. Two basic models are used; one assumes no interaction, the other postulates a separable kind of interaction in which each agent contributes an enhancement factor independent of all other agents. These two models provide yardsticks by which to measure synergisms and antagonisms in the interaction between the effects of toxic agents. Equations are given in approximations for small and large values of the risk. (author)

  9. Health promotion in context – a reflective-analytical model

    DEFF Research Database (Denmark)

    Liveng, Anne; Andersen, Heidi Lene; Lehn-Christiansen, Sine

    2018-01-01

    model,” which is presented in this article. The model provides a framework for the analysis of health-promotion initiatives, employing eight perspectives each intertwined with the others. It is based on the assumption that health and health inequities are contextual and that the theoretically inspired...

  10. A sequential model for the structure of health care utilization.

    NARCIS (Netherlands)

    Herrmann, W.J.; Haarmann, A.; Baerheim, A.

    2017-01-01

    Traditional measurement models of health care utilization are not able to represent the complex structure of health care utilization. In this qualitative study, we, therefore, developed a new model to represent the health care utilization structure. In Norway and Germany, we conducted episodic

  11. Prediction Model for Demands of the Health Meteorological Information Using a Decision Tree Method

    Directory of Open Access Journals (Sweden)

    Jina Oh, RN, PhD

    2010-09-01

    Conclusions: It can be effectively used as a reference model for future studies and is a suggested direction in health meteorological information service and policy development. We suggest health forecasting as a nursing service and a primary health care network for healthier and more comfortable life.

  12. Effect of a multifaceted social franchising model on quality and coverage of maternal, newborn, and reproductive health-care services in Uttar Pradesh, India: a quasi-experimental study.

    Science.gov (United States)

    Tougher, Sarah; Dutt, Varun; Pereira, Shreya; Haldar, Kaveri; Shukla, Vasudha; Singh, Kultar; Kumar, Paresh; Goodman, Catherine; Powell-Jackson, Timothy

    2018-02-01

    How to harness the private sector to improve population health in low-income and middle-income countries is heavily debated and one prominent strategy is social franchising. We aimed to evaluate whether the Matrika social franchising model-a multifaceted intervention that established a network of private providers and strengthened the skills of both public and private sector clinicians-could improve the quality and coverage of health services along the continuum of care for maternal, newborn, and reproductive health. We did a quasi-experimental study, which combined matching with difference-in-differences methods. We matched 60 intervention clusters (wards or villages) with a social franchisee to 120 comparison clusters in six districts of Uttar Pradesh, India. The intervention was implemented by two not-for-profit organisations from September, 2013, to May, 2016. We did two rounds (January, 2015, and May, 2016) of a household survey for women who had given birth up to 2 years previously. The primary outcome was the proportion of women who gave birth in a health-care facility. An additional 56 prespecified outcomes measured maternal health-care use, content of care, patient experience, and other dimensions of care. We organised conceptually similar outcomes into 14 families to create summary indices. We used multivariate difference-in-differences methods for the analyses and accounted for multiple inference. The introduction of Matrika was not significantly associated with the change in facility births (4 percentage points, 95% CI -1 to 9; p=0·100). Effects for any of the other individual outcomes or for any of the 14 summary indices were not significant. Evidence was weak for an increase of 0·13 SD (95% CI 0·00 to 0·27; p=0·053) in recommended delivery care practices. The Matrika social franchise model was not effective in improving the quality and coverage of maternal health services at the population level. Several key reasons identified for the absence of

  13. Health Effects of the New Nordic Diet

    DEFF Research Database (Denmark)

    Poulsen, Sanne Kellebjerg

    The health effects of the New Nordic Diet (NND) are investigated in a six month randomized controlled intervention, in which the NND was compared to the average Danish diet (ADD) among 181 adult participants. Foods were handed out free of charge from a study shop according to the ad libitum...... period. Based on this study, the health effects of the NND are considerable as shown by the lower body weight and lower blood pressure. The follow up period clearly illustrated the challenges related to the voluntary and self-administered adherence to new dietary guidelines but also supports thatthe NND...

  14. Family characteristics and health behaviour as antecedents of school nurses' concerns about adolescents' health and development: a path model approach.

