WorldWideScience

Sample records for health effects studies

  1. 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

  2. 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

  3. Health effects of employment: a systematic review of prospective studies

    NARCIS (Netherlands)

    van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I.

    2014-01-01

    The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

  6. Evaluating health effects of transport interventions methodologic case study.

    Science.gov (United States)

    Ogilvie, David; Mitchell, Richard; Mutrie, Nanette; Petticrew, Mark; Platt, Stephen

    2006-08-01

    There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

  7. Health effects of smoke from planned burns: a study protocol

    Directory of Open Access Journals (Sweden)

    David O’Keeffe

    2016-02-01

    Full Text Available Abstract Background Large populations are exposed to smoke from bushfires and planned burns. Studies investigating the association between bushfire smoke and health have typically used hospital or ambulance data and been done retrospectively on large populations. The present study is designed to prospectively assess the association between individual level health outcomes and exposure to smoke from planned burns. Methods/design A prospective cohort study will be conducted during a planned burn season in three locations in Victoria (Australia involving 50 adult participants who undergo three rounds of cardiorespiratory medical tests, including measurements for lung inflammation, endothelial function, heart rate variability and markers of inflammation. In addition daily symptoms and twice daily lung function are recorded. Outdoor particulate air pollution is continuously measured during the study period in these locations. The data will be analysed using mixed effect models adjusting for confounders. Discussion Planned burns depend on weather conditions and dryness of ‘fuels’ (i.e. forest. It is potentially possible that no favourable conditions occur during the study period. To reduce the risk of this occurring, three separate locations have been identified as having a high likelihood of planned burn smoke exposure during the study period, with the full study being rolled out in two of these three locations. A limitation of this study is exposure misclassification as outdoor measurements will be conducted as a measure for personal exposures. However this misclassification will be reduced as participants are only eligible if they live in close proximity to the monitors.

  8. 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.

  9. 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

  10. 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.

  11. 42 CFR 90.7 - Decision to conduct health effects study.

    Science.gov (United States)

    2010-10-01

    ... occurred, and any possible health effects resulting from such exposure. (b) Should ATSDR decide, in its... 42 Public Health 1 2010-10-01 2010-10-01 false Decision to conduct health effects study. 90.7... ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE...

  12. Radiation and health effects. A report on the TMI-2 accident and related health studies

    International Nuclear Information System (INIS)

    1986-08-01

    On March 28, 1979, the Unit 2 reactor at the Three Mile Island (TMI) Nuclear Station was severely damaged by an accident. Radioactivity was discharged to the environment resulting in a small amount of radiation exposure to the public. Continuing concerns by some members of the communities around TMI about the potential radiation-induced health effects prompted GPU Nuclear Corporation to examine the information gathered from the accident investigation in the context of our current knowledge of radiation and its effects on human health. Although this report deals with technical matters, the information is presented in a manner that can be understood by those who do not have scientific backgrounds. This report is divided into three major sections. The first section provides an overview of the past 80 years of relevant research on the subject of radiation and its effects on human health. During that time, scientists and physicians throughout the world have studied hundreds of thousands of individuals exposed to radiation from medical and occupational sources and from nuclear weapons explosions. Epidemiologic studies of humans, such as the Japanese survivors of the atomic bomb, have established that following exposure to large doses of radiation, certain health effects, including cancer, can be observed. Radiation-induced health effects from low doses of radiation, such as those associated with the TMI-2 accident, appear infrequently, if at all, and are identical and, therefore, indistinguishable from similar health effects which occur normally. For example, cancers induced by radiation are indistinguishable from those occurring spontaneously or normally. It is not possible, therefore, for scientists to determine directly whether radiation-induced health effects at low doses occur at all; such observations can only be inferred by statistical methods. The second section of this report provides a brief description of the TMI-2 accident. Most of the radioactivity from the

  13. Health effects study of the nuclear industry workers in Japan

    International Nuclear Information System (INIS)

    Tamiko Iwasaki

    1997-01-01

    To clarify the effects of low-dose and low-dose-rate exposure to the human body, study on the health effects of the nuclear industry workers in Japan was conducted since 1990 by the Institute of Radiation Epidemiology, the Radiation Effects Association, which had been entrusted by the Science and Technology Agency of the Japanese Government. In the first phase analysis between 1986 and 1992, the study population was selected from among persons who were engaged in radiation work at nuclear power plants and associated facilities, and registered in the Radiation Dose Registration Center for Workers. The cohort consisted of 114,900 persons who satisfied the criteria of nationality, age, sex, etc. The average follow-up period was 4.6 years, and the average cumulative dose per person was 13.9 mSv. The total number of deaths among the study population was 1,758, including 661 deaths due to all malignant neoplasms. The Standardized Mortality Ratio of various death causes was compared. Furthermore, the cohort was grouped by five different dose levels, and the O/E was calculated to test whether there is a trend for the death rate to increase with dose. Among nuclear workers no significant increase in deaths nor any relationship with radiation dose was found, except the pancreatic cancer with 10-years lag. Since many previous studies of nuclear industry workers have demonstrated no significant association between exposure dose and pancreatic cancer, we cannot immediately conclude a causal relationship between with radiation. (author)

  14. Cross-sectional study of health effects of cryolite production

    DEFF Research Database (Denmark)

    Friis, Henrik; Clausen, J; Gyntelberg, F

    1989-01-01

    A cross-sectional health study of 101 cryolite workers was performed, using spirometry and a questionnaire. Multiple regression analysis revealed a significant correlation between the index of smoking and a decrease in FEV1 (per cent). There was no significant correlation between work-related exp......A cross-sectional health study of 101 cryolite workers was performed, using spirometry and a questionnaire. Multiple regression analysis revealed a significant correlation between the index of smoking and a decrease in FEV1 (per cent). There was no significant correlation between work...

  15. Radiation and health effects. A report on the TMI-2 accident and related health studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-08-01

    On March 28, 1979, the Unit 2 reactor at the Three Mile Island (TMI) Nuclear Station was severely damaged by an accident. Radioactivity was discharged to the environment resulting in a small amount of radiation exposure to the public. Continuing concerns by some members of the communities around TMI about the potential radiation-induced health effects prompted GPU Nuclear Corporation to examine the information gathered from the accident investigation in the context of our current knowledge of radiation and its effects on human health. Although this report deals with technical matters, the information is presented in a manner that can be understood by those who do not have scientific backgrounds. This report is divided into three major sections. The first section provides an overview of the past 80 years of relevant research on the subject of radiation and its effects on human health. During that time, scientists and physicians throughout the world have studied hundreds of thousands of individuals exposed to radiation from medical and occupational sources and from nuclear weapons explosions. Epidemiologic studies of humans, such as the Japanese survivors of the atomic bomb, have established that following exposure to large doses of radiation, certain health effects, including cancer, can be observed. Radiation-induced health effects from low doses of radiation, such as those associated with the TMI-2 accident, appear infrequently, if at all, and are identical and, therefore, indistinguishable from similar health effects which occur normally. For example, cancers induced by radiation are indistinguishable from those occurring spontaneously or normally. It is not possible, therefore, for scientists to determine directly whether radiation-induced health effects at low doses occur at all; such observations can only be inferred by statistical methods. The second section of this report provides a brief description of the TMI-2 accident. Most of the radioactivity from the

  16. Challenges to studying the health effects of early life environmental chemical exposures on children's health.

    Science.gov (United States)

    Braun, Joseph M; Gray, Kimberly

    2017-12-01

    Epidemiological studies play an important role in quantifying how early life environmental chemical exposures influence the risk of childhood diseases. These studies face at least four major challenges that can produce noise when trying to identify signals of associations between chemical exposure and childhood health. Challenges include accurately estimating chemical exposure, confounding from causes of both exposure and disease, identifying periods of heightened vulnerability to chemical exposures, and determining the effects of chemical mixtures. We provide recommendations that will aid in identifying these signals with more precision.

  17. 38 CFR 1.17 - Evaluation of studies relating to health effects of radiation exposure.

    Science.gov (United States)

    2010-07-01

    ... relating to health effects of radiation exposure. 1.17 Section 1.17 Pensions, Bonuses, and Veterans' Relief... health effects of radiation exposure. (a) From time to time, the Secretary shall publish evaluations of scientific or medical studies relating to the adverse health effects of exposure to ionizing radiation in the...

  18. Health effects of laser printer emissions: a controlled exposure study.

    Science.gov (United States)

    Karrasch, S; Simon, M; Herbig, B; Langner, J; Seeger, S; Kronseder, A; Peters, S; Dietrich-Gümperlein, G; Schierl, R; Nowak, D; Jörres, R A

    2017-07-01

    Ultrafine particles emitted from laser printers are suspected to elicit adverse health effects. We performed 75-minute exposures to emissions of laser printing devices (LPDs) in a standardized, randomized, cross-over manner in 23 healthy subjects, 14 mild, stable asthmatics, and 15 persons reporting symptoms associated with LPD emissions. Low-level exposures (LLE) ranged at the particle background (3000 cm -3 ) and high-level exposures (HLE) at 100 000 cm -3 . Examinations before and after exposures included spirometry, body plethysmography, transfer factors for CO and NO (TLCO, TLNO), bronchial and alveolar NO, cytokines in serum and nasal secretions (IL-1β, IL-5, IL-6, IL-8, GM-CSF, IFNγ, TNFα), serum ECP, and IgE. Across all participants, no statistically significant changes occurred for lung mechanics and NO. There was a decrease in volume-related TLNO that was more pronounced in HLE, but the difference to LLE was not significant. ECP and IgE increased in the same way after exposures. Nasal IL-6 showed a higher increase after LLE. There was no coherent pattern regarding the responses in the participant subgroups or single sets of variables. In conclusion, the experimental acute responses to short but very high-level LPD exposures were small and did not indicate clinically relevant effects compared to low particle number concentrations. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

    Science.gov (United States)

    Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

    2011-11-01

    Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Health effects from indoor air pollution: case studies.

    Science.gov (United States)

    White, L E; Clarkson, J R; Chang, S N

    1987-01-01

    In recent years there has been a growing awareness of the health effects associated with the presence of contaminants in indoor air. Numerous agents can accumulate in public buildings, homes and automobiles as a result of ongoing activities that normally occur in these closed spaces. Ventilation is a major factor in the control of indoor air pollutants since proper movement of air can prevent or minimize the build up of compounds in buildings. The recent emphasis on energy conservation has lead to measures which economize on energy for heating and air conditioning, but which also trap pollutants within a building. Three cases of indoor air pollution were investigated. A typical investigation of indoor air pollutant problems includes the following: interviews with building occupants; history of the building with regard to maintenance, pesticide treatment, etc.; a survey of the building and ventilation; and when warranted, sampling and analysis of air. Each case presented is unique in that atypical situations caused agents to accumulate in a building or section of a building. The indoor air problems in these cases were solved by identifying and removing the source of the offending agent and/or improving the ventilation in the building.

  1. [Study protocol on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain].

    Science.gov (United States)

    Pérez, Glòria; Gotsens, Mercè; Palència, Laia; Marí-Dell'Olmo, Marc; Domínguez-Berjón, M Felicitas; Rodríguez-Sanz, Maica; Puig, Vanessa; Bartoll, Xavier; Gandarillas, Ana; Martín, Unai; Bacigalupe, Amaia; Díez, Elia; Ruiz, Miguel; Esnaola, Santiago; Calvo, Montserrat; Sánchez, Pablo; Luque Fernández, Miguel Ángel; Borrell, Carme

    The aim is to present the protocol of the two sub-studies on the effect of the economic crisis on mortality and reproductive health and health inequalities in Spain. Substudy 1: describe the evolution of mortality and reproductive health between 1990 and 2013 through a longitudinal ecological study in the Autonomous Communities. This study will identify changes caused by the economic crisis in trends or reproductive health and mortality indicators using panel data (17 Autonomous Communities per study year) and adjusting Poisson models with random effects variance. Substudy 2: analyse inequalities by socioeconomic deprivation in mortality and reproductive health in several areas of Spain. An ecological study analysing trends in the pre-crisis (1999-2003 and 2004-2008) and crisis (2009-2013) periods will be performed. Random effects models Besag York and Mollié will be adjusted to estimate mortality indicators softened in reproductive health and census tracts. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Health effects engineering: Perspectives for environmental health and environmental engineering studies-domestic biomass combustion as an example

    International Nuclear Information System (INIS)

    Gao Xiang; Yu Qi; Chen Limin

    2007-01-01

    Health effects engineering (HEE) is a newly developed research field, which involves collaboration with environmental scientists, engineering researchers, and toxicologists. By employing the methods of HEE, one can not only confirm which attributes of the project are likely to contribute to certain health effects, but can also get rid of the adverse health effects by engineering technologies. HEE is thought to be particularly important to domestic projects in which there is a lack of environmental assessment. This paper presented the authors' viewpoints of the principles of HEE in the field of the environmental health and engineering studies by using programs of domestic biomass combustion as an example. The authors showed that there are three sub-fields of HEE, which are as follows: engineering behavior, the pollution characteristics, and the health effects. The authors conclude that the principles of HEE compose a helix with the studies in the fields of environmental science, health, and engineering, and give suggestions on how to perform HEE in a practical field

  3. Effectiveness of pictorial health warning on cigarette packages: A cross-sectional study in Sarawak, Malaysia

    Directory of Open Access Journals (Sweden)

    Md Mizanur Rahman

    2015-07-01

    Full Text Available Specific health warning placed on the tobacco product packages is considered as an effective and low-cost method for increasing the knowledge and awareness among the community. Thus, a study was conducted to assess the perception of pictorial health warnings (PHWs against smoking among the adult rural population of Sarawak.

  4. 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

  5. The Effectiveness of Health Animations in Audiences With Different Health Literacy Levels : An Experimental Study

    NARCIS (Netherlands)

    Meppelink, Corine S.; van Weert, Julia C. M.; Haven, Carola J.; Smit, Edith G.

    Background: Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective: The aim of this paper

  6. The effectiveness of health animations in audiences with different health literacy levels: An experimental study

    NARCIS (Netherlands)

    Meppelink, C.S.; van Weert, J.C.M.; Haven, C.J.; Smit, E.G.

    2015-01-01

    Background: Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective: The aim of this paper

  7. The effectiveness of health animations in audiences with different health literacy levels: an experimental study.

    Science.gov (United States)

    Meppelink, Corine S; van Weert, Julia C M; Haven, Carola J; Smit, Edith G

    2015-01-13

    Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. The aim of this paper is to investigate what features of spoken health animations improve information recall and attitudes and whether there are differences between health literacy groups. We conducted an online experiment among 231 participants aged 55 years or older with either low or high health literacy. A 2 (spoken vs written text) x 2 (illustration vs animation) design was used. Participants were randomly exposed to one of the four experimental messages, all providing the same information on colorectal cancer screening. The results showed that, among people with low health literacy, spoken messages about colorectal cancer screening improved recall (P=.03) and attitudes (P=.02) compared to written messages. Animations alone did not improve recall, but when combined with spoken text, they significantly improved recall in this group (P=.02). When exposed to spoken animations, people with low health literacy recalled the same amount of information as their high health literate counterparts (P=.12), whereas in all other conditions people with high health literacy recalled more information compared to low health literate individuals. For people with low health literacy, positive attitudes mediated the relationship between spoken text and the intention to have a colorectal cancer screening (b=.12; 95% CI 0.02-0.25). We conclude that spoken animation is the best way to communicate complex health information to people with low health literacy. This format can even bridge the information processing gap between audiences with low and high health literacy as the recall differences between the two groups are eliminated. As animations do not negatively influence high health literate audiences, it is concluded that

  8. The Effectiveness of Health Animations in Audiences With Different Health Literacy Levels: An Experimental Study

    Science.gov (United States)

    van Weert, Julia CM; Haven, Carola J; Smit, Edith G

    2015-01-01

    Background Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective The aim of this paper is to investigate what features of spoken health animations improve information recall and attitudes and whether there are differences between health literacy groups. Methods We conducted an online experiment among 231 participants aged 55 years or older with either low or high health literacy. A 2 (spoken vs written text) x 2 (illustration vs animation) design was used. Participants were randomly exposed to one of the four experimental messages, all providing the same information on colorectal cancer screening. Results The results showed that, among people with low health literacy, spoken messages about colorectal cancer screening improved recall (P=.03) and attitudes (P=.02) compared to written messages. Animations alone did not improve recall, but when combined with spoken text, they significantly improved recall in this group (P=.02). When exposed to spoken animations, people with low health literacy recalled the same amount of information as their high health literate counterparts (P=.12), whereas in all other conditions people with high health literacy recalled more information compared to low health literate individuals. For people with low health literacy, positive attitudes mediated the relationship between spoken text and the intention to have a colorectal cancer screening (b=.12; 95% CI 0.02-0.25). Conclusions We conclude that spoken animation is the best way to communicate complex health information to people with low health literacy. This format can even bridge the information processing gap between audiences with low and high health literacy as the recall differences between the two groups are eliminated. As animations do not negatively influence high health

  9. Health effects of freshwater bathing among primary school children; Design for a randomised exposure study

    NARCIS (Netherlands)

    Asperen IA van; Medema GJ; Havelaar AH; Borgdorff MW; CIE; MGB

    1997-01-01

    To study the health effects of bathing in freshwaters that meet current water quality standard, large epidemiological studies are needed. A design is presented of a study among primary school children, that aims to evaluate current water quality standard. The study concerns a randomised exposure

  10. Findings from a prospective cohort study evaluating the effects of International Health Advisors’ work on recently settled migrants’ health

    Directory of Open Access Journals (Sweden)

    Susanne Sundell Lecerof

    2017-04-01

    Full Text Available Abstract Background Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b determine the moderating role of educational level and social capital; and c critically discuss the outcomes and suggest implications for health promotion practice. Methods The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02–5.22, after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24–0.92. No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the

  11. Findings from a prospective cohort study evaluating the effects of International Health Advisors' work on recently settled migrants' health.

    Science.gov (United States)

    Lecerof, Susanne Sundell; Stafström, Martin; Emmelin, Maria; Westerling, Ragnar; Östergen, Per-Olof

    2017-04-28

    Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants' self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and

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

    International Nuclear Information System (INIS)

    Ongel, Aybike; Sezgin, Fatih

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

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

    Directory of Open Access Journals (Sweden)

    A. V. Pavlysh

    2013-01-01

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

  15. [Time series studies of air pollution by fires and the effects on human health].

    Science.gov (United States)

    do Carmo, Cleber Nascimento; Hacon, Sandra de Souza

    2013-11-01

    Burnoffs (intentional fires for agricultural purposes) and forest fires of large proportions have been observed in various regions of the planet. Exposure to high levels of air pollutants emitted by fires can be responsible for various harmful effects on human health. In this article, the literature on estimating acute effects of air pollution on human health by fires in the regions with the highest number of fires on the planet, using a time series approach is summarized. An attempt was made to identify gaps in knowledge. The study consisted of a narrative review, in which the characteristics of the selected studies were grouped by regions of the planet with a higher incidence of burnoffs: Amazon, America, Australia and Asia. The results revealed a large number of studies in Australia, few studies in the Amazon and great heterogeneity in the results on the significant effects on human health.

  16. Legal aspects of recent studies on the health effects of radiation

    International Nuclear Information System (INIS)

    Persson, L.

    1992-01-01

    The risk of ionising radiation has recently been reviewed by three different high-level bodies. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) issued in 1988 a report to the General Assembly with the title ''Sources, Effects and Risks of Ionising Radiation''. A review of the biological effects of ionizing radiations has also been performed by the United States National Research Council's Committee BEIR V, published in 1989, with the title ''Health Effects of Exposure to Low Levels of Ionising Radiation''. The International Commission on Radiological Protection (ICRP) has in November 1990 adopted its new recommendations issued as ICRP Publication 60. One of the newer health hazards is non-ionizing radiation (NIR), exposure to which extends from occupational into the field of public health. There are also collaborate studies on the health risks of non-ionizing radiation performed by e.g. the World Health Organization (WHO) and the International Radiation Protection Association (IRPA). The most recent studies on the health effects of radiation are discussed in the paper. (author)

  17. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children's Health Study.

    Science.gov (United States)

    Chen, Zhanghua; Salam, Muhammad T; Eckel, Sandrah P; Breton, Carrie V; Gilliland, Frank D

    2015-01-01

    Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children's Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children's health while control measures are being implemented.

  18. Choosing populations to study the health effects of low-dose ionizing radiation

    International Nuclear Information System (INIS)

    Dreyer, N.A.; Loughlin, J.E.; Friedlander, E.R.; Clapp, R.W.; Fahey, F.H.

    1981-01-01

    In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public

  19. The effectiveness of a health promotion with group intervention by clinical trial. Study protocol

    Directory of Open Access Journals (Sweden)

    Campo Osaba Maria-Antonia

    2012-03-01

    Full Text Available Abstract Background The promotion of health and the interventions in community health continue to be one of the pending subjects of our health system. The most prevalent health problems (cardiovascular diseases, cancer, diabetes... are for the most part related to life habits. We propose a holistic and integral approach as the best option for tackling behavior and its determinants. The research team has elaborated the necessary educational material to realize group teaching, which we call "Health Workshops". The goal of the present study is to evaluate the effectiveness of these Health Workshops in the following terms: Health Related Quality of Life (HRQOL, incorporate and maintain a balanced diet, do physical activity regularly, maintain risk factors such as tension, weight, cholesterol within normal limits and diminish cardiovascular risk. Methods/Design Controlled and random clinical testing, comparing a group of persons who have participated in the Health Workshops with a control group of similar characteristics who have not participated in the Health Workshops. Field of study: the research is being done in Health Centers of the city of Barcelona, Spain. Population studied: The group is composed of 108 persons that are actually doing the Health Workshops, and 108 that are not and form the control group. They are assigned at random to one group or the other. Data Analysis: With Student's t-distribution test to compare the differences between numerical variables or their non parametric equivalent if the variable does not comply with the criteria of normality. (Kolmogorov-Smirnof test. Chi-square test to compare the differences between categorical variables and the Logistic Regression Model to analyze different meaningful variables by dichotomous analysis related to the intervention. Discussion The Health Workshop proposed in the present study constitutes an innovative approach in health promotion, placing the emphasis on the person's self

  20. Chernobyl Studies Project - working group 7.0 environmental transport and health effects

    International Nuclear Information System (INIS)

    Hendrickson, S.M.

    1994-01-01

    The DOE-funded Chernobyl Studies Project was begun as part of a cooperative agreement between the US and the former USSR, (quote) To develop jointly methods to project rapidly the health effects of any future reactor accident (quote). Most of the initial tasks for this project are completed or near completion. The focus has now turned primarily to the issue of health effects from the Chernobyl accident. Currently, we are extensively engaged in case-control and cohort studies of thyroid diseases among Belarussian children and in the Ukraine. A major part of the effort is providing methods and applications of dose reconstruction and providing support and equipment for the medical teams. This document contains reports on progress in the following task areas: Management; External Dose; Hydrological Transport; Chromosome Painting Dosimetry; Stochastic Effects; Thyroid Studies; and Leukemia Studies

  1. Systematic review of epidemiological studies on health effects associated with management of solid waste

    Science.gov (United States)

    2009-01-01

    Background Management of solid waste (mainly landfills and incineration) releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment. Methods We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties. Results In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer forms such as non

  2. Systematic review of epidemiological studies on health effects associated with management of solid waste

    Directory of Open Access Journals (Sweden)

    Lazzarino Antonio I

    2009-12-01

    Full Text Available Abstract Background Management of solid waste (mainly landfills and incineration releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment. Methods We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties. Results In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer

  3. Exposure to temporary employment and job insecurity: a longitudinal study of the health effects.

    Science.gov (United States)

    Virtanen, Pekka; Janlert, Urban; Hammarström, Anne

    2011-08-01

    This study analysed interactions between job insecurity and temporary employment and health. We tested the violation hypothesis (whether permanent employment increases the health risk associated with job insecurity) and the intensification hypothesis (whether temporary employment increases the health risk associated with job insecurity) in a longitudinal setting. Previous research on this topic is scarce and based on cross-sectional data. A population cohort (n=1071) was surveyed at age 30 and age 42. Exposure to temporary employment during this 12-year period was elicited with a job-time matrix and measured as the score of 6-month periods. Exposure to job insecurity was measured according to the perceived threat of unemployment. Health at follow-up was assessed as optimal versus suboptimal self-rated health, sleep quality and mental health. In addition to sociodemographics and baseline health, the analyses were adjusted for exposure to unemployment, non-employment and self-employment during the 12-year period. 26% of participants had been exposed to temporary employment. The effect of job insecurity on health was the same in the exposed and unexposed groups, that is the violation hypothesis was not supported. Non-significant interactions between the exposures and all health outcomes also indicated null findings regarding the intensification hypothesis. These findings suggest that perceived job insecurity can lead to adverse health effects in both permanent and temporary employees. Policies should aim to improve work-related well-being by reducing job insecurity. Efforts towards 'flexicurity' are important, but it is equally important to remember that a significant proportion of employees with a permanent contract experience job insecurity.

  4. Study of the health effects of bicycling in an urban atmosphere. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Waldman, M.; Weiss, S.; Articola, W.

    1977-10-14

    This report analyzes data on the health effects of bicycling in an urban environment through intensive study of ten healthy male subjects bicycling or driving in systematically varied conditions in the streets of Washington, D.C. Evaluation criteria for available technology and instrumentation are included and a methodology is developed for route selection. Specific air pollutants (carbon monoxide, ozone, sulfates, nitrates, and particulates) are measured concurrently with exposure and subsequent changes in health status identified through pulmonary function testing, cardiovascular testing, and blood and symptoms analysis. The report concludes that no major adverse short-term health effects were noted for ten healthy male subjects while bicycling or driving in levels of pollution and thermal stress encountered during the study period. Recommendations for further research are also presented.

  5. Effect of Women's autonomy on maternal health service utilization in Nepal: a cross sectional study.

    Science.gov (United States)

    Adhikari, Ramesh

    2016-05-13

    Women's role has been a priority area not only for sustainable development, but also in reproductive health since ICPD 1994. However, very little empirical evidence is available about women's role on maternal health service utilization in Nepal. This paper explores dimensions of women's autonomy and their relationship to utilization of maternal health services. The analysis uses data from the Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the 5 years preceding the survey (n = 4,148). Women's autonomy related variables are taken from the standard DHS questionnaire and measured based on decision in household about obtaining health care, large household purchases and visit to family or relative. The net effect of women's autonomy on utilization of maternal health services after controlling for the effect of other predictors has been measured through multivariate logistic regression analysis. The findings indicate only about a half of the women who had given birth in the past 5 years preceding the survey had 4 or more ANC check up for their last birth. Similarly, 40 % of the women had delivered their last child in the health facilities. Furthermore, slightly higher than two-fifth women (43 %) had postnatal check up for their last child. Only slightly higher than a fourth woman (27 %) had utilized all the services (adequate ANC visit, delivered at health institution and post natal check up) for their last child. This study found that many socio-demographic variables such as age of women, number of children born, level of education, ethnicity, place of residence and wealth index are predicators of utilizing the maternal health services of recent child. Notably, higher level autonomy was associated with higher use of maternal health services [adjusted odds ratio (aOR) =1.40; CI 1.18-1.65]. Utilization of maternal health services for the recent child among women is very low. The study results suggest that policy

  6. Studies of Health Effects from Nuclear Testing near the Semipalatinsk Nuclear Test Site, Kazakhstan

    Directory of Open Access Journals (Sweden)

    Bernd Grosche

    2015-05-01

    Full Text Available The nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today’s radiation protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing out directions for future epidemiologic studies.

  7. Studies of Health Effects from Nuclear Testing near the Semipalatinsk Nuclear Test Site, Kazakhstan.

    Science.gov (United States)

    Grosche, Bernd; Zhunussova, Tamara; Apsalikov, Kazbek; Kesminiene, Ausrele

    2015-01-01

    The nuclear bomb testing conducted at the Semipalatinsk nuclear test site in Kazakhstan is of great importance for today's radiation protection research, particularly in the area of low dose exposures. This type of radiation is of particular interest due to the lack of research in this field and how it impacts population health. In order to understand the possible health effects of nuclear bomb testing, it is important to determine what studies have been conducted on the effects of low dose exposure and dosimetry, and evaluate new epidemiologic data and biological material collected from populations living in proximity to the test site. With time, new epidemiological data has been made available, and it is possible that these data may be linked to biological samples. Next to linking existing and newly available data to examine health effects, the existing dosimetry system needs to be expanded and further developed to include residential areas, which have not yet been taken into account. The aim of this paper is to provide an overview of previous studies evaluating the health effects of nuclear testing, including some information on dosimetry efforts, and pointing out directions for future epidemiologic studies.

  8. Effective factors on menstrual health among female students in Bam city: a qualitative study.

    Science.gov (United States)

    Morowatisharifabad, Mohammad Ali; Vaezi, Aliakbar; Mohammadinia, Neda

    2018-02-01

    Menarche is an independent puberty event in a girl's life, and is associated with physical growth, ability in marriage and fertility. Therefore, poor menstrual health can be a major determinant of morbidity, as well as physical, mental and social problems in this age group. The aim of this study was to explore the effective factors on menstrual health among female students in Bam city. The qualitative study was conducted using content analysis approach in 2017. The participants were 32 individuals consisting of 13 students, 10 mothers of the same students, 9 school associates and health educators of 5 secondary schools in Bam city, who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were semi-structured and in-depth interview. Data analysis was performed using the steps suggested by Graneheim and Landman. There were two categories (easy interaction and inappropriate adaptation to changes in health behavior), 13 sub-categories and 52 initial codes. The positive factors included easy access to sanitary pads, appropriate school education, easy access to health and therapeutic services and school flexibility on menstrual issues, while the negative factors included inadequate facilities for sanitary pad disposal, lack of access to informed people about menstrual issues, insufficient attention to menstrual problems, feeling ashamed, the high cost of menstrual health, self-medication with traditional medicines, inadequate self-directed education, lack of awareness and trust in health center staff, and following family and teachers in menstrual problems. Overall, this study indicated that economic, social, cultural and educational factors affect menstrual health. Therefore, the identification of each of these factors helps planners to apply the most appropriate methods and strategies for menstrual health improvement.

  9. Effective factors on menstrual health among female students in Bam city: a qualitative study

    Science.gov (United States)

    Morowatisharifabad, Mohammad Ali; Vaezi, Aliakbar

    2018-01-01

    Background Menarche is an independent puberty event in a girl’s life, and is associated with physical growth, ability in marriage and fertility. Therefore, poor menstrual health can be a major determinant of morbidity, as well as physical, mental and social problems in this age group. Objective The aim of this study was to explore the effective factors on menstrual health among female students in Bam city. Methods The qualitative study was conducted using content analysis approach in 2017. The participants were 32 individuals consisting of 13 students, 10 mothers of the same students, 9 school associates and health educators of 5 secondary schools in Bam city, who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were semi-structured and in-depth interview. Data analysis was performed using the steps suggested by Graneheim and Landman. Results There were two categories (easy interaction and inappropriate adaptation to changes in health behavior), 13 sub-categories and 52 initial codes. The positive factors included easy access to sanitary pads, appropriate school education, easy access to health and therapeutic services and school flexibility on menstrual issues, while the negative factors included inadequate facilities for sanitary pad disposal, lack of access to informed people about menstrual issues, insufficient attention to menstrual problems, feeling ashamed, the high cost of menstrual health, self-medication with traditional medicines, inadequate self-directed education, lack of awareness and trust in health center staff, and following family and teachers in menstrual problems. Conclusion Overall, this study indicated that economic, social, cultural and educational factors affect menstrual health. Therefore, the identification of each of these factors helps planners to apply the most appropriate methods and strategies for menstrual health improvement. PMID:29629053

  10. Arsenic exposure and adverse health effects: A review of recent findings from arsenic and health studies in Matlab, Bangladesh

    Directory of Open Access Journals (Sweden)

    Mohammad Yunus

    2011-09-01

    Full Text Available The recent discovery of large-scale arsenic (As contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations.

  11. Arsenic exposure and adverse health effects: a review of recent findings from arsenic and health studies in Matlab, Bangladesh.

    Science.gov (United States)

    Yunus, Mohammad; Sohel, Nazmul; Hore, Samar Kumar; Rahman, Mahfuzar

    2011-09-01

    The recent discovery of large-scale arsenic (As) contamination of groundwater has raised much concern in Bangladesh. Reliable estimates of the magnitude of As exposure and related health problems have not been comprehensively investigated in Bangladesh. A large population-based study on As and health consequences in Matlab (AsMat) was done in Matlab field site where International Centre for Diarrhoeal Disease Research, Bangladesh has maintained a health and demographic surveillance system registering prospectively all vital events. Taking advantage of the health and demographic surveillance system and collecting data on detailed individual level As exposure using water and urine samples, AsMat investigated the morbidity and mortality associated with As exposure. Reviews of findings to date suggest the adverse effects of As exposure on the risk of skin lesions, high blood pressure, diabetes mellitus, chronic disease, and all-cause infant and adult disease mortality. Future studies of clinical endpoints will enhance our knowledge gaps and will give directions for disease prevention and mitigations. Copyright © 2011. Published by Elsevier B.V.

  12. Health effects of selected microbiological control agents. A 3-year follow-up study

    DEFF Research Database (Denmark)

    Baelum, Jesper; Larsen, Preben; Doekes, Gert

    2012-01-01

    Introduction and objectives: Microbiological control agents (MBCA) are widely used in greenhouses, replacing chemical pesticides. The presented study aims to describe health effects of exposure to three types commonly used: Bacillus thuringiensis, Verticillium lecanii, and Trichoderma harzenianum...... covering seven different products in greenhouse workers with emphasis on sensitization and respiratory effects. Methods: 579 persons aged 17-67 years culturing ornamental flowers were included. They were followed for three years with annual examinations including interview about exposure and symptoms, lung...... no effect on the occurrence of respiratory symptoms or lung function was observed. The persons had a relatively long exposure. Therefore, a healthy worker effect may have influenced the results....

  13. Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries

    Directory of Open Access Journals (Sweden)

    Jessica L. Reid

    2017-08-01

    Full Text Available Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16–18 in Beijing, China (n = 1070, Mumbai area, India (n = 1012, Dhaka, Bangladesh (n = 1018, and Republic of Korea (n = 1362. Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing, Bangladesh (Dhaka, and Korea (which had general, text-only warnings thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings. Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known.

  14. Does consideration of larger study areas yield more accurate estimates of air pollution health effects?

    DEFF Research Database (Denmark)

    Pedersen, Marie; Siroux, Valérie; Pin, Isabelle

    2013-01-01

    BACKGROUND: Spatially-resolved air pollution models can be developed in large areas. The resulting increased exposure contrasts and population size offer opportunities to better characterize the effect of atmospheric pollutants on respiratory health. However the heterogeneity of these areas may......: Simulations indicated that adjustment for area limited the bias due to unmeasured confounders varying with area at the costs of a slight decrease in statistical power. In our cohort, rural and urban areas differed for air pollution levels and for many factors associated with respiratory health and exposure....... Area tended to modify effect measures of air pollution on respiratory health. CONCLUSIONS: Increasing the size of the study area also increases the potential for residual confounding. Our simulations suggest that adjusting for type of area is a good option to limit residual confounding due to area...

  15. Effect of Health Comparisons on Functional Health and Depressive Symptoms - Results of a Population-Based Longitudinal Study of Older Adults in Germany.

    Directory of Open Access Journals (Sweden)

    André Hajek

    Full Text Available To investigate the effect of health comparisons on functional health and depressive symptoms in a longitudinal approach. Gender differences were examined.The German Ageing Survey (DEAS is a nationwide, representative longitudinal study of community dwelling individuals living in Germany aged 40 and older. The surveys in 2008 and 2011 were used, with n = 3,983 respondents taking part in both waves. Health comparisons were quantified by the question "How would you rate your health compared with other people your age" (Much better; somewhat better; the same; somewhat worse, much worse. Functional health was assessed by the subscale "physical functioning" of the 36-Item Short Form Health Survey (SF-36 and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D.Adjusting for sociodemographic factors, self-assessed health, social network, self-efficacy and optimism, and morbidity, fixed effects regressions revealed that functional health decreased significantly and considerably with negative health comparisons in the total sample (transitions from 'the same' to 'much worse': β = -11.8, predominantly in men. The effects of negative health comparisons (transitions from 'the same' to 'much worse': β = 4.8 on depressive symptoms were comparable (in terms of significance to the effects on functional health, with stronger effects in women. Positive comparisons did not affect functional health and depressive symptoms.Our findings underline the relevance of negative health comparisons on functional health (men and depressive symptoms (women. Comparison effects are asymmetric and mostly upwards.

  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. Chernobyl Studies Project. Working Group 7.0, environmental transport and health effects

    International Nuclear Information System (INIS)

    Hendrickson, S.M.