    Science.gov (United States)

    Poutiainen, Hannele; Levälahti, Esko; Hakulinen-Viitanen, Tuovi; Laatikainen, Tiina

    2015-05-01

    Family socio-economic factors and parents' health behaviours have been shown to have an impact on the health and well-being of children and adolescents. Family characteristics have also been associated with school nurses' concerns, which arose during health examinations, about children's and adolescents' physical health and psychosocial development. Parental smoking has also been associated with smoking in adolescents. The aim of this study was to determine to what extent school nurses' concerns about adolescents' physical health and psychosocial development related to family characteristics are mediated through parents' and adolescents' own health behaviours (smoking). A path model approach using cross-sectional data was used. In 2008-2009, information about health and well-being of adolescents was gathered at health examinations of the Children's Health Monitoring Study. Altogether 1006 eighth and ninth grade pupils in Finland participated in the study. The associations between family characteristics, smoking among parents and adolescents and school nurses' concerns about adolescents' physical health and psychosocial development were examined using a structural equation model. Paternal education had a direct, and, through fathers' and boys' smoking, an indirect association with school nurses' concerns about the physical health of boys. Paternal labour market status and family income were only indirectly associated with concerns about the physical health of boys by having an effect on boys' smoking through paternal smoking, and a further indirect effect on concerns about boys' health. In girls, only having a single mother was strongly associated with school nurses' concerns about psychosocial development through maternal and adolescent girl smoking. Socio-economic family characteristics and parental smoking influence adolescent smoking and are associated with school nurses' concerns about adolescents' physical health and psychosocial development. The findings

  15. Effects of Individual Health Topic Familiarity on Activity Patterns During Health Information Searches

    Science.gov (United States)

    Moriyama, Koichi; Fukui, Ken–ichi; Numao, Masayuki

    2015-01-01

    Background Non-medical professionals (consumers) are increasingly using the Internet to support their health information needs. However, the cognitive effort required to perform health information searches is affected by the consumer’s familiarity with health topics. Consumers may have different levels of familiarity with individual health topics. This variation in familiarity may cause misunderstandings because the information presented by search engines may not be understood correctly by the consumers. Objective As a first step toward the improvement of the health information search process, we aimed to examine the effects of health topic familiarity on health information search behaviors by identifying the common search activity patterns exhibited by groups of consumers with different levels of familiarity. Methods Each participant completed a health terminology familiarity questionnaire and health information search tasks. The responses to the familiarity questionnaire were used to grade the familiarity of participants with predefined health topics. The search task data were transcribed into a sequence of search activities using a coding scheme. A computational model was constructed from the sequence data using a Markov chain model to identify the common search patterns in each familiarity group. Results Forty participants were classified into L1 (not familiar), L2 (somewhat familiar), and L3 (familiar) groups based on their questionnaire responses. They had different levels of familiarity with four health topics. The video data obtained from all of the participants were transcribed into 4595 search activities (mean 28.7, SD 23.27 per session). The most frequent search activities and transitions in all the familiarity groups were related to evaluations of the relevancy of selected web pages in the retrieval results. However, the next most frequent transitions differed in each group and a chi-squared test confirmed this finding (Pinformation search patterns

  16. Chemical-based risk assessment and in vitro models of human health effects induced by organic pollutants in soils from the Olona valley

    Energy Technology Data Exchange (ETDEWEB)

    Baderna, Diego, E-mail: diego.baderna@marionegri.it; Colombo, Andrea; Amodei, Giorgia; Cantù, Stefano; Teoldi, Federico; Cambria, Felice; Rotella, Giuseppe; Natolino, Fabrizio; Lodi, Marco; Benfenati, Emilio