    1994-01-01

    The focus of the Chernobyl Studies Project has now turned to the issue of health effects from the Chernobyl accident. Currently, we are involved in and making progress on the case-control and co-hort studies of thyroid diseases among Belarussian children. Dosimetric aspects are a fundamental part of these studies. We are working to implement similar studies in Ukraine. A major part of the effort of these projects is supporting these studies, both by providing methods and applications of dose reconstruction and by providing support and equipment for the medical teams

  18. Health and coping predict work ability: a prospective study on the differential effects of mental and physical health among aging workers

    OpenAIRE

    Heuvel, S.G. van der; Vijfeijke, H. van de; Leijten, F.R.M.; Ybema, J.F.; Robroek, S.J.W.; Beek, A.J. van der; Burdorf, A.; Taris, T.W.

    2013-01-01

    Objective This study examines whether mental and physical health among older employees relate to work ability and whether coping styles moderate the effects of health. Methods A one-year longitudinal study was conducted among 8842 employees aged 45–64 years from the Study on Transitions in Employment, Ability, and Motivation (STREAM). Online questionnaires measured self-perceived mental and physical health (short form-12 health survey) at baseline, and coping styles (Utrecht Coping List) and ...

  19. Effects of internet use on health and depression: a longitudinal study.

    Science.gov (United States)

    Bessière, Katie; Pressman, Sarah; Kiesler, Sara; Kraut, Robert

    2010-02-28

    Internet for communication with friends and family purposes from 3 to 5 days per week to once a day was associated with .07 standard deviations fewer symptoms of depression, P = .007). There were no significant effects of respondents' initial health status (P = .234) or role as a caregiver (P = .911) on the association between health-related Internet use and depression. Neither type of use was associated with changes in general health (P = .705 for social uses and P = .494 for health uses). Using the Internet for health purposes was associated with increased depression. The increase may be due to increased rumination, unnecessary alarm, or over-attention to health problems. Additionally, those with unmeasured problems or those more prone to health anxiety may self-select online health resources. In contrast, using the Internet to communicate with friends and family was associated with declines in depression. This finding is comparable to other studies showing that social support is beneficial for well-being and lends support to the idea that the Internet is a way to strengthen and maintain social ties.

  20. 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

  1. 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.

  2. Feasibility of future epidemiological studies on possible health effects of mobile phone base stations.

    Science.gov (United States)

    Neubauer, Georg; Feychting, Maria; Hamnerius, Yngve; Kheifets, Leeka; Kuster, Niels; Ruiz, Ignacio; Schüz, Joachim; Uberbacher, Richard; Wiart, Joe; Röösli, Martin

    2007-04-01

    The increasing deployment of mobile communication base stations led to an increasing demand for epidemiological studies on possible health effects of radio frequency emissions. The methodological challenges of such studies have been critically evaluated by a panel of scientists in the fields of radiofrequency engineering/dosimetry and epidemiology. Strengths and weaknesses of previous studies have been identified. Dosimetric concepts and crucial aspects in exposure assessment were evaluated in terms of epidemiological studies on different types of outcomes. We conclude that in principle base station epidemiological studies are feasible. However, the exposure contributions from all relevant radio frequency sources have to be taken into account. The applied exposure assessment method should be piloted and validated. Short to medium term effects on physiology or health related quality of life are best investigated by cohort studies. For long term effects, groups with a potential for high exposure need to first be identified; for immediate effect, human laboratory studies are the preferred approach. (c) 2006 Wiley-Liss, Inc.

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

    Science.gov (United States)

    Zhou, Leming; Bao, Jie; Parmanto, Bambang

    2017-08-01

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

  4. An analysis of uranium dispersal and health effects using a Gulf War case study

    International Nuclear Information System (INIS)

    Marshall, Albert Christian

    2005-01-01

    The study described in this report used mathematical modeling to estimate health risks from exposure to depleted uranium (DU) during the 1991 Gulf War for both U.S. troops and nearby Iraqi civilians. The analysis found that the risks of DU-induced leukemia or birth defects are far too small to result in an observable increase in these health effects among exposed veterans or Iraqi civilians. Only a few veterans in vehicles accidentally struck by U.S. DU munitions are predicted to have inhaled sufficient quantities of DU particulate to incur any significant health risk (i.e., the possibility of temporary kidney damage from the chemical toxicity of uranium and about a 1% chance of fatal lung cancer). The health risk to all downwind civilians is predicted to be extremely small. Recommendations for monitoring are made for certain exposed groups. Although the study found fairly large calculational uncertainties, the models developed and used are generally valid. The analysis was also used to assess potential uranium health hazards for workers in the weapons complex. No illnesses are projected for uranium workers following standard guidelines; nonetheless, some research suggests that more conservative guidelines should be considered

  5. An analysis of uranium dispersal and health effects using a Gulf War case study.

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, Albert Christian

    2005-07-01

    The study described in this report used mathematical modeling to estimate health risks from exposure to depleted uranium (DU) during the 1991 Gulf War for both U.S. troops and nearby Iraqi civilians. The analysis found that the risks of DU-induced leukemia or birth defects are far too small to result in an observable increase in these health effects among exposed veterans or Iraqi civilians. Only a few veterans in vehicles accidentally struck by U.S. DU munitions are predicted to have inhaled sufficient quantities of DU particulate to incur any significant health risk (i.e., the possibility of temporary kidney damage from the chemical toxicity of uranium and about a 1% chance of fatal lung cancer). The health risk to all downwind civilians is predicted to be extremely small. Recommendations for monitoring are made for certain exposed groups. Although the study found fairly large calculational uncertainties, the models developed and used are generally valid. The analysis was also used to assess potential uranium health hazards for workers in the weapons complex. No illnesses are projected for uranium workers following standard guidelines; nonetheless, some research suggests that more conservative guidelines should be considered.

  6. Curative and health enhancement effects of aquatic exercise: evidence based on interventional studies

    Directory of Open Access Journals (Sweden)

    Honda T

    2012-03-01

    Full Text Available Takuya Honda1, Hiroharu Kamioka21Research Fellow of the Japanese Society for the Promotion of Science, 2Laboratory of Physical and Health Education, Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, JapanBackground: The purpose of this study was to report on the health benefits and curative effects of aquatic exercise.Methods: We adopted the results of high-grade study designs (ie, randomized controlled trials and nonrandomized controlled trials, for which there were many studies on aquatic exercise. Aquatic exercise, in this study, means walking in all directions, stretching, and various exercises and conditioning performed with the feet grounded on the floor of a swimming pool. We excluded swimming. We decided to treat aquatic exercise, underwater exercise, hydrotherapy, and pool exercise as all having the same meaning.Results: Aquatic exercise had significant effects on pain relief and related outcome measurements for locomotor diseases.Conclusion: Patients may become more active, and improve their quality of life, as a result of aquatic exercise.Keywords: aquatic exercise, health enhancement, evidence

  7. Studies of health effects of low dose radiation and its application to medicare

    International Nuclear Information System (INIS)

    Yamaoka, Kiyonori; Ishida, Kenji; Iwasaki, Toshiyasu; Koana, Takao; Magae, Junji; Watanabe, Masami; Sakamoto, Kiyohiko

    2008-01-01

    The articles contain following 7 topics of low dose radiation effects. Studies of Health Effects of Low dose Radiation and Its Application to Medicare'', describes the indication of Rn therapy and investigations of its usefulness mechanism mainly in Misasa Spa, Okayama Pref. ''Challenges for the Paradigm Shift (CRIEPI Studies)'', introduces studies against the paradigm that radiation dose is linearly and proportionally hazardous. ''Studies of High Background Radiation Area (CRIEPI Studies)'', describes global HBRA studies on chromosome affection and effect of smoking in HBRA. ''Is the Radiation Effect on Man Proportional to Dose? (CRIEPI Studies)'', describes studies of immature sperm irradiated at low dose against Linear-Non-threshold Theory (LNT) hypothesis. ''Induction of Radiation Resistance by Low Dose Radiation and Assessment of Its Effect in Models of Human Diseases (CRIEPI Studies)'', explains the adoptive response in radiation effect, suppression of carcinogenesis and immune regulation by previous low dose radiation in the mouse, and improvement of diabetes in the db/db mouse. ''Modulation of Biological Effects of Low Dose Radiation: Adoptive Response, Bystander Effect, Genetic Instability and Radiation Hormesis'', summarizes findings of each item. ''Cancer Treatment with Low dose Radiation to the Whole Body'', describes basic studies in the mouse tumor in relation to suppression of carcinogenesis and metastasis, immune activation and treatment, and successful clinical studies in patients with ovary, colon cancers and malignant lymphoma where survival has been significantly improved: a base of recent European Organization for Research and Treatment of Cancer (EORTC) clinical trials. The mechanism is essentially based on immune activation of patients to cure the disease. (R.T.)

  8. The impact of mindfulness on leadership effectiveness in a health care setting: a pilot study.

    Science.gov (United States)

    Wasylkiw, Louise; Holton, Judith; Azar, Rima; Cook, William

    2015-01-01

    The purpose of this paper is to examine the impact of mindfulness awareness practice (MAP) on mid-level health-care managers' leadership. In total, 11 mid-level health-care managers in eastern Canada took part in an intensive weekend retreat and a follow-up webinar on mindfulness awareness. Perceived stress and leadership effectiveness were assessed pre- and post-intervention (i.e. four and eight weeks). A control group (n=10) also completed the same measures twice. Additionally, informants (n=28) provided assessments of participants' leadership pre- and post-intervention. Follow-up interviews were carried out with eight participants 12-16 weeks post-intervention. In comparison to controls, retreat participants showed significant increases in mindfulness and corresponding decreases in stress that were sustained across eight weeks post-retreat; retreat participants reported significant positive changes in their leadership effectiveness that were corroborated by informants. Qualitative data, however, suggest that sustaining a mindfulness practice presents significant challenges to middle managers in a health care setting. The findings are useful to management working in health services that are plagued by increasing demands and changes. Despite the small sample and lack of random assignment, the pilot data support the efficacy of MAP in improving leadership. Little empirical research supports the claim that MAP enhances leadership. The present study employed a mixed methods approach to address this gap and demonstrates the potential benefits of MAP among mid-level managers.

  9. A Study of Air Quality and its Effect on Health: A Geographical Perspective of Lucknow city

    Directory of Open Access Journals (Sweden)

    Dipak Prasad

    2016-06-01

    Full Text Available Erudite groups of people, scientists, planners, and policy-makers of different countries have come to realise that quality of environment is not necessarily a simple function of nature as in primitive earth. Today nature’s self-regulatory functions are inoperative. All the developed and developing countries are deeply concerned to make balance between their environmental anxiety and their economic development. Dreadful environmental conditions are affecting the biological segment of the ecosystem of these areas. Human being, ‘one of the most precious component in biosphere’, have regular predicament situation with accretion of sullied air, water, and soil degradation. Though water and land pollution is extremely dangerous, air pollution has its own peculiarities, due to its trans-boundary dispersion of pollutants over the entire world. The effect of air pollution on health is very complex as there are many different sources and their individual effect varying from one to other. It is not only the ambient air quality in the cities but also the indoor air quality in the rural and urban areas that are causing concern. The study is confined with the health impact of deteriorating air quality in Lucknow city. The aim of the present study is also to determine the consequences of ambient air quality on health of the people in the study area.

  10. Health and coping predict work ability: a prospective study on the differential effects of mental and physical health among aging workers

    NARCIS (Netherlands)

    Heuvel, S.G. van der; Vijfeijke, H. van de; Leijten, F.R.M.; Ybema, J.F.; Robroek, S.J.W.; Beek, A.J. van der; Burdorf, A.; Taris, T.W.

    2013-01-01

    Objective This study examines whether mental and physical health among older employees relate to work ability and whether coping styles moderate the effects of health. Methods A one-year longitudinal study was conducted among 8842 employees aged 45–64 years from the Study on Transitions in

  11. A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

    Science.gov (United States)

    Williams, Beth B.

    2011-01-01

    Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

  12. Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.

    Science.gov (United States)

    Bécares, Laia; Dewey, Michael E; Das-Munshi, Jayati

    2017-12-14

    Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes. We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis. We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76-0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79-0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis. The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.

  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 Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies

    Science.gov (United States)

    Coker, Eric; Kizito, Samuel

    2018-01-01

    An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region. PMID:29494501

  15. A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies.

    Science.gov (United States)

    Coker, Eric; Kizito, Samuel

    2018-03-01

    An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region.

  16. A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies

    Directory of Open Access Journals (Sweden)

    Eric Coker

    2018-03-01

    Full Text Available An important aspect of the new sustainable development goals (SDGs is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region.

  17. The effect of a severe disaster on the mental health of adolescents: A controlled study

    NARCIS (Netherlands)

    Reijneveld, S.A.; Crone, M.R.; Verhulst, F.C.; Verloove-Vanhorick, S.P.

    2003-01-01

    Background: Disasters greatly affect the mental health of children and adolescents, but quantification of such effects is difficult. Using prospective predisaster and postdisaster data for affected and control populations, we aimed to assess the effects of a severe disaster on the mental health and

  18. Cost-effectiveness of health research study participant recruitment strategies: a systematic review.

    Science.gov (United States)

    Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A

    2014-10-01

    A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

  19. Occupational radiation exposure and its health effects on interventional medical workers: study protocol for a prospective cohort study.

    Science.gov (United States)

    Ko, Seulki; Chung, Hwan Hoon; Cho, Sung Bum; Jin, Young Woo; Kim, Kwang Pyo; Ha, Mina; Bang, Ye Jin; Ha, Yae Won; Lee, Won Jin

    2017-12-15

    Although fluoroscopically guided procedures involve a considerably high dose of radiation, few studies have investigated the effects of radiation on medical workers involved in interventional fluoroscopy procedures. Previous research remains in the early stages and has not reached a level comparable with other occupational studies thus far. Furthermore, the study of radiation workers provides an opportunity to estimate health risks at low doses and dose rates of ionising radiation. Therefore, the objectives of this study are (1) to initiate a prospective cohort study by conducting a baseline survey among medical radiation workers who involve interventional fluoroscopy procedures and (2) to assess the effect of occupational radiation exposure and on the overall health status through an in-depth cross-sectional study. Intervention medical workers in Korea will be enrolled by using a self-administered questionnaire survey, and the survey data will be linked with radiation dosimetry data, National Health Insurance claims data, cancer registry and mortality data. After merging these data, the radiation organ dose, lifetime attributable risk due to cancer and the risk per unit dose will be estimated. For the cross-sectional study, approximately 100 intervention radiology department workers will be investigated for blood tests, clinical examinations such as ultrasonography (thyroid and carotid artery scan) and lens opacity, the validation of badge dose and biodosimetry. This study was reviewed and approved by the institutional review board of Korea University (KU-IRB-12-12-A-1). All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations, and a report will be submitted to the relevant public health authorities in the Korea Centers for Disease Control and Prevention to help with the development of appropriate research and management policies.

  20. Environmental health studies

    International Nuclear Information System (INIS)

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

    1978-01-01

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

  1. Effects of TCMC on Transformation of Good Health Status to Suboptimal Health Status: A Nested Case-Control Study

    Science.gov (United States)

    Wang, Tian; Chen, Jieyu; Sun, Xiaomin; Xiang, Lei; Zhou, Lin; Li, Fei; Lin, Changsong; Jiang, Pingping; Wu, Shengwei; Xiao, Ya; Cheng, Jingru; Luo, Ren; Liu, Yanyan; Zhao, Xiaoshan

    2015-01-01

    To explore the effects of traditional Chinese medicine constitution (TCMC) on transformation of good health status to suboptimal health status (SHS), we conducted a nested case-control study among college students in China. During the 18-month mean follow-up time, 543 cases of SHS (42.7%) occurred in 1273 healthy students. There was a significant (P = 0.000) and marked reduction in SHMS V1.0 total score in the case group at the 18-month follow-up (69.32 ± 5.45) compared with baseline (78.60 ± 4.70), but there was no significant change in the control group. Conditional logistic regression analysis showed that respondents reporting Yin-deficiency and Qi-deficiency were, respectively, 2.247 and 2.198 times more likely to develop SHS, while tendency to Yin-deficiency and tendency to Damp-heat were, respectively, 1.642 and 1.506 times more likely to develop SHS. However, the Balanced Constitution was a significant protective factor (OR 0.649; P < 0.05). Altogether, these findings demonstrate that Yin-deficiency, Qi-deficiency, tendency to Yin-deficiency, and tendency to Damp-heat appeared to induce a change in health status to SHS, while the Balanced Constitution seemed to restrain this change. We conclude that regulating the unbalanced TCMC (such as Yin-deficiency and Qi-deficiency) may prevent a healthy status developing into SHS or lead to the regression of SHS. PMID:26346320

  2. Effects of TCMC on Transformation of Good Health Status to Suboptimal Health Status: A Nested Case-Control Study

    Directory of Open Access Journals (Sweden)

    Tian Wang

    2015-01-01

    Full Text Available To explore the effects of traditional Chinese medicine constitution (TCMC on transformation of good health status to suboptimal health status (SHS, we conducted a nested case-control study among college students in China. During the 18-month mean follow-up time, 543 cases of SHS (42.7% occurred in 1273 healthy students. There was a significant (P=0.000 and marked reduction in SHMS V1.0 total score in the case group at the 18-month follow-up (69.32 ± 5.45 compared with baseline (78.60 ± 4.70, but there was no significant change in the control group. Conditional logistic regression analysis showed that respondents reporting Yin-deficiency and Qi-deficiency were, respectively, 2.247 and 2.198 times more likely to develop SHS, while tendency to Yin-deficiency and tendency to Damp-heat were, respectively, 1.642 and 1.506 times more likely to develop SHS. However, the Balanced Constitution was a significant protective factor (OR 0.649; P<0.05. Altogether, these findings demonstrate that Yin-deficiency, Qi-deficiency, tendency to Yin-deficiency, and tendency to Damp-heat appeared to induce a change in health status to SHS, while the Balanced Constitution seemed to restrain this change. We conclude that regulating the unbalanced TCMC (such as Yin-deficiency and Qi-deficiency may prevent a healthy status developing into SHS or lead to the regression of SHS.

  3. Health effects of water-borne radon: review of a proposed study. Final report

    International Nuclear Information System (INIS)

    1986-01-01

    The Science Advisory Board's Radiation Advisory Committee was requested to review the scientific merit of a proposal to conduct an epidemiological study of radon in indoor air. The Board accepted the request and formed a Radioepidemiology Subcommittee which responded to two overriding scientific issues: Can further epidemiological study contribute to an understanding of the risks of lung cancer associated with household exposures. The Subcommittee concludes that scientific uncertainties in current epidemiological studies (chiefly studies of uranium miners) could be further reduced through direct investigations of the domestic population. Is the proposed study under review by the Office of Research and Development, entitled Health Effects of Waterborne Radon, appropriately designed to address the risk. For reasons cited in the attached report, the Subcommittee concludes that it is not appropriately designed

  4. Health system delay and its effect on clinical stage of breast cancer: Multicenter study.

    Science.gov (United States)

    Unger-Saldaña, Karla; Miranda, Alfonso; Zarco-Espinosa, Gelasio; Mainero-Ratchelous, Fernando; Bargalló-Rocha, Enrique; Miguel Lázaro-León, Jesús

    2015-07-01

    The objective of this study was to determine the correlation between health system delay and clinical disease stage in patients with breast cancer. This was a cross-sectional study of 886 patients who were referred to 4 of the largest public cancer hospitals in Mexico City for the evaluation of a probable breast cancer. Data on time intervals, sociodemographic factors, and clinical stage at diagnosis were retrieved. A logistic regression model was used to estimate the average marginal effects of delay on the probability of being diagnosed with advanced breast cancer (stages III and IV). The median time between problem identification and the beginning of treatment was 7 months. The subinterval with the largest delay was that between the first medical consultation and diagnosis (median, 4 months). Only 15% of the patients who had cancer were diagnosed with stage 0 and I disease, and 48% were diagnosed with stage III and IV disease. Multivariate analyses confirmed independent correlations for the means of problem identification, patient delay, health system delay, and age with a higher probability that patients would begin cancer treatment in an advanced stage. In the sample studied, the majority of patients with breast cancer began treatment after a delay. Both patient delays and provider delays were associated with advanced disease. Research aimed at identifying specific access barriers to medical services is much needed to guide the design of tailored health policies that go beyond the promotion of breast care awareness and screening participation to include improvements in health services that facilitate access to timely diagnosis and treatment. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  5. Quasi-experimental study on the effectiveness of a flipped classroom for teaching adult health nursing.

    Science.gov (United States)

    Park, Esther O; Park, Ji Hyun

    2018-04-01

    The effectiveness of flipped learning as one of the teaching methods of active learning has been left unexamined in nursing majors, compared to the frequent attempts to uncover the effectiveness of it in other disciplines. The purpose of this study was to reveal the effectiveness of flipped learning pedagogy in an adult health nursing course, controlling for other variables. The study applied a quasi-experimental approach, comparing pre- and post-test results in learning outcomes. Included in this analysis were the records of 81 junior nursing major students. The convenience sampling method was used to select the participants. Those in the experimental group were exposed to a flipped classroom experience that was given after the completion of their traditional class. The students' learning outcomes and the level of critical thinking skills were evaluated before and after the intervention of the flipped classroom. After the flipped classroom experience, the scores of the students' achievement in subject topics and critical thinking skills, specifically intellectual integrity and creativity, showed a greater level of increase than those of their controlled counterparts. This remained true even after controlling for previous academic performance and the level of creativity. This study confirmed the effectiveness of the flipped classroom as a measure of active learning by applying a quantitative approach. But, regarding the significance of the initial contribution of flipped learning in the discipline of nursing science, carrying out a more authentic experimental study could justify the impact of flipped learning pedagogy. © 2017 Japan Academy of Nursing Science.

  6. Effectiveness of pictorial health warning on cigarette packages: A cross-sectional study in Sarawak, Malaysia.

    Science.gov (United States)

    Rahman, M M; Arif, M T; Abd, Razak Mf; Suhaili, M R; Tambi, Z; Akoi, C; Gabriel Bain, M; Hussain, H

    2015-01-01

    Specific health warning placed on the tobacco product packages is considered as an effective and low-cost method for increasing the knowledge and awareness among the community. Thus, a study was conducted to assess the perception of pictorial health warnings (PHWs) against smoking among the adult rural population of Sarawak. Cross-sectional data were collected from 10 villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Nonprobability sampling method was adopted to select the villages. All the households of the selected villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software IBM SPSS 20.0 version. Analysis showed that 28.8% of the respondents were current smokers, 7.8% were past smokers and the rest were non-smokers. Six items of pictorial health warnings were evaluated with five point Likert's scales for attractiveness, fearfulness and adequacy of the information. Analysis revealed that the majority of the respondents had perceived awareness on PHWs, but the smokers believed that this was not adequate to make them quit smoking. Only one-fifth (19.7%) of them reported that current pictorial health warnings were sufficient to motivate people to quit smoking. Though the PHWs on cigarette packages are appealing, it is not sufficient as a reason to stop smoking. Thus, an approach using an integrated anti-tobacco public health programme should be focused into the specific targeted community.

  7. A Study of the Possible Harmful Effects of Cosmetic Beauty Products on Human Health.

    Science.gov (United States)

    Kaličanin, Biljana; Velimirović, Dragan

    2016-04-01

    The origins of the usage of different substances in beauty, skin, body, hair, and nails care products can be found in ancient times. To achieve better quality and enhance their effects, some additives such as preservatives, stabilizers, mineral pigments, dye, and shine were added to these products. Some of these substances may also have allergic, irritating, and harmful effects on human health. The aim of this study was the optimization of the potentiometric stripping analysis (PSA) for the purpose of determining the content of heavy metals (lead, cadmium, zinc), in some commercial cosmetic beauty products (lipsticks, lip glosses, eye shadows, and henna hair dye). In addition, in order to monitor the potential adverse effects of henna dye on hair quality, as well as the total body burden of heavy metals (Pb, Cd), the paper analyzed hair samples before and after henna dye treatment. Beauty products used for cosmetic purposes can have adverse effects to human health due to the fact that they contain lead, a highly toxic metal. The lead content in the tested samples varied depending on the additives used along with the method of production. The cosmetic products that were analyzed in this study contained a certain amount of zinc, which is an essential element, although its content above the prescribed limit may lead to side effects. Highly toxic metal, cadmium, was not detected in the tested samples. The presence of these metals in cosmetic products certainly indicate that it is necessary to monitor and determinate the content of toxic heavy metals in these products, especially because they are in direct contact with skin or mucous membranes and are often used in daily life.

  8. The "Residential" Effect Fallacy in Neighborhood and Health Studies: Formal Definition, Empirical Identification, and Correction.

    Science.gov (United States)

    Chaix, Basile; Duncan, Dustin; Vallée, Julie; Vernez-Moudon, Anne; Benmarhnia, Tarik; Kestens, Yan

    2017-11-01

    Because of confounding from the urban/rural and socioeconomic organizations of territories and resulting correlation between residential and nonresidential exposures, classically estimated residential neighborhood-outcome associations capture nonresidential environment effects, overestimating residential intervention effects. Our study diagnosed and corrected this "residential" effect fallacy bias applicable to a large fraction of neighborhood and health studies. Our empirical application investigated the effect that hypothetical interventions raising the residential number of services would have on the probability that a trip is walked. Using global positioning systems tracking and mobility surveys over 7 days (227 participants and 7440 trips), we employed a multilevel linear probability model to estimate the trip-level association between residential number of services and walking to derive a naïve intervention effect estimate and a corrected model accounting for numbers of services at the residence, trip origin, and trip destination to determine a corrected intervention effect estimate (true effect conditional on assumptions). There was a strong correlation in service densities between the residential neighborhood and nonresidential places. From the naïve model, hypothetical interventions raising the residential number of services to 200, 500, and 1000 were associated with an increase by 0.020, 0.055, and 0.109 of the probability of walking in the intervention groups. Corrected estimates were of 0.007, 0.019, and 0.039. Thus, naïve estimates were overestimated by multiplicative factors of 3.0, 2.9, and 2.8. Commonly estimated residential intervention-outcome associations substantially overestimate true effects. Our somewhat paradoxical conclusion is that to estimate residential effects, investigators critically need information on nonresidential places visited.

  9. Comparative study on the health effects of smoking and indoor air pollution in summer and winter

    Energy Technology Data Exchange (ETDEWEB)

    Matsuki, H.; Kasuga, H.; Osaka, F.; Yanagisawa, Y.; Nishimura, H.

    1985-08-01

    This study compares summer and winter to demonstrate the health effects of indoor air pollution with special reference to NO/sub 2/ and smoking, on the subjects composed of 820 school children and their 546 mothers in the two areas with different ambient NO/sub 2/ concentrations. In either case, examination was carried out with standardized questionnaire test for respiratory symptoms, personal NO/sub 2/ exposure measurement using the filter badge by Yanagisawa, and analysis of urinary hydroxyproline and creatinine in two areas with different ambient NO/sub 2/ levels. Personal NO/sub 2/ exposure level in winter season was 2-3 times higher than that in summer, particularly NO/sub 2/ level among residents living in homes with non-vented stove for space heating was substantially higher from those of residents with vented stove. Wives with vented stove had a moderate exposure level in winter season by the contribution of NO/sub 2/ originated from the kitchen and poor ventilation rate. Since the hydroxyproline to creatinine ratio (HOP-ratio) of children increased more, their household location were nearer to any heavy traffic roads in summer, health effects from automobile exhaust were suggested only in summer season. In summer season, personal NO/sub 2/ exposure level were almost the same with the ambient NO/sub 2/ concentrations over both areas. These results suggest that indoor air pollution in winter season may be separated from outdoor air pollution. It was a matter of course that hydroxyproline to creatinine ratio in winter season was higher than that in summer, in any group and in any area, but the range of variation of hydroxyproline to creatinine ratio was smaller by far than that of personal NO/sub 2/ exposure level. Judging from urinary hydroxyproline to creatinine ratio, health effects of active smoking and passive smoking increased with increasing the number of smoked, dose-dependently in any season.

  10. Olive oil and health effects: from epidemiological studies to the molecular mechanisms of phenolic fraction

    Directory of Open Access Journals (Sweden)

    Amiot Marie Josèphe

    2014-09-01

    Full Text Available Olive oil is a key component of the Mediterranean diet which is recognized to contribute to its health benefits. Recent prospective studies point towards a protective effect from an olive oil-rich diet in relation to the incidence of cardiovascular diseases and an improvement of cardiometabolic markers such as blood pressure, glycaemia and dyslipidemia, notably by reducing LDL cholesterol and LDL oxidation. The role of minor phenolic fraction was evidenced in intervention trials where lipid profiles showed greater improvement in participants receiving olive oil with higher phenolic content. The phenolic fraction of olive oil is composed of simple phenols (hydroxytyrosol, phenolic secoiridoids (oleuropein aglycone, lignans (pinoresinol, flavonoids and hydroxyisochromans. All these compounds have diverse biological activities that are described in the present review, supporting the protective effects of olive oil against degenerative diseases found in large cohorts monitored in Southern European countries.

  11. The effect of food insecurity on health status of adolescents in Ethiopia: longitudinal study

    Directory of Open Access Journals (Sweden)

    Mulusew G. Jebena

    2017-05-01

    Full Text Available Abstract Background The effect of food insecurity on health and wellbeing of a population has been the subject of much research. Yet, limited research has investigated its effect on adolescents’ health and wellbeing in Ethiopia. Method We used data from the Jimma Longitudinal Family Survey of Youth which began tracking a cohort of adolescents in 2005 to examine the social, behavioral and economic determinants of their health and well-being. A total of 1,919 sample were included in the main analyses. All youths provided data related to their food insecurity experiences and their health status. A mixed effect logistic regression using random intercept and trend model was used to examine the relationship between food insecurity and their health status. Fixed effects estimates were also computed to check the parsimoniousness of the random intercept and trend model. Results The results indicated that the mean (±SD age of adolescents was 18.6(±1.4. Nine hundred twenty three (48.1% of them were female. The magnitude of self-rated health status was relatively unstable ranging from 18.9%, 34.7% to 37.3% in each round. Similarly, 20.4%, 48.4% and 20.6% of adolescents were food insecure during each consecutive round of the survey respectively. Exposure to food insecurity is strongly associated with self-rated health status (β = 0.28, P < 0.001 and poor self-rated health was also more pronounced for some time (β =2.11, P < 0.001 and decline after a turning point (β = −0.38, P < 0.001. Conclusions These findings imply that any social, nutrition and public health interventions designed to improve adolescent health should consider underlying social determinants of health such as food insecurity.

  12. The Effectiveness of Health Education on Maternal Anxiety, Circumcision Knowledge, and Nursing Hours: A Quasi-Experimental Study.

    Science.gov (United States)

    Chang, Shu-Fang; Hung, Chich-Hsiu; Hsu, Yu-Yun; Liu, Yi; Wang, Tsu-Nai

    2017-08-01

    Many studies have shown that providing health education before surgery may significantly increase health knowledge and decrease anxiety in both patients and their family members. However, few studies have compared the effects on pediatric outpatient surgery outcomes of different health education instruction modes. This study compares the effects of two health education delivery modes on maternal knowledge and anxiety, the number of unexpected early hospital follow-up visits, and the time spent by nurses on health education. A quasi-experimental design with pretest and posttest was used to compare the effect on the outcomes of pediatric circumcision of a multimedia compact disc (CD) and a printed material.Seventy mothers of children who underwent Plastibell circumcision participated in this study. Both the printed material and the multimedia CD significantly increased the knowledge and reduced the anxiety levels of the participants. However, no significant differences in unscheduled early hospital follow-up visits postsurgery were found between the two modes of instruction. Furthermore, we found that significantly fewer hours were spent by nurses on health education for the multimedia CD group in comparison with the printed material group. In the current clinical environment of common staffing shortages, information tools may be used to cost-effectively assist and simplify nursing work. The findings of this study may provide a reference to medical centers that are working to reduce the time spent by nurses on health education for outpatient surgery patients. Furthermore, audiovisual health education tools are recommended to increase nursing effectiveness and save nursing time.

  13. Geriatric study in Europe on health effects of air quality in nursing homes (GERIE study) profile: objectives, study protocol and descriptive data.

    Science.gov (United States)

    Annesi-Maesano, Isabella; Norback, Dan; Zielinski, Jan; Bernard, Alfred; Gratziou, Cristina; Sigsgaard, Torben; Sestini, Piersante; Viegi, Giovanni

    2013-11-21

    Indoor air pollution (IAP) constitutes a major global public health problem requiring increasing efforts in research and policymaking that may have special significance for elderly that are likely to spend most of their day indoors and appear to be particularly susceptible to adverse effects of chemical pollutants and bio-contaminants. Yet, evidence existing on the effects of IAP in elderly is scanty. The Geriatric study in Europe on health effects of air quality in nursing homes (GERIE) study aimed to assess health effects of major indoor air pollutants and thermal conditions in elderly (> 70 years) living stably in nursing homes (NH) across Europe. Respiratory effects were particularly considered as airways and lung constitute the first target of air pollutants. We describe here the rationale and the methods of the GERIE Study. 8 nursing homes were randomly selected in 7 European countries. Twenty individuals were randomly selected in each nursing home. Major indoor and outdoor air chemical pollutants (PM10, PM2.5, PM0.1, formaldehyde, NO2; O3, VOC, CO2) and bio-contaminants (moulds, allergens) were assessed objectively with standardized procedures. Major health status indicators were assessed through a standardized questionnaire, non-invasive clinical tests and blood and urine biomarkers as well as saliva for ADN. The GERIE study has given the opportunity to publish two reviews on respiratory health effects of indoor and outdoor air pollution in elderly. In addition it has provided the inventory of air quality and thermal conditions in 50 nursing homes across Europe and data on respiratory health status in 600 elderly aged 82 years in mean. Major future results will include the relationships between NH environment and health in elderly. The main long-term purpose of the GERIE study is to improve the health of elderly who permanently reside in nursing homes or of those who are exposed to indoor air pollution because of reduced mobility.

  14. Developing effective communication materials on the health effects of climate change for vulnerable groups: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Jennifer M. Kreslake

    2016-09-01

    Full Text Available Abstract Background Individuals with chronic health conditions or low socioeconomic status (SES are more vulnerable to the health impacts of climate change. Health communication can provide information on the management of these impacts. This study tested, among vulnerable audiences, whether viewing targeted materials increases knowledge about the health impacts of climate change and strength of climate change beliefs, and whether each are associated with stronger intentions to practice recommended behaviors. Methods Low-SES respondents with chronic conditions were recruited for an online survey in six cities. Respondents were shown targeted materials illustrating the relationship between climate change and chronic conditions. Changes in knowledge and climate change beliefs (pre- and post-test and behavioral intentions (post-test only were tested using McNemar tests of marginal frequencies of two binary outcomes or paired t-tests, and multivariable linear regression. Qualitative interviews were conducted among target audiences to triangulate survey findings and make recommendations on the design of messages. Results Respondents (N = 122 reflected the target population regarding income, educational level and prevalence of household health conditions. (1 Knowledge. Significant increases in knowledge were found regarding: groups that are most vulnerable to heat (children [p < 0.001], individuals with heart disease [p < 0.001], or lung disease [p = 0.019]; and environmental conditions that increase allergy-producing pollen (increased heat [p = 0.003], increased carbon dioxide [p < 0.001]. (2 Strength of certainty that climate change is happening increased significantly between pre- and post-test (p < 0.001, as did belief that climate change affected respondents’ health (p < 0.001. (3 Behavioral intention. At post-test, higher knowledge of heat vulnerabilities and environmental conditions that trigger pollen

  15. The Effects of Housing on Health and Health Risks in an Aging Population: A Qualitative Study in Rural Thailand

    Directory of Open Access Journals (Sweden)

    Ratana Somrongthong

    2014-01-01

    Full Text Available Background. Over the last decade, Thailand has experienced an aging population, especially in rural areas. Research finds a strong, positive relationship between good quality housing and health, and this paper assesses the impact and living experience of housing of older people in rural Thailand. Methods. This was a mixed-method study, using data from observations of the physical adequacy of housing, semistructured interviews with key informants, and archival information from health records for 13 households in rural Thailand. Results. There were four main themes, each of which led to health risks for the older people: “lighting and unsafe wires,” “house design and composition,” “maintenance of the house,” and “health care equipment.” The housing was not appropriately designed to accommodate health care equipment or to fully support individual daily activities of older people. Numerous accidents occurred as a direct result of inadequate housing and the majority of houses had insufficient and unsafe lighting, floor surfaces and furniture that created health risks, and toilets or beds that were at an unsuitable height for older people. Conclusion. This paper provides an improved and an important understanding of the housing situation among older people living in rural areas in Thailand.

  16. Working Group 7.0 Environmental Transport and Health Effects, Chernobyl Studies Project. Progress report, October 1994 -- March 1995

    International Nuclear Information System (INIS)

    Anspaugh, L.R.; Hendrickson, S.M.