    2013-10-01

    Risk assessment of soils is usually based on chemical measurements and assuming accidental soil ingestion and evaluating induced toxic and carcinogenic effects. Recently biological tools have been coupled to chemical-based risk assessment since they integrate the biological effects of all xenobiotics in soils. We employed integrated monitoring of soils based on chemical analyses, risk assessment and in vitro models in the highly urbanized semirural area of the Olona Valley in northern Italy. Chemical characterization of the soils indicated low levels of toxic and carcinogenic pollutants such as PAHs, PCDD/Fs, PCBs and HCB and human risk assessment did not give any significant alerts. HepG2 and BALB/c 3T3 cells were used as a model for the human liver and as a tool for the evaluation of carcinogenic potential. Cells were treated with soil extractable organic matters (EOMs) and the MTS assay, LDH release and morphological transformation were selected as endpoints for toxicity and carcinogenicity. Soil EOMs induced dose-dependent inhibition of cell growth at low doses and cytotoxicity after exposure to higher doses. This might be the result of block of cell cycle progression to repair DNA damage caused by oxidative stress; if this DNA damage cannot be repaired, cells die. No significant inductions of foci were recorded after exposure to EOMs. These results indicate that, although the extracts contain compounds with proven carcinogenic potential, the levels of these pollutants in the analyzed soils were too low to induce carcinogenesis in our experimental conditions. In this proposed case study, HepG2 cells were found an appropriate tool to assess the potential harm caused by the ingestion of contaminated soil as they were able to detect differences in the toxicity of soil EOMs. Moreover, the cell transformation assay strengthened the combined approach giving useful information on carcinogenic potential of mixtures. Highlights: • A combined approach for risk

  17. Literature survey: health effects of radiation

    International Nuclear Information System (INIS)

    Tveten, U.; Garder, K.

    This report was originally written as a chapter of a report entitled 'Air pollution effects of electric power generation, a literature survey', written jointly by the Norwegian Institute for Air Research (NILU) and the Institutt for Atomenergi (IFA). (INIS RN242406). A survey is presented of the health effects of radiation. It has not, however, been the intention of the authors to make a complete list of all the literature relevant to this subject. The NILU/IFA report was meant as a first step towards a method of comparing the health effects of electric power generation by fission, gas and oil. Consequently information relevant to quantification of the health effects on humans has been selected. It is pointed out that quantitative information on the health effects of low radiation and dose rates, as are relevant to routine releases, does not exist for humans. The convention of linear extrapolation from higher doses and dose rates is used worldwide, but it is felt by most that the estimates are conservative. As an example of the use of the current best estimates, a calculation of normal release radiation doses is performed. (Auth.)

  18. Complexity of Choice: Teachers' and Students' Experiences Implementing a Choice-Based Comprehensive School Health Model

    Science.gov (United States)

    Sulz, Lauren; Gibbons, Sandra; Naylor, Patti-Jean; Wharf Higgins, Joan

    2016-01-01

    Background: Comprehensive School Health models offer a promising strategy to elicit changes in student health behaviours. To maximise the effect of such models, the active involvement of teachers and students in the change process is recommended. Objective: The goal of this project was to gain insight into the experiences and motivations of…

  19. Health Insurance: principles, models and the Nigerian National ...

    African Journals Online (AJOL)

    ... more resources to the health care sector and improve the level of access and ... This article amongst other things outlines the principles and models of health ... journal articles, abstracts, relevant books and internet articles were reviewed.

  20. A MODEL FOR HIGHER EDUCATION CAMPUS HEALTH SERVICES

    African Journals Online (AJOL)

    2010-03-17

    Mar 17, 2010 ... generation was used to develop a holistic healthcare model for a higher education campus' health service. It became ... innovative. Health plays a .... conducted will set the tone for the interactive process of holistic healthcare.

  1. Modelling and implementing electronic health records in Denmark

    DEFF Research Database (Denmark)

    Bernstein, Knut; Rasmussen, Morten Bruun; Vingtoft, Søren

    2003-01-01

    The Danish Health IT strategy points out that integration between electronic health records (EHR) systems has a high priority. This paper reporst reports new tendencies in modelling and integration platforms globally and how this is reflected in the natinal development....

  2. The link between health governance models and global health innovation: an exploration of OECD nations.

    Science.gov (United States)

    Schnarr, Karin; Snowdon, Anne; Cramm, Heidi; Cohen, Jason; Alessi, Charles

    2015-01-01

    While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations. We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, The Netherlands, Switzerland, and the United States). Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition. Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

  3. Chernobyl: the effects on public health?

    Energy Technology Data Exchange (ETDEWEB)

    Aurengo, A. [Hopital Pitie-Salpetriere, Dept. Nucleaire Medecine, 75 - Paris (France)

    2003-07-01

    Because of its public health, ecological and industrial consequences, the Chernobyl accident has become a myth which serves as the focus of many fears, justified or not. no one can question the seriousness of the event, but after fifteen years there is still no agreement about the effect it has had or will have on public health. For example, the total number of deaths attributed to Chernobyl varies from less than a hundred to several millions and congenital malformations from negligible to cataclysmic. Effects on public health may be calculated from data on contamination, from the dose received and from the risk, all three of which are likely to be very roughly known; or they may be evaluated on the spot, either by epidemiological studies or by examining medical registers. This report makes an inventory of the different risks and takes stock on them. (N.C.)