    1995-01-01

    This document presents the details from the working group 7.0 Chernobyl Studies Project. This working group looked at the environmental transport and health effects from the fallout due to the meltdown of Chernobylsk-4 reactor. Topics include: hydrological transport; chromosome painting dosimetry; EPR, TL and OSL dosimetry; stochastic effects; thyroid studies; and leukemia studies

  17. 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

  18. The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: a longitudinal study before and during the financial crisis.

    Science.gov (United States)

    Drydakis, Nick

    2015-03-01

    The current study uses six annual waves of the Longitudinal Labor Market Study (LLMS) covering the 2008-2013 period to obtain longitudinal estimations suggesting statistically significant negative effects from unemployment on self-reported health and mental health in Greece. The specifications suggest that unemployment results in lower health and the deterioration of mental health during the 2008-2009 period compared with the 2010-2013 period, i.e., a period in which the country's unemployment doubled as a consequence of the financial crisis. Unemployment seems to be more detrimental to health/mental health in periods of high unemployment, suggesting that the unemployment crisis in Greece is more devastating as it concerns more people. Importantly, in all specifications, comparable qualitative patterns are found by controlling for unemployment due to firm closure, which allows us to minimize potential bias due to unemployment-health related reverse causality. Moreover, in all cases, women are more negatively affected by unemployment in relation to their health and mental health statuses than are men. Greece has been more deeply affected by the financial crisis than any other EU country, and this study contributes by offering estimates for before and during the financial crisis and considering causality issues. Because health and mental health indicators increase more rapidly in a context of higher surrounding unemployment, policy action must place greater emphasis on unemployment reduction and supporting women's employment. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2012-01-01

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

  20. The effects of outdoor air pollution on the respiratory health of Canadian children: A systematic review of epidemiological studies.

    Science.gov (United States)

    Rodriguez-Villamizar, Laura Andrea; Magico, Adam; Osornio-Vargas, Alvaro; Rowe, Brian H

    2015-01-01

    Outdoor air pollution is a global problem with serious effects on human health, and children are considered to be highly susceptible to the effects of air pollution. To conduct a comprehensive and updated systematic review of the literature reporting the effects of outdoor air pollution on the respiratory health of children in Canada. Searches of four electronic databases between January 2004 and November 2014 were conducted to identify epidemiological studies evaluating the effect of exposure to outdoor air pollutants on respiratory symptoms, lung function measurements and the use of health services due to respiratory conditions in Canadian children. The selection process and quality assessment, using the Newcastle-Ottawa Scale, were conducted independently by two reviewers. Twenty-seven studies that were heterogeneous with regard to study design, population, respiratory outcome and air pollution exposure were identified. Overall, the included studies reported adverse effects of outdoor air pollution at concentrations that were below Canadian and United States standards. Heterogeneous effects of air pollutants were reported according to city, sex, socioeconomic status and seasonality. The present review also describes trends in research related to the effect of air pollution on Canadian children over the past 25 years. The present study reconfirms the adverse effects of outdoor air pollution on the respiratory health of children in Canada. It will help researchers, clinicians and environmental health authorities identify the available evidence of the adverse effect of outdoor air pollution, research gaps and the limitations for further research.

  1. Effects of Horticultural Therapy on Psychosocial Health in Older Nursing Home Residents: A Preliminary Study.

    Science.gov (United States)

    Chen, Yuh-Min; Ji, Jeng-Yi

    2015-09-01

    This preliminary study examined the effect of horticultural therapy on psychosocial health in older nursing home residents. A combined quantitative and qualitative design was adopted. Convenience sampling was used to recruit 10 older residents from a nursing home in Taichung, Taiwan. Participants joined a 10-week indoor horticultural program once a week, with each session lasting for about 1.5 hours. A single-group design with multiple measurements was adopted for the quantitative component of this study. Interviews held 1-2 days before the intervention (T0) were used to collect baseline data. The two outcome variables of this study, depression and loneliness, were reassessed during the 5th (T1) and 10th (T2) weeks of the intervention. Generalized estimating equations were used to test the mean differences among T0, T1, and T2 measures. After the 10-week program, qualitative data were collected by asking participants to share their program participation experiences. The results of generalized estimating equation showed significant improvements in depression and loneliness. Four categories emerged from the qualitative data content analysis: social connection, anticipation and hope, sense of achievement, and companionship. Given the beneficial effects of the horticulture therapy, the inclusion of horticultural activities in nursing home activity programs is recommended.

  2. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals.

    Science.gov (United States)

    Gärtner, Fania R; Ketelaar, Sarah M; Smeets, Odile; Bolier, Linda; Fischer, Eva; van Dijk, Frank J H; Nieuwenhuijsen, Karen; Sluiter, Judith K

    2011-05-10

    Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group) with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in both intervention arms will be assessed, and

  3. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    Directory of Open Access Journals (Sweden)

    van Dijk Frank JH

    2011-05-01

    Full Text Available Abstract Background Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS mental module may be an effective strategy to monitor and promote good (mental health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. Methods The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in

  4. Studying health consequences of microchimerism

    DEFF Research Database (Denmark)

    Olsen, J.; Campi, Rita; Frydenberg, Morten

    2003-01-01

    may thus have a health effect beyond the parity effect. A possible design for studying this is to compare health effects for women with or without multiple partners but with the same parity. We compared total and cause specific mortality in these two groups in order to estimate their comparability......Abstract. A pregnancy requires a reasonably good health and may have positive as well as negative health consequences for the woman. Part of these health effects may depend on the immune response to the exchange of fetal cells (microchimerism). The number of biological fathers to a woman’s children...... unlikely that these large differences are entirely related to microchimerism. The study shows that caution is needed when studying health effects of procreation with multiple partners....

  5. Heat stress management program improving worker health and operational effectiveness: a case study.

    Science.gov (United States)

    Huss, Rosalyn G; Skelton, Scott B; Alvis, Kimberly L; Shane, Leigh A

    2013-03-01

    Heat stress monitoring is a vital component of an effective health and safety program when employees work in exceptionally warm environments. Workers at hazardous waste sites often wear personal protective equipment (PPE), which increases the body heat stress load. No specific Occupational Safety and Health Administration (OSHA) regulations address heat stress; however, OSHA does provide several guidance documents to assist employers in addressing this serious workplace health hazard. This article describes a heat stress and surveillance plan implemented at a hazardous waste site as part of the overall health and safety program. The PPE requirement for work at this site, coupled with extreme environmental temperatures, made heat stress a significant concern. Occupational health nurses and industrial hygienists developed a monitoring program for heat stress designed to prevent the occurrence of significant heat-related illness in site workers. The program included worker education on the signs of heat-related illness and continuous physiologic monitoring to detect early signs of heat-related health problems. Biological monitoring data were collected before workers entered the exclusion zone and on exiting the zone following decontamination. Sixty-six site workers were monitored throughout site remediation. More than 1,700 biological monitoring data points were recorded. Outcomes included improved worker health and safety, and increased operational effectiveness. Copyright 2013, SLACK Incorporated.

  6. 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

  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

    2016-01-01

    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

  8. 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

  9. 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

  10. The Effect of Active Creation on Psychological Health: A Feasibility Study on (Therapeutic Mechanisms

    Directory of Open Access Journals (Sweden)

    Gudrun Lange

    2018-02-01

    Full Text Available Creation is an important part of many interventions in creative arts therapies (art, music, dance, and drama therapy. This active part of art-making in arts therapies has not yet been closely investigated. The present study commits to this field of research using a mixed-methods design to investigate the effects of active creation on health-related psychological outcomes. In an artistic inquiry within an experimental design, N = 44 participants engaged in active art-making for eight minutes in the presence of the researcher (first author with a choice of artistic materials: paper and colors for drawing and writing, musical instruments, space for moving or performing. Before and after the creation, participants completed a well-being, a self-efficacy and an experience of creation scale, and in addition found their own words to express the experiences during the activity. We hypothesized that the experience of empowerment, freedom, impact, and creativity (Experience of Creation Scale mediates the positive effect of active creation on the outcomes of self-efficacy and well-being, and evaluated this assumption with a mediation analysis. Results suggest that the effect of active creation on both self-efficacy and well-being is significantly mediated by the Experience of Creation Scale. This article focuses on the quantitative side of the investigation. During the process, qualitative and quantitative results were triangulated for a more valid evaluation and jointly contribute to the emerging theory frame of embodied aesthetics.

  11. The Effect of Active Creation on Psychological Health: A Feasibility Study on (Therapeutic) Mechanisms.

    Science.gov (United States)

    Lange, Gudrun; Leonhart, Rainer; Gruber, Harald; Koch, Sabine C

    2018-02-12

    Creation is an important part of many interventions in creative arts therapies (art, music, dance, and drama therapy). This active part of art-making in arts therapies has not yet been closely investigated. The present study commits to this field of research using a mixed-methods design to investigate the effects of active creation on health-related psychological outcomes. In an artistic inquiry within an experimental design, N = 44 participants engaged in active art-making for eight minutes in the presence of the researcher (first author) with a choice of artistic materials: paper and colors for drawing and writing, musical instruments, space for moving or performing. Before and after the creation, participants completed a well-being, a self-efficacy and an experience of creation scale, and in addition found their own words to express the experiences during the activity. We hypothesized that the experience of empowerment, freedom, impact, and creativity (Experience of Creation Scale) mediates the positive effect of active creation on the outcomes of self-efficacy and well-being, and evaluated this assumption with a mediation analysis. Results suggest that the effect of active creation on both self-efficacy and well-being is significantly mediated by the Experience of Creation Scale. This article focuses on the quantitative side of the investigation. During the process, qualitative and quantitative results were triangulated for a more valid evaluation and jointly contribute to the emerging theory frame of embodied aesthetics.

  12. Long term effects of preventive activities of youth health care in The Netherlands: results of a four-part study

    Directory of Open Access Journals (Sweden)

    Pieter A. Wiegersma

    2004-12-01

    Full Text Available

    Background. In this article the results are presented of a four part study on the effect of screening for scoliosis and (repeated well-care visits and freely accessible consultation hours at secondary schools, on the incidence and prevalence of (parasuicide, mental health, adolescent health compromising behaviour and lastly obesity.

    Methods. An ecologic case-referent study design was used with data from the Netherlands Bureau of Statistics, the Ministry of Defence, the 1992 High-School Student Study, all of the youth health care departments in The Netherlands and relevant censuses.

    Results. Attention to mental and physical health and health compromising behaviour, either during screening, open consultation hours or during well-care visits seems to be ineffective and in some instances even detrimental to youth health.

    Of the 18 different outcome measurements, 5 were significantly negative and none were significantly positive.

    Conclusions. This four part study does not support the hypothesis that on a population level, the preventive activities of youth health care departments such as screening for scoliosis, (more frequent well-care visits or offering open consultation hours at secondary schools, have a beneficial effect on prevention of (parasuicide, poor mental health, health compromising behaviour or obesity.

  13. Proposal for health effects studies related to nuclear weapon testing at Semipalatinsk, Kazakhstan

    International Nuclear Information System (INIS)

    Peterson, L.E.; Weinberg, A.D.

    1997-01-01

    Populations that resided and who now resid in and the Semipalatinsk Test Site have emained there for decades and experienced little in and out migration. Semipalatinsk City was literally a secret city until the dissolution of the USSR. The urban population of the city of Semipalatinsk has steadily grown from several hundred thousand to about 1 million people in the area. Although current urban and rural levels of exposure from environmental radiocontamination are not markedly increased beyond natural background, there are many villagers who resided near the Semipalatinsk Test Site whose cumulative lifetime doses are on the order of 0.8-2 Sv. Over the course of 40 years, more than 470 nuclear weapons were tested at the Semipalatinsk Test Site (STS) in the Semipalatinsk region of Kazakhstan. From 1949 to 1963, 38 detonations occured on the ground and 128 in the air. Radionuclides emanating from there tests resulted in atmospheric and enviromental contamination leading to varios levels of acute and chronic radiation exposure. The medical, scientific and social ramifications of the nuclear testing pose serius challenges to the Kazakhstan Repubic and its scientific and health care systems. The release of radionuclides over a long period of time and their spread in the enveronment posed major problems to the Kazakhstan authorities. Efforts to study the association between fallout radiation and radiation-induced health effects were prevented by official decree until 1980. Initially, efforts to address the medical and scientific challenges of the radioactive contamination which was classified in the FSU. After the dissolution of the FSU, efforts to study populations aroud STS were hampered and further encumbered by the political and social changes that increased sharply in the FSU soon after test suspension

  14. Health Effects Study of Nuclear Industry Workers in Japan: Results of the Second Analysis

    International Nuclear Information System (INIS)

    Murata, M.; Ohshima, S.; Miyake, T.; Yamagishi, C.; Kaneko, M.; Matsudaira, H.

    2001-01-01

    Full text: A cohort study of nuclear industry workers in Japan was initiated in 1990 aiming to clarify health effects of low dose radiation. About 24 000 male workers were followed up by using municipal residence registration records. About 176,000 subjects were successfully followed up and 5527 deaths were detected during the observation period of 1986 through 1997. Underlying causes of death were identified by record linkage with magnetic tapes of National Vital Statistics. The collective dose of the study population was about 2109 person-Sv. Both external and internal comparisons were made. For external comparisons, standardised mortality ratios (SMRs) were calculated with Japanese males as the reference population. For internal comparisons, trend analyses of death rates were done against cumulative radiation dose. SMRs (95% confidence interval) were 0.90 (0.87-0.92), 0.80 (0.77-0.84) and 0.94 (0.90-0.98) for all causes, non-malignant diseases and cancers, respectively. These lower SMRs were ascribed to possible healthy worker effects and others. No causes of death showed significantly higher SMRs. With the trend analyses, neither death rates for cancer of all sites nor for leukemia showed positive correlations with radiation dose, while significantly positive correlations were found for cancers of the esophagus (p<0.05) and the stomach (p<0.01), and also for the external causes (p<0.001). Besides this study, we conducted life style studies for some (about 49,000) of those workers. Both smoking and drinking habits were positively correlated with cumulative radiation doses. Thus we consider that these life styles can be an important factor which affects the present results. (author)

  15. Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies

    Science.gov (United States)

    2016-01-01

    This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment. PMID:27365998

  16. Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies.

    Science.gov (United States)

    Song, Dae Jong; Choi, Jae Wook; Kim, Kyunghee; Kim, Min Soo; Moon, Jiwon Monica

    2016-07-01

    This experimental study examined differences in doctor-patient relationships according to the health communication strategies during cases of medical malpractices occurred at primary medical institution. A total of 116 subjects aged in their 20s-50s was sampled. The first medical malpractice scenario chosen was the medical malpractice case most frequently registered at the Korean Medical Association Mutual Aid and the second scenario was associated with materials and devices as the cause of malpractice. Four types of crisis communication strategy messages were utilized, consisting of denial, denial + ingratiation, apology, and apology + ingratiation. Subjects were classified into four research groups by crisis communication strategy to measure levels of trust, control mutuality, commitment, and satisfaction, before and after the occurrence of medical malpractice and application of communication strategies. The findings of this study revealed that the apology strategy, compared with the denial strategy, showed a smaller difference before and after the application of communication strategies in all variables of trust (F = 8.080, F = 5.768), control mutuality (F = 8.824, F = 9.081), commitment (F = 9.815, F = 8.301), and satisfaction (F = 8.723, F = 5.638). Further, a significant interaction effect was shown between variables. The apology strategy, compared with the denial strategy, was effective in the improvement of doctor-patient relationships in both Scenarios I and II. For Scenario I, the apology strategy without ingratiation boosted commitment and satisfaction, but for Scenario II, utilizing the apology strategy with ingratiation boosted the effectiveness of trust and commitment.

  17. Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa.

    Science.gov (United States)

    Ackatia-Armah, Nana M; Addy, Nii Antiaye; Ghosh, Shibani; Dubé, Laurette

    2016-06-01

    As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers' "reflective trust" in community health nurses develops as a key influencer in their health-related decision-making and behavior. Between December 2012 and June 2013, our ethnographic study gathered data in three adjacent rural and semi-rural communities in Ghana's Eastern Region, using interviews with 39 nursing mothers, three focus groups - with mothers, health-workers, and community leaders - as well as 941 h of participant observation. We focused on interactions between mothers and nurses, highlighting tensions between communities' traditions and messages that nurses bring, which are often based on modern science. We also investigated how mothers come to exhibit reflective trust in the nurses to make sense of traditional and scientific knowledge on infant feeding, and integrate them into their own feeding decisions. Our findings have global implications for effectively sustaining and scaling health and nutrition efforts through community approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Effect of yoga on mental health: Comparative study between young and senior subjects in Japan

    Directory of Open Access Journals (Sweden)

    Derebail Gururaja

    2011-01-01

    Conclusion: Decrease in Salivary amylase activity may be due to reduction in sympathetic response. Reduction in State and Trait anxiety score signifies that yoga has both immediate as well as long-term effect on anxiety reduction. Thus yoga helps to improve the mental health in both the groups.

  19. Effect of anti-asthmatic drugs on dental health: A comparative study

    Directory of Open Access Journals (Sweden)

    P Chellaih

    2016-01-01

    Full Text Available Aims: Bronchial asthma constitutes important problem worldwide. This chronic lung disease has detrimental effect in the oral cavity like reduction of salivary secretion, change in salivary composition and pH. Materials and Methods: This study was conducted to compare the prevalence of dental caries in asthmatic children and healthy children, and also to evaluate the correlation between the Streptococcus mutans , Lactobacillus and dental caries in both the groups. Results: In this study, the mean decayed, missing, filled teeth score of children in the study group was (4.53 ± 3.38 higher than the control group (1.51 ± 1.58 (P < 0.01. The S. mutans count of the study group was (59574.47 ± 28510.67 higher than the control group (19777.78 ± 17899.83 P < 0.01. The Lactobacillus count in study group was (43553.19 ± 58776.96 higher than the control group (8843.84 ± 7982.72 P < 0.01. Subjects using inhaled corticosteroids were more prone to develop dental caries than the control group with odds ratio = 6.26 and 95% confidence interval. Conclusions: The dental caries prevalence increases with the usage of β2agonist and corticosteroid inhalers for the treatment of asthma. Thus in asthmatic children, increase in caries prevalence might be due to the drug treatment and not due to the disease by itself. It can be concluded that asthmatic children have a higher prevalence of dental caries than healthy children. Hence, special oral health care is needed for asthmatic children.

  20. The effects of umbilical cord entanglement upon labor management and fetal health: retrospective case control study.

    Science.gov (United States)

    Buyukkayaci Duman, Nuriye; Topuz, Senay; Bostanci, Mehmet Omer; Gorkem, Umit; Yuksel Kocak, Derya; Togrul, Cihan; Gungor, Tayfun

    2018-03-01

    This retrospective study aimed at determining prognostic factors that paved the way for umbilical cord entanglement (UCE) and the effects of UCE upon labor management and fetal health. Sixty women who gave term birth with head presentation and received UCE diagnosis following birth composed the case group while another 60 women with the same characteristics who were selected with randomized sampling method and who did not develop UCE comprised the control group. The data obtained were processed with SPSS 22.0 statistical program. T test was used for comparing demographic and obstetric data and mean birth weight of babies in the case group and control group. For comparing data on active labor management and fetal health, numbers, percentages and chi-square test were used. Also for comparing values case: 58.3.0%; control: 21.7%), vacuum assisted vaginal delivery (case: 20.0%; control: 3.3%), forceps assisted vaginal delivery (case: 8.3%; control: 1.7%), fetal distress (case: 60.0%; control: 25.0%), amniotic fluid meconium (case: 58.3%; control: 21.7%), APGAR score less than 7 at the 1st minute (case: 58.3%; control: 21.7%) and APGAR score less than 7 at the 5th minute were higher in the women in the case group than the women in the control group (p < 0.05). UCE increased rates of interventional birth, emergent cesarean delivery, vacuum assisted vaginal delivery, forceps assisted vaginal delivery, amniotic fluid meconium and fetal distress.

  1. The Effect of a Community Health Worker Utilized Mobile Health Application on Maternal Health Knowledge and Behavior: A Quasi-Experimental Study

    Directory of Open Access Journals (Sweden)

    Onaedo Ilozumba

    2018-05-01

    Full Text Available BackgroundMobile technology (mHealth is increasingly being used to achieve improved access and quality of maternal care, particularly in rural areas of low- and middle-income countries. In 2011, a mobile application—Mobile for Mothers (MfM—was implemented in Jharkhand, India to support home visits by community health workers. The objective of this study is to assess the impact of the mHealth intervention on maternal health.MethodsHouseholds from three subdistricts in the Deoghar district of Jharkhand were selected using a multistage cluster sampling approach. Households from the Sarwan subdistrict received the MfM intervention, those from Devipur subdistrict received other interventions asides MfM from the implementing non-governmental organization (NGO, while households from Mohanpur subdistrict received the current standard of care. Women (n = 2,200 between the ages of 18 and 45 who had delivered a baby in the past 1 year were enrolled into the study. The primary outcomes of interest were maternal health knowledge, antenatal care (ANC attendance, and delivery in a health facility.ResultsPost-intervention, women in the MfM group had higher maternal health knowledge, were more likely to attend four or more ANC visits, and deliver at the health facility when compared with the NGO and standard care group. After controlling for predictors, women in the intervention group significantly performed better than both the NGO and standard care groups on all three-outcome variables (all P > 0.05.ConclusionThe results indicate that although the MfM mHealth intervention could influence adherence and practice of recommended maternal health behaviors, it could not overcome key sociocultural determinants of maternal health such as caste and educational status, which are specific to the Indian context. mHealth holds continued promise for maternal health but implementers and policy makers must additionally address health system and sociocultural

  2. A longitudinal study of health effects of in utero radiation exposure from the Chernobyl accident

    International Nuclear Information System (INIS)

    Dardynskaya, I.; Hryhorczuk, D.; Anspaugh, L.R.; Khrouch, V.T.; Gavrilin, Y.I.; Shinkarev, S.M.; Dardynskiy, O.

    2002-01-01

    1500 children who were born between April 26, 1986, and December 31, 1987 (Study Groups 1 and 2) were identified from lists of children undergoing mandatory surveillance in the Minsk Chernobyl Dispensary. During pregnancy mothers of these children lived in highly contaminated territories in several areas of three Belarus Regions - Gomel, Mogilev, and Brest. Children in Study Group 1 were born between April 26, 1986, and January 31, 1987. The mothers of these children during their pregnancy period were exposed both to radiocesium and radioiodine. Children in Study Group 2 were born between February 1, 1987 and December 31, 1987. The mothers of children from Study Group 2 lived in the same areas as the mothers of children from Study Group 1, but during their pregnancy period were mainly exposed to radiocesium. The Control Group consists of children born between April 26, 1986, and December 31, 1987, to mothers living throughout pregnancy in the uncontaminated Vitebsk Region. These children were randomly selected from medical records of family-practice clinics, and were matched to Study Groups 1 and 2 by age and sex. To assess the health effects of in utero radiation exposure among the cohort, the specific protocol for annual health examination was developed in 1988. The study protocol included collection of data on family history; history of mothers pregnancy and delivery; head circumference at birth; annual measurements of standing height and weight; examination by neurologist; clinical thyroid evaluation, and ultrasound examination of the thyroid; annual measurements of levels of thyroid hormones and antibodies in children's blood (i.e. thyrotropin (TSH), total and free thyroxin (T4), triiodthyronin (T3), thyroglobulin (TG) and TG autoantibodies, thyroid binding globulin (TBG), and anti-TPO (thyroid microsomal )assay; annual blood count; analyses of the components of the immune system (T- cells, B-cells, immunoglobulins, complement, etc.); and data on general

  3. Effectiveness of "Step into Health" program in Qatar: a pedometer-based longitudinal study.

    Science.gov (United States)

    Al-Kuwari, Mohamed G; Al-Mohannadi, Abdulla S; Sayegh, Suzan

    2017-11-01

    This study examines the impact of a one-year pedometer-based intervention on increasing the physical activity level among adult population in Qatar. This longitudinal study was conducted over a one-year period and included a total of 268 adults aged between 18-64 years old. Data were extracted and used from the "Step into Health" (SIH) program, a community-based program launched in 2012, as an approach to improve physical activity in Qatar. Walking intervention encouraged members of SIH to accumulate 10,000 steps or more per day and monitor their progress through a pedometer supported by a self-monitoring online account and a reinforcement system. This study shows a significant increase in average daily steps from 3933±3240 steps/day at baseline into 7507±5416 steps/week at the 12th month (P<0.001). It was found that 18.6% of participants met the daily target of 10,000 steps or more; however, there was a considerable increase of 39.2% by the 12th month. Females showed an increase in their physical activity; still, they remain less active than males. It was found that non-Arabs subgroup were more active than Arabs. Interestingly, older members (≥50 years old) were more active throughout the study period. Pedometer program was found to be effective in increasing the level of physical activity among participants. A decline in physical activity has been observed during hot weather, while re-enforcement campaign had a positive impact on the number of steps/day.

  4. Persistence of the effect of the Lung Health Study (LHS) smoking intervention over eleven years.

    Science.gov (United States)

    Murray, Robert P; Connett, John E; Rand, Cynthia S; Pan, Wei; Anthonisen, Nicholas R

    2002-10-01

    Research on the long-term persistence of effects of interventions aimed at smoking cessation is limited. This paper examined the quitting behavior of individuals who were randomized to a smoking cessation intervention (SI) or to usual care (UC), at a point approximately 11 years later. The initial sample consisted of 5,887 adult smokers in 10 clinics who had evidence of airways obstruction. Two-thirds of the original participants were offered an intensive 12-week smoking cessation intervention. Of these, 4,517 were enrolled in the long-term follow-up study. Randomized group assignment was a strong predictor of smoking behavior after 11 years, in that 21.9% of SI participants and only 6.0% of UC participants maintained abstinence throughout the interval. Logistic regressions identified covariates associated with abstinence. A higher proportion of abstinence was observed in participants that had been assigned to SI (OR = 4.45), were older (OR = 1.11, increment 5 years), had more years of education (OR = 1.05), and fewer cigarettes/day at baseline (OR = 0.90, increment 10 cigarettes). Smokers exposed to an aggressive smoking intervention program and who sustain abstinence for a five-year period are very likely to still be abstinent after 11 years. Copyright 2002 American Health Foundation and Elsevier Science (USA)

  5. Research Review: Environmental exposures, neurodevelopment, and child mental health - new paradigms for the study of brain and behavioral effects.

    Science.gov (United States)

    Rauh, Virginia A; Margolis, Amy E

    2016-07-01

    Environmental exposures play a critical role in the genesis of some child mental health problems. We open with a discussion of children's vulnerability to neurotoxic substances, changes in the distribution of toxic exposures, and cooccurrence of social and physical exposures. We address trends in prevalence of mental health disorders, and approaches to the definition of disorders that are sensitive to the subtle effects of toxic exposures. We suggest broadening outcomes to include dimensional measures of autism spectrum disorders, attention-deficit hyperactivity disorder, and child learning capacity, as well as direct assessment of brain function. We consider the impact of two important exposures on children's mental health: lead and pesticides. We argue that longitudinal research designs may capture the cascading effects of exposures across biological systems and the full-range of neuropsychological endpoints. Neuroimaging is a valuable tool for observing brain maturation under varying environmental conditions. A dimensional approach to measurement may be sensitive to subtle subclinical toxic effects, permitting the development of exposure-related profiles and testing of complex functional relationships between brain and behavior. Questions about the neurotoxic effects of chemicals become more pressing when viewed through the lens of environmental justice. Reduction in the burden of child mental health disorders will require longitudinal study of neurotoxic exposures, incorporating dimensional approaches to outcome assessment, and measures of brain function. Research that seeks to identify links between toxic exposures and mental health outcomes has enormous public health and societal value. © 2016 Association for Child and Adolescent Mental Health.

  6. An empirical study of mHealth adoption in a developing country: the moderating effect of gender concern.

    Science.gov (United States)

    Hoque, Md Rakibul

    2016-05-03

    mHealth has become a valuable tool for providing health care services in developing countries. Despite the potential benefits of mHealth, its adoption remains a very challenge in developing countries like Bangladesh. The aim of this study is to investigate the factors that affect the adoption of mHealth services in Bangladesh using Extended Technology Acceptance Model (TAM). Data were collected from over 250 respondents in Dhaka, Bangladesh. The data were analyzed using the Partial Least Squares (PLS) method, a statistical analysis technique based on the Structural Equation Modeling (SEM). The study found that perceived ease of use, perceived usefulness and subjective norm (p mHealth services. Surprisingly, the effects of personal innovativeness in IT (p > 0.05) on mHealth adoption were insignificant. This study also revealed that gender was strongly associated with the adoption and use of mHealth in developing countries. The findings of this study can be used by government, policy makers, and mobile phone Company to maximize the acceptance of mHealth services in Bangladesh. The paper concludes with a discussion of research results and draws several implications for future research.

  7. Study on indoor radon exposure and its effect on human health

    International Nuclear Information System (INIS)

    Lu Xinwei

    2005-01-01

    Radon and its daughters relate to people health. Radon widely exists in the nature. The paper discusses the source, exposure and activity level of indoor radon, systematically analyzes the hazards and dose-response of residential radon exposure, and at last indicates the concrete method of controlling residential radon concentration. By interdicting radon pollution source and ventilation might effectively reduce indoor radon concentration and improve environmental air quality. (authors)

  8. EC multicentre study on short-term effects of air pollution on health. The aphea project

    Energy Technology Data Exchange (ETDEWEB)

    Katsouyanni, K [Univ. of Athens (Greece). Medical School; Zmirou, D [Grenoble Univ. (France). Faculte de Medecine; Spix, C [GSF- Forschungszentrum Umwelt und Gesundheit (Germany)

    1996-12-31

    The APHEA project is an attempt to provide quantitative estimates of the short-term health effects of air pollution, using an extensive data base from ten different European countries which represent various social, environmental and air pollution situations. Within the framework of the project, the methodology of analyzing epidemiologic time series data, as well as that of performing meta-analysis, are further developed and standardized

  9. EC multicentre study on short-term effects of air pollution on health. The aphea project

    Energy Technology Data Exchange (ETDEWEB)

    Katsouyanni, K. [Univ. of Athens (Greece). Medical School; Zmirou, D. [Grenoble Univ. (France). Faculte de Medecine; Spix, C. [GSF- Forschungszentrum Umwelt und Gesundheit (Germany)

    1995-12-31

    The APHEA project is an attempt to provide quantitative estimates of the short-term health effects of air pollution, using an extensive data base from ten different European countries which represent various social, environmental and air pollution situations. Within the framework of the project, the methodology of analyzing epidemiologic time series data, as well as that of performing meta-analysis, are further developed and standardized

  10. Measuring the effect of intimate partner violence on health-related quality of life: a qualitative focus group study

    Directory of Open Access Journals (Sweden)

    Thomas Kristie A

    2007-12-01

    Full Text Available Abstract Background Health related quality of life (HRQOL can be measured by a wide range of instruments, many of which have been designed for specific conditions or uses. "Preference-based" measures assess the value individuals place on health, and are included in economic evaluations of treatments and interventions (such as cost effectiveness analysis. As economic evaluation becomes more common, it is important to assess the applicability of preference-based health related quality of life (HRQOL measures to public health issues. This study investigated the usefulness of such instruments in the context of intimate partner violence (IPV, a public health concern that that can seriously affect quality of life. Methods The study consisted of focus groups with abused women to determine the aspects of life affected by IPV, and an analysis of existing HRQOL measures. Eight focus groups (n = 40 were conducted in which participants discussed the domains of health affected by IPV. Results were content analyzed and compared with the domains of health included in four commonly-used, preference-based HRQOL measures. Results The average focus group participant was 43 years old, unemployed, African American, with 3 children. Domains of health reported to be affected by IPV included physical functioning, emotional and psychological functioning, social functioning and children's functioning. Psychological health was the most severely affected domain. The Short Form 36, the Health Utilities Index, the EuroQol 5D, and the Quality of Well-being Scale were found to vary in the degree to which they include domains of health important in IPV. Psychological health is included to a limited extent, and the spill-over effect of a condition on other family members, including children, is not included at all. Conclusion Emotional and psychological health plays an important role in the overall HRQOL of abused women but is relatively underemphasized in preference-based HRQOL

  11. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts

    Directory of Open Access Journals (Sweden)

    Wang Hong

    2011-01-01

    Full Text Available Abstract Background One of the key functions of health insurance is to provide financial protection against high costs of health care, yet evidence of such protection from developing countries has been inconsistent. The current study uses the case of Ghana to contribute to the evidence pool about insurance's financial protection effects. It evaluates the impact of the country's National Health Insurance Scheme on households' out-of-pocket spending and catastrophic health expenditure. Methods We use data from a household survey conducted in two rural districts, Nkoranza and Offinso, in 2007, two years after the initiation of the Ghana National Health Insurance Scheme. To address the skewness of health expenditure data, the absolute amount of out-of-pocket spending is estimated using a two-part model. We also conduct a probit estimate of the likelihood of catastrophic health expenditures, defined at different thresholds relative to household income and non-food consumption expenditure. The analysis controls for chronic and self-assessed health conditions, which typically drive adverse selection in insurance. Results At the time of the survey, insurance coverage was 35 percent. Although the benefit package of insurance is generous, insured people still incurred out-of-pocket payment for care from informal sources and for uncovered drugs and tests at health facilities. Nevertheless, they paid significantly less than the uninsured. Insurance has been shown to have a protective effect against the financial burden of health care, reducing significantly the likelihood of incurring catastrophic payment. The effect is particularly remarkable among the poorest quintile of the sample. Conclusions Findings from this study confirm the positive financial protection effect of health insurance in Ghana. The effect is stronger among the poor group than among general population. The results are encouraging for many low income countries who are considering a

  12. Effect on attendance by including focused information on spirometry in preventive health checks: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ørts, Lene Maria; Løkke, Anders; Bjerregaard, Anne-Louise; Maindal, Helle Terkildsen; Sandbæk, Annelli

    2016-12-01

    Early detection of lung diseases can help to reduce their severity. Lung diseases are among the most frequently occurring and serious diseases worldwide; nonetheless, many patients remain undiagnosed. Preventive health checks including spirometry can detect lung diseases at early stages; however, recruitment for health checks remains a challenge, and little is known about what motivates the attendance. The aim of the study is to examine whether focused information on spirometry in the invitation compared to general information will impact the attendance rate in preventive health checks. This randomized, controlled trial tests the effect of information on spirometry embedded in the Check your Health Preventive Program (CHPP). The CHPP is an open-label, household cluster-randomized, controlled trial offering a preventive health check to 30- to -49-year-olds in a Danish municipality from 2012 to 2017 (n = 26,216). During 2015-2016, 4356 citizens aged 30-49 years will be randomized into two groups. The intervention group receives an invitation which highlights the value and contents of spirometry as part of a health check and information about lung diseases. The comparison group receives a standard invitation containing practical information and specifies the contents of the general health check. Outcomes are (1) differences in attendance rates measured by the proportion of citizens attending each of the two study groups and (2) proportion of persons at risk defined by smoking status and self-reported lung symptoms in the study groups. The proportion of participants with abnormal spirometry assessed at the preventive health check will be compared between the two study groups. The results from the present study will inform future recruitment strategies to health checks. The developed material on content, value, and information about lung disease is feasible and transferable to other populations, making it easy to implement if effective. ClinicalTrials.gov: NCT

  13. The Sociological Study of the Effect of Family Structure on Social Health of Males

    Directory of Open Access Journals (Sweden)

    Naima Mohammadi

    Full Text Available Social health depends on different social and cultural factors. One of the most important suppliers of individual’s health is family structures and relations. In recent years due to functional changes in polygamous structure, there are threats against social health of men in Sarbaz city. In this research, to compare the rate of social health of men in polygamous and monogamous families in Sarbaz city we use a standard questionnaire of Shapiro & Keyes (2007. The population of this study consisted of 300 males who are residents of this city. They selected by using cluster sampling method. Gathered data were analyzed using SPSS software version 22. Findings from independent T-Test revealed that the average of social Coherence, Integration, Contribution and Actualization between men in polygamous families were significantly lower than monogamous. Based on these findings, we can conclude however a lot of traditional social customs were useful, functional and compatible and provide social acceptance, but today have become dysfunctional and threated social health of family members and community system face with crisis.