  4. Chernobyl: the effects on public health?

    International Nuclear Information System (INIS)

    Aurengo, A.

    2003-01-01

    Because of its public health, ecological and industrial consequences, the Chernobyl accident has become a myth which serves as the focus of many fears, justified or not. no one can question the seriousness of the event, but after fifteen years there is still no agreement about the effect it has had or will have on public health. For example, the total number of deaths attributed to Chernobyl varies from less than a hundred to several millions and congenital malformations from negligible to cataclysmic. Effects on public health may be calculated from data on contamination, from the dose received and from the risk, all three of which are likely to be very roughly known; or they may be evaluated on the spot, either by epidemiological studies or by examining medical registers. This report makes an inventory of the different risks and takes stock on them. (N.C.)

  5. 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…

  6. Public relations effectiveness in public health institutions.

    Science.gov (United States)

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  7. Toward a model of institutional scholarship in health professions education.

    Science.gov (United States)

    Jahangiri, Leila; Mucciolo, Thomas W

    2011-12-01

    Using an expanded definition of scholarship that goes beyond the scholarship of discovery (research) to include the scholarship of integration, the scholarship of application, and the scholarship of teaching, this article explains interrelationships among these scholarship types in health professions and specifically dental education. Such interrelationships can lead to meaningful expansion of scholarship especially in the form of translational research, which relies on the development of all four of these types of scholarship. In recent years, health care-related organizations have been seeking ways to expand translational research. At the same time, an increasing number of academic institutions have been considering how to redefine what qualifies as advancing one's discipline in ways that go beyond mere number of publications and grants to better reflect the faculty member's overall scholarly effort. These redefinitions and a new attention to scholarly collaboration have led to the concept of a "complete scholar": one who makes contributions in all four areas of scholarship by collaborating with other scholars, practitioners, and members of the community. Expanding the concept of a complete scholar to that of a "complete institution" is the basis for what we propose as a Model of Institutional Scholarship. This model is exemplified by the Cochrane Collaboration, a gold standard for a complete vision of research on evidence-based health care. In the Model of Institutional Scholarship, an institution can visualize, plan, develop, and orchestrate all scholarship being conducted within its realm, creating collaborations among individual efforts that will enhance effectiveness and the creation of new knowledge.

  8. Conceptual Models in Health Informatics Research: A Literature Review and Suggestions for Development.

    Science.gov (United States)

    Gray, Kathleen; Sockolow, Paulina

    2016-02-24

    Contributing to health informatics research means using conceptual models that are integrative and explain the research in terms of the two broad domains of health science and information science. However, it can be hard for novice health informatics researchers to find exemplars and guidelines in working with integrative conceptual models. The aim of this paper is to support the use of integrative conceptual models in research on information and communication technologies in the health sector, and to encourage discussion of these conceptual models in scholarly forums. A two-part method was used to summarize and structure ideas about how to work effectively with conceptual models in health informatics research that included (1) a selective review and summary of the literature of conceptual models; and (2) the construction of a step-by-step approach to developing a conceptual model. The seven-step methodology for developing conceptual models in health informatics research explained in this paper involves (1) acknowledging the limitations of health science and information science conceptual models; (2) giving a rationale for one's choice of integrative conceptual model; (3) explicating a conceptual model verbally and graphically; (4) seeking feedback about the conceptual model from stakeholders in both the health science and information science domains; (5) aligning a conceptual model with an appropriate research plan; (6) adapting a conceptual model in response to new knowledge over time; and (7) disseminating conceptual models in scholarly and scientific forums. Making explicit the conceptual model that underpins a health informatics research project can contribute to increasing the number of well-formed and strongly grounded health informatics research projects. This explication has distinct benefits for researchers in training, research teams, and researchers and practitioners in information, health, and other disciplines.