  14. Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

    Science.gov (United States)

    Angevine, Peter D; Berven, Sigurd

    2014-10-15

    Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

  15. Seasonal effects on great ape health: a case study of wild chimpanzees and Western gorillas.

    Directory of Open Access Journals (Sweden)

    Shelly Masi

    Full Text Available Among factors affecting animal health, environmental influences may directly or indirectly impact host nutritional condition, fecundity, and their degree of parasitism. Our closest relatives, the great apes, are all endangered and particularly sensitive to infectious diseases. Both chimpanzees and western gorillas experience large seasonal variations in fruit availability but only western gorillas accordingly show large changes in their degree of frugivory. The aim of this study is to investigate and compare factors affecting health (through records of clinical signs, urine, and faecal samples of habituated wild ape populations: a community (N = 46 individuals of chimpanzees (Pan troglodytes in Kanyawara, Kibale National Park (Uganda, and a western gorilla (G. gorilla group (N = 13 in Bai Hokou in the Dzanga-Ndoki National Park (Central African Republic. Ape health monitoring was carried out in the wet and dry seasons (chimpanzees: July-December 2006; gorillas: April-July 2008 and December 2008-February 2009. Compared to chimpanzees, western gorillas were shown to have marginally greater parasite diversity, higher prevalence and intensity of both parasite and urine infections, and lower occurrence of diarrhea and wounds. Parasite infections (prevalence and load, but not abnormal urine parameters, were significantly higher during the dry season of the study period for western gorillas, who thus appeared more affected by the large temporal changes in the environment in comparison to chimpanzees. Infant gorillas were the most susceptible among all the age/sex classes (of both apes having much more intense infections and urine blood concentrations, again during the dry season. Long term studies are needed to confirm the influence of seasonal factors on health and parasitism of these great apes. However, this study suggest climate change and forest fragmentation leading to potentially larger seasonal fluctuations of the environment may affect

  16. Networking between community health programs: a case study outlining the effectiveness, barriers and enablers

    Directory of Open Access Journals (Sweden)

    Grills Nathan J

    2012-07-01

    Full Text Available Abstract Background In India, since the 1990s, there has been a burgeoning of NGOs involved in providing primary health care. This has resulted in a complex NGO-Government interface which is difficult for lone NGOs to navigate. The Uttarakhand Cluster, India, links such small community health programs together to build NGO capacity, increase visibility and better link to the government schemes and the formal healthcare system. This research, undertaken between 1998 and 2011, aims to examine barriers and facilitators to such linking, or clustering, and the effectiveness of this clustering approach. Methods Interviews, indicator surveys and participant observation were used to document the process and explore the enablers, the barriers and the effectiveness of networks improving community health. Results The analysis revealed that when activating, framing, mobilising and synthesizing the Uttarakhand Cluster, key brokers and network players were important in bridging between organisations. The ties (or relationships that held the cluster together included homophily around common faith, common friendships and geographical location and common mission. Self interest whereby members sought funds, visibility, credibility, increased capacity and access to trainings was also a commonly identified motivating factor for networking. Barriers to network synthesizing included lack of funding, poor communication, limited time and lack of human resources. Risk aversion and mistrust remained significant barriers to overcome for such a network. Conclusions In conclusion, specific enabling factors allowed the clustering approach to be effective at increasing access to resources, creating collaborative opportunities and increasing visibility, credibility and confidence of the cluster members. These findings add to knowledge regarding social network formation and collaboration, and such knowledge will assist in the conceptualisation, formation and success of

  17. Networking between community health programs: a case study outlining the effectiveness, barriers and enablers.

    Science.gov (United States)

    Grills, Nathan J; Robinson, Priscilla; Phillip, Maneesh

    2012-07-19

    In India, since the 1990s, there has been a burgeoning of NGOs involved in providing primary health care. This has resulted in a complex NGO-Government interface which is difficult for lone NGOs to navigate. The Uttarakhand Cluster, India, links such small community health programs together to build NGO capacity, increase visibility and better link to the government schemes and the formal healthcare system. This research, undertaken between 1998 and 2011, aims to examine barriers and facilitators to such linking, or clustering, and the effectiveness of this clustering approach. Interviews, indicator surveys and participant observation were used to document the process and explore the enablers, the barriers and the effectiveness of networks improving community health. The analysis revealed that when activating, framing, mobilising and synthesizing the Uttarakhand Cluster, key brokers and network players were important in bridging between organisations. The ties (or relationships) that held the cluster together included homophily around common faith, common friendships and geographical location and common mission. Self interest whereby members sought funds, visibility, credibility, increased capacity and access to trainings was also a commonly identified motivating factor for networking. Barriers to network synthesizing included lack of funding, poor communication, limited time and lack of human resources. Risk aversion and mistrust remained significant barriers to overcome for such a network. In conclusion, specific enabling factors allowed the clustering approach to be effective at increasing access to resources, creating collaborative opportunities and increasing visibility, credibility and confidence of the cluster members. These findings add to knowledge regarding social network formation and collaboration, and such knowledge will assist in the conceptualisation, formation and success of potential health networks in India and other developing world countries.

  18. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    OpenAIRE

    Gärtner, Fania R; Ketelaar, Sarah M; Smeets, Odile; Bolier, Linda; Fischer, Eva; van Dijk, Frank JH; Nieuwenhuijsen, Karen; Sluiter, Judith K

    2011-01-01

    Abstract Background Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective o...

  19. Intimate partner violence and mental health effects: a population-based study among married women in Karachi, Pakistan.

    Science.gov (United States)

    Ali, Tazeen S; Mogren, Ingrid; Krantz, Gunilla

    2013-03-01

    Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated. This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women were interviewed by trained community midwives using a structured questionnaire. In the total population of women, mental symptoms were prevalent. Women subjected to any form of violence reported, however, considerably poorer mental health than unexposed women. A statistically significant difference for almost all of the studied health parameters persisted even after controlling for socio-demographic factors. The strongest associations were found for suicidal thoughts and physical violence (OR 4.41; 3.18-6.12), sexual abuse (OR 4.39; 3.17-6.07) and psychological abuse (OR 5.17; 3.28-8.15). The interviews revealed that only 27% of the women subjected to violence had disclosed this to anyone, in most cases to their parents. The findings in this study highlight that the violence women have to face contributes to the development of multiple forms of psychological stress and serious mental health problems. Women's restrictive life circumstances seriously hamper women's empowerment. Reliable health surveillance system and health care services are needed to serve abused women. Policy initiatives focused on IPV and gender inequality in Pakistan should be initiated.

  20. 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

  1. Effects of economic crises on population health outcomes in Latin America, 1981–2010: an ecological study

    Science.gov (United States)

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-01

    Objectives The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Design Ecological study. Setting Latin America (21 countries), 1981–2010. Outcome measures Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981–2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Results Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (pinflation rate was associated with significant deteriorations (pinflation, significant deteriorations (pinflation. Conclusions Rises in unemployment and inflation are associated with long-lasting deteriorations in several population health outcomes. Unemployment exerted much larger effects on health than inflation. In contrast, changes in GDP per capita had almost no association with the explored health outcomes. Contrary to neoclassical development economics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. PMID:26739715

  2. Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study.

    Science.gov (United States)

    Afework, Mesganaw Fantahun; Admassu, Kesteberhan; Mekonnen, Alemayehu; Hagos, Seifu; Asegid, Meselech; Ahmed, Saifuddin

    2014-04-04

    Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. The objective of the study is to assess the role of Health Extension Workers in improving women's utilization of antenatal care, delivery at health facility and postnatal care services. A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. The non-adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. In general HEWs visit during pregnancy improved utilization of maternal health

  3. Effect of Mobile-health on maternal health care service utilization in Eastern Ethiopia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Gelano, Tilayie Feto; Assefa, Nega; Bacha, Yadeta Dessie; Mahamed, Afendi Abdi; Roba, Kedir Teji; Hambisa, Mitiku Teshome

    2018-02-12

    Globally, the rapid development of mobile technology has created new ways of addressing public health challenges and shifted the paradigm of health care access and delivery. The primary aim of this study is to examine the effectiveness of Mobile-health on maternal health care service utilization in Eastern Ethiopia. Through, a cluster-randomized controlled trial, 640 participants will be selected based on their districts and respective health centers as the unit of randomization. All pregnant mothers who fulfill the inclusion criteria will be allocated to a mobile-phone-based intervention and existing standard of care or control with a 1:1 allocation ratio. The intervention consists of a series of 24 voice messages which will be sent every 2 weeks from the date of enrollment until the close-out time. The control group will receive existing standard of care without voice messages. Data related to outcome variables will be assessed at three phases of the data collection periods. The primary outcome measures will be the proportion of antenatal care visits and institutional delivery, whereas the secondary outcome measures will consist of the proportion of postnatal care visits and pregnancy outcomes. Risk ratios will be used to a measure the effect of intervention on the outcomes which will be estimated with 95% confidence interval and all the analyses will be done with consideration of clustering effect. This study should generate evidence on the effectiveness of mobile-phone-based voice messages for the early initiation of maternal health care service use and its uptake. It has been carefully designed with the assumption of obtaining higher levels of maternal health care service use among the treatment group as compared to the control. Pan African Clinical Trial Registry, www.panctr.org , ID: PACTR201704002216259 . Registered on 28 April 2017.

  4. 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 ...

  5. 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.

  6. The effectiveness of introducing Group Prenatal Care (GPC) in selected health facilities in a district of Bangladesh: study protocol.

    Science.gov (United States)

    Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Ahmed, Sayem; Islam, Ziaul; Khan, Jahangir A M; Sarker, Abdur Razzaque

    2017-01-31

    Despite high rates of antenatal care and relatively good access to health facilities, maternal and neonatal mortality remain high in Bangladesh. There is an immediate need for implementation of evidence-based, cost-effective interventions to improve maternal and neonatal health outcomes. The aim of the study is to assess the effect of the intervention namely Group Prenatal Care (GPC) on utilization of standard number of antenatal care, post natal care including skilled birth attendance and institutional deliveries instead of usual care. The study is quasi-experimental in design. We aim to recruit 576 pregnant women (288 interventions and 288 comparisons) less than 20 weeks of gestational age. The intervention will be delivered over around 6 months. The outcome measure is the difference in maternal service coverage including ANC and PNC coverage, skilled birth attendance and institutional deliveries between the intervention and comparison group. Findings from the research will contribute to improve maternal and newborn outcome in our existing health system. Findings of the research can be used for planning a new strategy and improving the health outcome for Bangladeshi women. Finally addressing the maternal health goal, this study is able to contribute to strengthening health system.

  7. The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

    OpenAIRE

    Pantip Sangprasert; Surasak Buranatrevedh; Duangnate Pipatsatitpong

    2016-01-01

    This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perceptio...

  8. Studies on the health effects of a-bomb radiation exposure appeared in health examinations of adult survivors by the Radiation Effects Research Foundation

    International Nuclear Information System (INIS)

    Yamada, Michiko

    2006-01-01

    The Research Foundation has conducted the health examinations in the title since 1958, based on which studies of a cohort type have been performed, and their results at present are summarized in this paper. Subjects have included a cohort of about 120000 cases in total. They have been those 4993 initial cases (the center group) exposed to estimated radiation doses of 4 -6 Gy within the distance of 2 km from the hypocenter and with acute exposure symptoms either in Hiroshima or Nagasaki, and 19961 cases (exposed ones within 2 km from the hypocenter but without the symptoms, exposed residents in the city 3 km far from the hypocenter, or ones absent in the city at explosion) matched to the above center group in the city, age and sex. Lower statures and weights are noted in some of the center group who were in growing ages at exposure. Increases of prevalence or incidence rate are suggested in malignant tumors, diseases of the thyroid and parathyroid, uterine myoma, chronic liver diseases, cataract, circulatory diseases, abnormal hemoglobin value, and psychological states. Relative risk at 1 Gy for incidence of non-cancer diseases is calculated and presented. Results are not always consistent with those of such population exposed to <6 Gy as that of Chernobyl Accident, of radiation technologist and of people accidentally exposed to environmental radiation. The Foundation is to continue the study and more profound results of radiation effects are expected to be obtainable. (T.I)

  9. Chernobyl Studies Project - working group 7.0 environmental transport and health effects. Progress report, October 1993--January 1994

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, S.M. [ed.

    1994-03-01

    The DOE-funded Chernobyl Studies Project was begun as part of a cooperative agreement between the US and the former USSR, (quote) To develop jointly methods to project rapidly the health effects of any future reactor accident (quote). Most of the initial tasks for this project are completed or near completion. The focus has now turned primarily to the issue of health effects from the Chernobyl accident. Currently, we are extensively engaged in case-control and cohort studies of thyroid diseases among Belarussian children and in the Ukraine. A major part of the effort is providing methods and applications of dose reconstruction and providing support and equipment for the medical teams. This document contains reports on progress in the following task areas: Management; External Dose; Hydrological Transport; Chromosome Painting Dosimetry; Stochastic Effects; Thyroid Studies; and Leukemia Studies.

  10. Health effects of swimming in fecally-contaminated recreational water: Results from studies at nine coastal beaches

    Science.gov (United States)

    Exposure to fecally-contaminated water has long been known to transmit infectious disease. In 2003, EPA and the CDC initiated studies to better describe the health effects associated with exposure to fecal contamination in recreational waters and to test faster ways of measuring ...

  11. A longitudinal study on the effects of health policy in organizations on job satisfaction, burnout, and sickness absence

    NARCIS (Netherlands)

    Ybema, J.F.; Evers, M.S.; Scheppingen, A.R. van

    2011-01-01

    Objective: The present study examines the effects of health policy in organizations as perceived by employees on their job satisfaction, burnout, and sickness absence. METHODS: The data were collected with Internet questionnaires in a longitudinal three-wave design among a heterogeneous sample of

  12. Applicability of the Environmental Relative Moldiness Index for Quantification of Residential Mold Contamination in an Air Pollution Health Effects Study

    Science.gov (United States)

    As part of the Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS) investigating the respiratory health impacts of traffic-related air pollutants on asthmatic children in Detroit, Michigan, residential dust samples were collected to quantify mold exposure. Sett...

  13. The Start2Bike program is effective in increasing health-enhancing physical activity : A controlled study

    NARCIS (Netherlands)

    Ooms, Linda; Veenhof, Cindy; De Bakker, Dinny H.

    2017-01-01

    Background: The sports club is seen as a new relevant setting to promote health-enhancing physical activity (HEPA) among inactive population groups. Little is known about the effectiveness of strategies and activities implemented in the sports club setting on increasing HEPA levels. This study

  14. Effects of economic crises on population health outcomes in Latin America, 1981-2010: an ecological study.

    Science.gov (United States)

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-06

    The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Ecological study. Latin America (21 countries), 1981-2010. Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981-2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (peconomics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Developing effective communication materials on the health effects of climate change for vulnerable groups: a mixed methods study.

    Science.gov (United States)

    Kreslake, Jennifer M; Price, Katherine M; Sarfaty, Mona

    2016-09-07

    Individuals with chronic health conditions or low socioeconomic status (SES) are more vulnerable to the health impacts of climate change. Health communication can provide information on the management of these impacts. This study tested, among vulnerable audiences, whether viewing targeted materials increases knowledge about the health impacts of climate change and strength of climate change beliefs, and whether each are associated with stronger intentions to practice recommended behaviors. Low-SES respondents with chronic conditions were recruited for an online survey in six cities. Respondents were shown targeted materials illustrating the relationship between climate change and chronic conditions. Changes in knowledge and climate change beliefs (pre- and post-test) and behavioral intentions (post-test only) were tested using McNemar tests of marginal frequencies of two binary outcomes or paired t-tests, and multivariable linear regression. Qualitative interviews were conducted among target audiences to triangulate survey findings and make recommendations on the design of messages. Respondents (N = 122) reflected the target population regarding income, educational level and prevalence of household health conditions. (1) Knowledge. Significant increases in knowledge were found regarding: groups that are most vulnerable to heat (children [p concise language, how climate change affects health conditions and how to engage in protective adaptation behaviors.

  16. Effect of treatment with fixed and removable dental prostheses. An oral health-related quality of life study

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus

    2012-01-01

    The aim of the study was to evaluate patient-reported effects of treatment with fixed dental prostheses (FDP) and removable dental prostheses (RDP) and relate the change in Oral Health Related Quality of Life (OHRQoL) to the type of treatment and objective dental variables of aesthetics and masti......The aim of the study was to evaluate patient-reported effects of treatment with fixed dental prostheses (FDP) and removable dental prostheses (RDP) and relate the change in Oral Health Related Quality of Life (OHRQoL) to the type of treatment and objective dental variables of aesthetics...... were obtained. The participants completed the Oral Health Impact Profile 49 (OHIP-49) before and after treatment. A control group with no need for dental treatment also completed the OHIP-49. All participants had a significant improvement in OHRQoL. The improvement was higher for the RDP group than...

  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. A trial epidemiological study on health effects of long term and low level radiation exposure

    International Nuclear Information System (INIS)

    Hattori, Yoshiaki; Maeda, Kazuho

    1980-01-01

    As a trial evaluation of applicability of multivariate model in an analysis of health effects of radiation workers, the multiple logistic function method was applied to the data of occupational exposure record and long term absence record obtained from 593 employees of two institutions both of which practice R and D relating nuclear power. In order to estimate parameters of multiple logistic function by maximum likelihood method, followings were defined as variables: age, length of employment and cumulative exposure dose of radiation as independent variables, and the fact that whether the individual worker had the experience of absence lasting more than a week or not as a dependent variable. As the results, due to shortage of amount of data, only the age of workers shows a significant relationship with the absence data, the other variables do not have any significant results in the association with absence. In this preliminary trial, the applicability of multiple logistic function model in risk estimation of long term occupational exposure was not clearly demonstrated because of data shortage. To testify the applicability, further investigations will be needed, accumulating plenty of data concerning exposure and health effects. (author)

  19. [Study on the health effect of the occupational stress in aircrew].

    Science.gov (United States)

    Zhou, L P; Tian, H E; Liu, L L; Ma, L; Zhang, H; Zhang, Q D; Zhu, X Y; Zhu, H B

    2017-02-20

    Objective: To explore the relationship between occupational stress and physiological and biochemical indexes, to research the health effect of the occupational stress in aircrew. Methods: 450 aircrews were conducted with the OSI-R questionnaire survey, examine the level of blood pressure, blood routine, ALT and UA. Results: The concentration of HB was positively related with task conflict and entertainment and leisure ( β =0.262 and 0.106, both P stress reactions were negatively related with HB ( β =-0.163, -0.102, and -0.137, all P stress reactions and social support were negatively related with RBC ( β =-0.157, -0.119, and -0.113, all P stress reactions and social support had a negative relationship with ALT ( β =-0.176, -0.096, and -0.102, all P stress reactions and social support were negatively related with SBP ( β =-0.093, -0.103, and -0.111, all P Occupational stress of the aircrew is significantly related with blood pressure, RBC, ALT and UA, occupational stress can make effects on the health of aircrew.

  20. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children’s Health Study

    Science.gov (United States)

    Chen, Zhanghua; Salam, Muhammad T.; Eckel, Sandrah P.; Breton, Carrie V.