  9. Overcoming Barriers to Rural Children's Mental Health: An Interconnected Systems Public Health Model

    Science.gov (United States)

    Huber, Brenda J.; Austen, Julie M.; Tobin, Renée M.; Meyers, Adena B.; Shelvin, Kristal H.; Wells, Michael

    2016-01-01

    A large, Midwestern county implemented a four-tiered public health model of children's mental health with an interconnected systems approach involving education, health care, juvenile justice and community mental health sectors. The community sought to promote protective factors in the lives of all youth, while improving the capacity,…

  10. Health Effects of Chronic Arsenic Exposure

    Directory of Open Access Journals (Sweden)

    Young-Seoub Hong

    2014-09-01

    Full Text Available Arsenic is a unique element with distinct physical characteristics and toxicity whose importance in public health is well recognized. The toxicity of arsenic varies across its different forms. While the carcinogenicity of arsenic has been confirmed, the mechanisms behind the diseases occurring after acute or chronic exposure to arsenic are not well understood. Inorganic arsenic has been confirmed as a human carcinogen that can induce skin, lung, and bladder cancer. There are also reports of its significant association to liver, prostate, and bladder cancer. Recent studies have also suggested a relationship with diabetes, neurological effects, cardiac disorders, and reproductive organs, but further studies are required to confirm these associations. The majority of research to date has examined cancer incidence after a high exposure to high concentrations of arsenic. However, numerous studies have reported various health effects caused by chronic exposure to low concentrations of arsenic. An assessment of the health effects to arsenic exposure has never been performed in the South Korean population; thus, objective estimates of exposure levels are needed. Data should be collected on the biological exposure level for the total arsenic concentration, and individual arsenic concentration by species. In South Korea, we believe that biological exposure assessment should be the first step, followed by regular health effect assessments.

  11. Effective and Sustainable Health Research Partnerships : a ...

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

    IDRC frequently supports collaborative Canada-South research on subjects of vital ... to structure and manage Canada-South research partnerships more effectively. ... Africa, Latin America and Canada leading to region-specific working papers on ... for the Joint Canada-Israel Health Research Program 2018 competition.

  12. Human health effects of air pollution

    International Nuclear Information System (INIS)

    Kampa, Marilena; Castanas, Elias

    2008-01-01

    Hazardous chemicals escape to the environment by a number of natural and/or anthropogenic activities and may cause adverse effects on human health and the environment. Increased combustion of fossil fuels in the last century is responsible for the progressive change in the atmospheric composition. Air pollutants, such as carbon monoxide (CO), sulfur dioxide (SO 2 ), nitrogen oxides (NOx), volatile organic compounds (VOCs), ozone (O 3 ), heavy metals, and respirable particulate matter (PM2.5 and PM10), differ in their chemical composition, reaction properties, emission, time of disintegration and ability to diffuse in long or short distances. Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs. It ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults, aggravating pre-existing heart and lung disease, or asthmatic attacks. In addition, short- and long-term exposures have also been linked with premature mortality and reduced life expectancy. These effects of air pollutants on human health and their mechanism of action are briefly discussed. - The effect of air pollutants on human health and underlying mechanisms of cellular action are discussed

  13. Intermediate and long-term health effects

    International Nuclear Information System (INIS)

    Leaf, A.

    1987-01-01

    This report summarizes the health effects caused by immune suppression, infectious diseases, and food supplies and starvation in the aftermath of a nuclear war. It has been concluded that starvation will be essentially global - a consequence of a major nuclear war that at present seems likely to cause more deaths than all the direct effects of nuclear war combined. 68 refs, 1 fig., 1 tab

  14. Kriging with mixed effects models

    Directory of Open Access Journals (Sweden)

    Alessio Pollice

    2007-10-01

    Full Text Available In this paper the effectiveness of the use of mixed effects models for estimation and prediction purposes in spatial statistics for continuous data is reviewed in the classical and Bayesian frameworks. A case study on agricultural data is also provided.

  15. Effect of health system reforms in Turkey on user satisfaction.

    Science.gov (United States)

    Stokes, Jonathan; Gurol-Urganci, Ipek; Hone, Thomas; Atun, Rifat

    2015-12-01

    In 2003, the Turkish government introduced major health system changes, the Health Transformation Programme (HTP), to achieve universal health coverage (UHC). The HTP leveraged changes in all parts of the health system, organization, financing, resource management and service delivery, with a new family medicine model introducing primary care at the heart of the system. This article examines the effect of these health system changes on user satisfaction, a key goal of a responsive health system. Utilizing the results of a nationally representative yearly survey introduced at the baseline of the health system transformation, multivariate logistic regression analysis is used to examine the yearly effect on satisfaction with health services. During the 9-year period analyzed (2004-2012), there was a nearly 20% rise in reported health service use, coinciding with increased access, measured by insurance coverage. Controlling for factors known to contribute to user satisfaction in the literature, there is a significant (P < 0.001) increase in user satisfaction with health services in almost every year (bar 2006) from the baseline measure, with the odds of being satisfied with health services in 2012, 2.56 (95% confidence interval (CI) of 2.01-3.24) times that in 2004, having peaked at 3.58 (95% CI 2.82-4.55) times the baseline odds in 2011. Additionally, those who used public primary care services were slightly, but significantly (P < 0.05) more satisfied than those who used any other services, and increasingly patients are choosing primary care services rather than secondary care services as the provider of first contact. A number of quality indicators can probably help account for the increased satisfaction with public primary care services, and the increase in seeking first-contact with these providers. The implementation of primary care focused UHC as part of the HTP has improved user satisfaction in Turkey.

  16. Effect of health system reforms in Turkey on user satisfaction

    Directory of Open Access Journals (Sweden)

    Jonathan Stokes

    2015-12-01

    Full Text Available In 2003, the Turkish government introduced major health system changes, the Health Transformation Programme (HTP, to achieve universal health coverage (UHC. The HTP leveraged changes in all parts of the health system, organization, financing, resource management and service delivery, with a new family medicine model introducing primary care at the heart of the system. This article examines the effect of these health system changes on user satisfaction, a key goal of a responsive health system. Utilizing the results of a nationally representative yearly survey introduced at the baseline of the health system transformation, multivariate logistic regression analysis is used to examine the yearly effect on satisfaction with health services. During the 9–year period analyzed (2004–2012, there was a nearly 20% rise in reported health service use, coinciding with increased access, measured by insurance coverage. Controlling for factors known to contribute to user satisfaction in the literature, there is a significant (P < 0.001 increase in user satisfaction with health services in almost every year (bar 2006 from the baseline measure, with the odds of being satisfied with health services in 2012, 2.56 (95% Confidence Interval (CI of 2.01–3.24 times that in 2004, having peaked at 3.58 (CI, 2.82–4.55 times the baseline odds in 2011. Additionally, those who used public primary care services were slightly, but significantly (P < 0.05 more satisfied than those who used any other services, and increasingly patients are choosing primary care services rather than secondary care services as the provider of first contact. A number of quality indicators can probably help account for the increased satisfaction with public primary care services, and the increase in seeking first–contact with these providers. The implementation of primary care focused UHC as part of the HTP has improved user satisfaction in Turkey.

  17. Systems thinking: what business modeling can do for public health.

    Science.gov (United States)

    Williams, Warren; Lyalin, David; Wingo, Phyllis A

    2005-01-01

    Today's public health programs are complex business systems with multiple levels of collaborating federal, state, and local entities. The use of proven systems engineering modeling techniques to analyze, align, and streamline public health operations is in the beginning stages. The authors review the initial business modeling efforts in immunization and cancer registries and present a case to broadly apply business modeling approaches to analyze and improve public health processes.

  18. Racism, other discriminations and effects on health.

    Science.gov (United States)

    Gil-González, Diana; Vives-Cases, Carmen; Borrell, Carme; Agudelo-Suárez, Andrés A; Davó-Blanes, Mari Carmen; Miralles, Juanjo; Álvarez-Dardet, Carlos

    2014-04-01

    We study the probability of perceived racism/other forms of discrimination on immigrant and Spanish populations within different public spheres and show their effect on the health of immigrants using a cross-sectional design (ENS-06). perceived racism/other forms of discrimination (exposure), socio-demographic (explicative), health indicators (dependent). Frequencies, prevalences, and bivariate/multivariate analysis were conducted separately for men (M) and women (W). We estimated the health problems attributable to racism through the population attributable proportion (PAP). Immigrants perceived more racism than Spaniards in workplace (ORM = 48.1; 95% CI 28.2-82.2), and receiving health care (ORW = 48.3; 95% CI 24.7-94.4). Racism and other forms of discrimination were associated with poor mental health (ORM = 5.6; 95% CI 3.9-8.2; ORW = 7.3; 95% CI 4.1-13.0) and injury (ORW = 30.6; 95% CI 13.6-68.7). It is attributed to perceived racism the 80.1% of consumption of psychotropics (M), and to racism with other forms of discrimination the 52.3% of cases of injury (W). Racism plays a role as a health determinant.

  19. Internet advertising effectiveness measurement model

    OpenAIRE

    Marcinkevičiūtė, Milda

    2007-01-01

    The research object of the master thesis is internet advertising effectiveness measurement. The goal of the work is after making theoretical studies of internet advertising effectiveness measurement (theoretical articles, practical researches and cetera), formulate the conceptual IAEM model and examine it empirically. The main tasks of the work are: to analyze internet advertising, it’s features, purposes, spread formats, functions, advantages and disadvantages; present the effectiveness of i...

  20. The Effect of Educational Program on the Prevention of Pediculosis in Primary School Fifth Grade Students: An application of the Health Belief Model

    Directory of Open Access Journals (Sweden)

    Abbasali Dehghani Tafti

    2018-04-01

    Conclusion: Considering that both constructs of self-efficacy and perceived benefits were behavior predictors and the educational program led to improve the attitude and behavior of students, health-based and belief-based programs can be implemented based on these two constructs to improve students' performance in lice preventive behaviors.

  1. MODEL DEVELOPMENT OF NURSING STUDENT LOYALTY IN POLITEKNIK OF HEALTH

    Directory of Open Access Journals (Sweden)

    Hammad Hammad

    2017-04-01

    Full Text Available Introduction: Loyalty of nursing student is an important factor that nursing education should pay attention in order to compete with other nursing educations; involved by perceived value, expectation, and quality assurance in nursing higher education. The purpose of this study was to develop a loyalty model of nursing student in nursing higher education. Methods: This study was an explanatory research with cross sectional approach. Population were nursing student in Poltekkes Banjarmasin, with 112 samples which is selected by proportional random sampling. Data was collected by giving questionnaire and analyzed by partial least square. Result: Result of this study indicates that was an effect of costumer expectation on quality assurance in nursing higher education, there was effect of costumer expectation on perceived value in nursing student, there was an effect of customer expectation on student satisfaction (4 there was effect of quality assurance in nursing higher education, there wasn’t any affect of quality assurance in nursing higher education on student satisfaction, there was effect of perceived value in nursing student on student satisfaction, there was effect of student satisfaction on student loyalty. Discussion: Overall result of this research were, student loyalty in nursing higher education developed by student satisfaction. Student satisfaction formed by perceived value. Perceived value developed from two aspects quality assurance, and student expectation, quality assurance of higher education wasn’t directly effect to student sasfaction. However, indirectly effect through student perceived value. Student satisfaction in nursing higher education was stronger effect than any other variable in this loyalty model. Loyalty model in this research can be use for improvement student loyalty on health education that focused on improvement student satisfaction without deny the other aspect. Further research is needed to analyze word of

  2. Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention.

    Science.gov (United States)

    Montague, Enid; Asan, Onur

    2014-03-01

    The aim of this study was to examine eye gaze patterns between patients and physicians while electronic health records were used to support patient care. Eye gaze provides an indication of physician attention to patient, patient/physician interaction, and physician behaviors such as searching for information and documenting information. A field study was conducted where 100 patient visits were observed and video recorded in a primary care clinic. Videos were then coded for gaze behaviors where patients' and physicians' gaze at each other and artifacts such as electronic health records were coded using a pre-established objective coding scheme. Gaze data were then analyzed using lag sequential methods. Results showed that there are several eye gaze patterns significantly dependent to each other. All doctor-initiated gaze patterns were followed by patient gaze patterns. Some patient-initiated gaze patterns were also followed by doctor gaze patterns significantly unlike the findings in previous studies. Health information technology appears to contribute to some of the new significant patterns that have emerged. Differences were also found in gaze patterns related to technology that differ from patterns identified in studies with paper charts. Several sequences related to patient-doctor-technology were also significant. Electronic health records affect the patient-physician eye contact dynamic differently than paper charts. This study identified several patterns of patient-physician interaction with electronic health record systems. Consistent with previous studies, physician initiated gaze is an important driver of the interactions between patient and physician and patient and technology. Published by Elsevier Ireland Ltd.

  3. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Science.gov (United States)

    Eckelman, Matthew J; Sherman, Jodi

    2016-01-01

    The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  4. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Directory of Open Access Journals (Sweden)

    Matthew J Eckelman

    Full Text Available The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA modeling using National Health Expenditures (NHE for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%, greenhouse gas emissions (10%, smog formation (10% criteria air pollutants (9%, stratospheric ozone depletion (1%, and carcinogenic and non-carcinogenic air toxics (1-2%. The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors and demand side (NHE categories, as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  5. EFFECTS OF ARSENIC EXPOSURE IN HUMAN HEALTH

    Directory of Open Access Journals (Sweden)

    Aline Sueli de Lima Rodrigues

    2008-10-01

    Full Text Available In recent years, ingestion of inorganic arsenic from drinking water has emerged as an important public health concern. It enters drinking water supplies from natural deposits in the earth or from agricultural and industrial practices, mainly the mining. The health consequences of chronic arsenic exposure include increased risk for various forms of cancer and numerous pathologic effects, such as cutaneous effects (hyperpigmentation and hyperkeratoses, gastrointestinal effects, vascular effects, diabetes mellitus, and peripheral neuropathy. This way, this study presents through a critical revision of the literature, the more relevant current aspects on the immunological consequences, carcinogenic and resulting genetics of the human intoxication for arsenic. They were identified and analyzed 50 works published on the subject among the years of 1979 and 2008, being used as main sources LILACS-BIREME MEDLINE/Index Medicus, SciELO and PubMed. The specific Arsênio e saúde humana effects of the intoxication for arsenic about the human health are not still completely elucidated. Thus, is possible that this element affects functions still unknown, becoming important the scientificexploration on the subject.

  6. [Effects of urban noise on mental health].

    Science.gov (United States)

    Belojević, G; Jakovljević, B; Kocijancić, R; Pjerotić, L; Dimitrijević, J

    1995-01-01

    The results of the latest studies on the effects of urban noise on mental health are presented in this paper. Numerous psychiatric symptoms have been frequently noticed in the population of the settlements with a high level of urban noise: fatigue, headaches, tension, anxiety, irritability, bad concentration, insomnia, whith a consequently high consumption of psychotropic medicines. Higher admission rates in psychiatric hospitals have been noticed from noisy areas in comparison with low noise regions. By use of diagnostic psychiatric interviews it has been shown as well, that in sensitive categories of population positive correlation can be expected between the number of persons with mental disorder and the level of environmental noise. Noise annoyance and sleep disturbance, namely shortening or absence of the sleep phase 4 and REM, are the basic negative psychological effects of noise, with an adverse effect on mental health in general.

  7. Health monitoring of plants by their emitted volatiles: A model to predict the effect of Botrytis cinerea on the concentration of volatiles in a large-scale greenhouse

    NARCIS (Netherlands)

    Jansen, R.M.C.; Hofstee, J.W.; Wildt, J.; Vanthoor, B.H.E.; Verstappen, F.W.A.; Takayama, K.; Bouwmeester, H.J.; Henten, van E.J.

    2010-01-01

    This paper describes a model to calculate the concentrations of (Z)-3-hexenol, a-pinene, a-terpinene, ß-caryophyllene, and methyl salicylate in a greenhouse on the basis of their source and sink behaviour. The model was used to determine whether these volatile organic compounds (VOCs) can be used to

  8. Effects of low income on infant health.

    Science.gov (United States)

    Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

    2003-06-10

    Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not

  9. Exploring models for the roles of health systems' responsiveness and social determinants in explaining universal health coverage and health outcomes.

    Science.gov (United States)

    Valentine, Nicole Britt; Bonsel, Gouke J

    2016-01-01

    Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002-2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems' responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Health determinants' indicators - access to improved drinking sources, accountability, and average years of schooling - were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the Gini mattered most for inequalities in child

  10. Health care models guiding mental health policy in Kenya 1965 - 1997

    Directory of Open Access Journals (Sweden)

    Jenkins Rachel

    2010-04-01

    Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.

  11. Managing the health of the elite athlete: a new integrated performance health management and coaching model.

    Science.gov (United States)

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

    2014-04-01

    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health managemen