    2015-01-01

    Outdoor air pollution is one of the leading contributors to adverse respiratory health outcomes in urban areas around the world. Children are highly sensitive to the adverse effects of air pollution due to their rapidly growing lungs, incomplete immune and metabolic functions, patterns of ventilation and high levels of outdoor activity. The Children’s Health Study (CHS) is a continuing series of longitudinal studies that first began in 1993 and has focused on demonstrating the chronic impacts of air pollution on respiratory illnesses from early childhood through adolescence. A large body of evidence from the CHS has documented that exposures to both regional ambient air and traffic-related pollutants are associated with increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits of lung function growth, and airway inflammation. These associations may be modulated by key genes involved in oxidative-nitrosative stress pathways via gene-environment interactions. Despite successful efforts to reduce pollution over the past 40 years, air pollution at the current levels still brings many challenges to public health. To further ameliorate adverse health effects attributable to air pollution, many more toxic pollutants may require regulation and control of motor vehicle emissions and other combustion sources may need to be strengthened. Individual interventions based on personal susceptibility may be needed to protect children’s health while control measures are being implemented. PMID:25694817

  1. The effects of yoga on stress and psychological health among employees: an 8- and 16-week intervention study.

    Science.gov (United States)

    Maddux, Rachel E; Daukantaité, Daiva; Tellhed, Una

    2018-03-01

    The stresses of modern work life necessitate effective coping strategies that are accessible and affordable to the general public. Yoga has been found to reduce stress in clinical samples, but studies are needed to examine standard gym yoga classes among functional individuals. This study investigated the effects of 8- and 16-week gym yoga on stress and psychological health. Ninety individuals reporting moderate-to-high stress were randomly assigned to 16 consecutive weeks of yoga, or to a waitlist crossover group who did not practice yoga for 8 weeks then practiced yoga for 8 weeks. Stress and psychological health variables were assessed at baseline, 8 weeks, and 16 weeks. Significant reductions in stress and all psychological health measures were found within the Yoga group over 16 weeks. When compared to the control group, yoga practitioners showed significant decreases in stress, anxiety, and general psychological health, and significant increases in well-being. The group who did not practice yoga showed significant decreases in stress, anxiety, depression, and insomnia after they crossed over and practiced yoga for 8 weeks. Gym yoga appears to be effective for stress amelioration and promotion of psychological health among workers experiencing stress.

  2. Does farming have an effect on health status? A comparison study in west Greece.

    Science.gov (United States)

    Demos, Konstantinos; Sazakli, Eleni; Jelastopulu, Eleni; Charokopos, Nikolaos; Ellul, John; Leotsinidis, Michalis

    2013-02-26

    Investigating the health status of agricultural workers is a challenging goal. Contradictory outcomes concerning farmers' health are reported in the literature. In this cross-sectional study, certain clinical and neurobehavioral health outcomes were compared between farmers and non-farmers living in the same rural area. Farmers (328) and non-farmers (347), matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Sociodemographic, personal medical, nutritional and lifestyle data were recorded. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase's activity were found to be lower among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non-farmers, while these findings were reversed in older ages. Odds Ratios were calculated through multivariate logistic regression models. Factors affecting these impairments remain to be clarified.

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

    Directory of Open Access Journals (Sweden)

    Laan Eva K

    2012-03-01

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

  4. 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.

  5. Health effects of low-dose radiation on atomic workers: a case study of employer-directed research

    International Nuclear Information System (INIS)

    Sterling, T.D.

    1980-01-01

    The 15-year history of a study on the health effects of low-dose radiation on workers at the Hanford Atomic Plant in Washington State demonstrates different facets of political control by employers over investigations of employee working conditions. Evidence obtained through the Freedom of Information Act shows that the original study, under the guidance of Dr. Thomas Mancuso, an experienced and respected occupational health epidemiologist, was proof to employees that their exposure levels were safe. When it turned out that the study might show an increase in cancer rates among plant employees, its control was transferred to the employer. Lessons from these events are that it may be necessary for organized labor to negotiate the conduct of occupational health investigations as part of negotiated settlements

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  7. Health interventions for the metal working industry: which is the most cost-effective? A study from a developing country.

    Science.gov (United States)

    Salinas, A M; Villarreal, E; Nuñez, G M; Garza, M E; Briones, H; Navarro, O

    2002-05-01

    This study ranked the cost-effectiveness of health interventions in the metal working industry in a developing country. Data were based on 82 034 workers of the Northern region of Mexico. Effectiveness was measured through 'healthy life years' (HeaLYs) gained. Costs were estimated per worker according to type and appropriate inputs from selected health interventions. 'Hand' was the anatomical region that yielded the most gain of HeaLYs and amputation was the injury that yielded the most gain of HeaLYs. The most effective health intervention corresponded to training, followed by medical care, education, helmets, safety shoes, lumbar supports, safety goggles, gloves and safety aprons. In dollar terms, education presented the best cost-effectiveness ratio (US$637) and safety aprons presented the worst cost-effectiveness ratio (US$1 147 770). Training proved to be a very expensive intervention, but presented the best effectiveness outcome and the second best cost-effectiveness ratio (US$2084). Cost-effectiveness analyses in developing countries are critical. Corporations might not have the same funds and technology as those in developed countries or multinational companies.

  8. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    NARCIS (Netherlands)

    Gärtner, F.R.; Ketelaar, S.M.; Smeets, O.; Bolier, L.; Fischer, E.; van Dijk, F.J.H.; Nieuwenhuijsen, K.; Sluiter, J.K.

    2011-01-01

    Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions

  9. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study.

    Science.gov (United States)

    Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar

    2014-08-09

    Motivation and job satisfaction have been identified as key factors for health worker retention and turnover in low- and middle-income countries. District health managers in decentralized health systems usually have a broadened 'decision space' that enables them to positively influence health worker motivation and job satisfaction, which in turn impacts on retention and performance at district-level. The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. We conducted a cross-sectional survey in three districts of the Eastern Region in Ghana and interviewed 256 health workers from several staff categories (doctors, nursing professionals, allied health workers and pharmacists) on their intentions to leave their current health facilities as well as their perceptions on various aspects of motivation and job satisfaction. The effects of motivation and job satisfaction on turnover intention were explored through logistic regression analysis. Overall, 69% of the respondents reported to have turnover intentions. Motivation (OR = 0.74, 95% CI: 0.60 to 0.92) and job satisfaction (OR = 0.74, 95% CI: 0.57 to 0.96) were significantly associated with turnover intention and higher levels of both reduced the risk of health workers having this intention. The dimensions of motivation and job satisfaction significantly associated with turnover intention included career development (OR = 0.56, 95% CI: 0.36 to 0.86), workload (OR = 0.58, 95% CI: 0.34 to 0.99), management (OR = 0.51. 95% CI: 0.30 to 0.84), organizational commitment (OR = 0.36, 95% CI: 0.19 to 0.66), and burnout (OR = 0.59, 95% CI: 0.39 to 0.91). Our findings indicate that effective human resource management practices at district level influence health worker motivation and job satisfaction, thereby reducing the likelihood for

  10. The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Motivation and job satisfaction have been identified as key factors for health worker retention and turnover in low- and middle-income countries. District health managers in decentralized health systems usually have a broadened ‘decision space’ that enables them to positively influence health worker motivation and job satisfaction, which in turn impacts on retention and performance at district-level. The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. Methods We conducted a cross-sectional survey in three districts of the Eastern Region in Ghana and interviewed 256 health workers from several staff categories (doctors, nursing professionals, allied health workers and pharmacists) on their intentions to leave their current health facilities as well as their perceptions on various aspects of motivation and job satisfaction. The effects of motivation and job satisfaction on turnover intention were explored through logistic regression analysis. Results Overall, 69% of the respondents reported to have turnover intentions. Motivation (OR = 0.74, 95% CI: 0.60 to 0.92) and job satisfaction (OR = 0.74, 95% CI: 0.57 to 0.96) were significantly associated with turnover intention and higher levels of both reduced the risk of health workers having this intention. The dimensions of motivation and job satisfaction significantly associated with turnover intention included career development (OR = 0.56, 95% CI: 0.36 to 0.86), workload (OR = 0.58, 95% CI: 0.34 to 0.99), management (OR = 0.51. 95% CI: 0.30 to 0.84), organizational commitment (OR = 0.36, 95% CI: 0.19 to 0.66), and burnout (OR = 0.59, 95% CI: 0.39 to 0.91). Conclusions Our findings indicate that effective human resource management practices at district level influence health worker motivation and job satisfaction

  11. Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014).

    Science.gov (United States)

    Raeissi, Pouran; Harati-Khalilabad, Touraj; Rezapour, Aziz; Hashemi, Seyed Yaser; Mousavi, Abdoreza; Khodabakhshzadeh, Saeed

    2018-05-01

    Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures. This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships. Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term. The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

  12. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions.

    Science.gov (United States)

    Baker, Michael G; Zhang, Jane; Blakely, Tony; Crane, Julian; Saville-Smith, Kay; Howden-Chapman, Philippa

    2016-02-16

    Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5% of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96%) of applicant and tenant household members with their National Health Index (NHI) number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44% containing one or more smokers compared with 33% for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52%) and tenants (38%) compared with New Zealanders as whole (10%). This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low incomes and high levels of exposure to household crowding and environmental

  13. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions

    Directory of Open Access Journals (Sweden)

    Michael G. Baker

    2016-02-01

    Full Text Available Abstract Background Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. Methods This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5 % of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. Results It was possible to match the majority (96 % of applicant and tenant household members with their National Health Index (NHI number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44 % containing one or more smokers compared with 33 % for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52 % and tenants (38 % compared with New Zealanders as whole (10 %. Conclusions This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low

  14. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Tucker, Patrick S; Fenning, Andrew S

    2017-03-01

    The current review clarifies the cardiometabolic health effects of high-intensity interval training (HIIT) in adults. A systematic search (PubMed) examining HIIT and cardiometabolic health markers was completed on 15 October 2015. Sixty-five intervention studies were included for review and the methodological quality of included studies was assessed using the Downs and Black score. Studies were classified by intervention duration and body mass index classification. Outcomes with at least 5 effect sizes were synthesised using a random-effects meta-analysis of the standardised mean difference (SMD) in cardiometabolic health markers (baseline to postintervention) using Review Manager 5.3. Short-term (ST) HIIT (HIIT (≥12 weeks) significantly improved waist circumference (SMD -0.20, 95% CI -0.38 to -0.01; pHIIT demonstrated no effect on insulin, lipid profile, C reactive protein or interleukin 6 in overweight/obese populations. In normal weight populations, ST-HIIT and LT-HIIT significantly improved VO 2 max, but no other significant effects were observed. Current evidence suggests that ST-HIIT and LT-HIIT can increase VO 2 max and improve some cardiometabolic risk factors in overweight/obese populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Smokers' increased risk for disability pension: social confounding or health-mediated effects? Gender-specific analyses of the Hordaland Health Study cohort.

    Science.gov (United States)

    Haukenes, Inger; Riise, Trond; Haug, Kjell; Farbu, Erlend; Maeland, John Gunnar

    2013-09-01

    Studies indicate that cigarette smokers have an increased risk for disability pension, presumably mediated by adverse health effects. However, smoking is also related to socioeconomic status. The current study examined the association between smoking and subsequent disability pension, and whether the association is explained by social confounding and/or health-related mediation. A subsample of 7934 men and 8488 women, aged 40-46, from the Hordaland Health Study, Norway (1997-1999), provided baseline information on smoking status, self-reported health measures and socioeconomic status. Outcome was register-based disability pension from 12 months after baseline to end of 2004. Gender stratified Cox regression analyses were used adjusted for socioeconomic status, physical activity, self-reported health and musculoskeletal pain sites. A total of 155 (2%) men and 333 (3.9%) women were granted disability pension during follow-up. The unadjusted disability risk associated with heavy smoking versus non-smoking was 1.88 (95% CI 1.23 to 2.89) among men and 3.06 (95% CI 2.23 to 4.20) among women. In multivariate analyses, adjusting for socioeconomic status, HRs were 1.33 (95% CI 0.84 to 2.11) among men and 2.22 (95% CI 1.58 to 3.13) among women. Final adjustment for physical activity, self-reported health and musculoskeletal pain further reduced the effect of heavy smoking in women (HR=1.53, 95% CI 1.09 to 2.16). Socioeconomic status confounded the smoking-related risk for disability pension; for female heavy smokers, however, a significant increased risk persisted after adjustment. Women may be particularly vulnerable to heavy smoking and to its sociomedical consequences, such as disability pension.

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

    Science.gov (United States)

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

    2016-02-01

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

  17. Studying health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Mulvad, Gert; Olsen, Jørn

    2003-01-01

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

  18. 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…

  19. The Effect of Life Skills Training on Mental Health of Iranian Middle School Students: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Saman Jamali

    2016-12-01

    Full Text Available Objective: This research aimed to study the effect of life skill training on mental health of Iranian middle school students.Method: This experimental study was conducted In 2015 on 100 students of city of Ghaemshahr (North of Iran, who were randomly selected and divided into two equal groups of intervention (n = 50 and control (n = 50. Qualified trainers provided eight sessions (two sessions a week for 2 hours of life skills training to the intervention group for one month. The control group did not participate in any training sessions during the same period. Mental health in both groups was assessed by a questionnaire pre- and post-training. Data were analyzed using descriptive and infernal (ANCOVA and paired t-test statistic tests.Results: The average age of the participants in both groups was 13.5±1.01. ANCOVA test results revealed that the average score of violence, addiction, stress and sensation-seeking before and after the training was statistically significant in the intervention group and control groups (p<0.001.Conclusion: Life skills training had positive effects on mental health of the participants. Given the importance of mental health in modern societies, it is necessary for schools to incorporate life skills in their curriculum to support the mental health of adolescents.

  20. The effectiveness of specialist roles in mental health metabolic monitoring: a retrospective cross-sectional comparison study.

    Science.gov (United States)

    McKenna, Brian; Furness, Trentham; Wallace, Elizabeth; Happell, Brenda; Stanton, Robert; Platania-Phung, Chris; Edward, Karen-leigh; Castle, David

    2014-09-02

    People with serious mental illness (SMI) exhibit a high prevalence of cardiovascular diseases. Mental health services have a responsibility to address poor physical health in their consumers. One way of doing this is to conduct metabolic monitoring (MM) of risk factors for cardiovascular diseases. This study compares two models of MM among consumers with SMI and describes referral pathways for those at high risk of cardiovascular diseases. A retrospective cross-sectional comparison design was used. The two models were: (1) MM integrated with case managers, and (2) MM integrated with case managers and specialist roles. Retrospective data were collected for all new episodes at two community mental health services (CMHS) over a 12-month period (September 2012 - August 2013). A total of 432 consumers with SMI across the two community mental health services were included in the analysis. At the service with the specialist roles, MM was undertaken for 78% of all new episode consumers, compared with 3% at the mental health service with case managers undertaking the role. Incomplete MM was systemic to both CMHS, although all consumers identified with high risk of cardiovascular diseases were referred to a general practitioner or other community based health services. The specialist roles enabled more varied referral options. The results of this study support incorporating specialist roles over case manager only roles for more effective MM among new episode consumers with SMI.

  1. The effect of health literacy on knowledge and receipt of colorectal cancer screening: a survey study

    Directory of Open Access Journals (Sweden)

    Pignone Michael P

    2007-03-01

    Full Text Available Abstract Background An estimated one-half of Americans have limited health literacy skills. Low literacy has been associated with less receipt of preventive services, but its impact on colorectal cancer (CRC screening is unclear. We sought to determine whether low literacy affects patients' knowledge or receipt of CRC screening. Methods Pilot survey study of patients aged 50 years and older at a large, university-affiliated internal medicine practice. We assessed patients' knowledge and receipt of CRC screening, basic sociodemographic information, and health literacy level. We defined limited literacy as reading below the ninth grade level as determined by the Rapid Estimate of Adult Literacy in Medicine. Bivariate analyses and exact logistic regression were used to determine the association of limited health literacy with knowledge and receipt of CRC screening. Results We approached 105 patients to yield our target sample of 50 completing the survey (recruitment rate 48%. Most subjects were female (72%, African-American (58%, and had household incomes less than $25,000 (87%. Overall, 48% of patients had limited literacy skills (95% CI 35% to 61%. Limited literacy patients were less likely than adequate literacy patients to be able to name or describe any CRC screening test (50% vs. 96%, p Conclusion Patients with limited literacy skills are less likely to be knowledgeable of CRC screening compared to adequate literacy patients. Primary care providers should ensure patients' understanding of CRC screening when discussing screening options. Further research is needed to determine if educating low literacy patients about CRC screening can increase screening rates.

  2. Study of lead effects on the mental health of tin laborers in a carmaking company of Tehran city 2007

    Directory of Open Access Journals (Sweden)

    M. Hamedani

    2009-07-01

    Full Text Available Background and aims   The main objective of this research was assessing the effects of lead on the mental health of laborers engaged in tinworks of a car making company in Tehran city.   Methods   This study is a descriptive and cross sectional study. The sample included matched and randomly selected of 30 tin laborers and 30 administration employees in a car making  company in Tehran city. The 28 version of general health questionnaire (GHQ-28 used as a   screening tool for detection of mental disorders in the two groups.   Results   Study on knowledge of tin workshop employees showed that 16.7% of them were not familiar with lead effects on their body. There was a meaningful differences between total scores of two groups in GHQ-28. 28.3 percent of samples were detected as mental patients; the   prevalence rate was 33.3percent in tin laborers and 23.3 percent in administration employee.   Conclusion   This study shows that working with lead, increases prevalence of mental disorders in the work environment and decreases their efficacy, Therefore with conducting training workshops in the aspects of mental health and immunization, can prevent and promote the mental   health status of laborers.  

  3. Disability acquisition and mental health: effect modification by demographic and socioeconomic characteristics using data from an Australian longitudinal study.

    Science.gov (United States)

    Aitken, Zoe; Simpson, Julie Anne; Bentley, Rebecca; Kavanagh, Anne Marie

    2017-09-18

    There is evidence of a causal relationship between disability acquisition and poor mental health, but the substantial heterogeneity in the magnitude of the effect is poorly understood and may be aetiologically informative. This study aimed to identify demographic and socioeconomic factors that modify the effect of disability acquisition on mental health. The Household, Income and Labour Dynamics in Australia Survey is a nationally representative longitudinal survey of Australian households that has been conducted annually since 2001. Four waves of data were included in this analysis, from 2011 to 2014. Individuals who acquired a disability (n=387) were compared with those who remained disability-free in all four waves (n=7936). Mental health was measured using the mental health subscale of the Short Form 36 (SF-36) general health questionnaire, which measures symptoms of depression, anxiety and psychological well-being. Linear regression models were fitted to estimate the effect of disability acquisition on mental health, testing for effect modification by key demographic and socioeconomic characteristics. To maximise causal inference, we used a propensity score approach with inverse probability of treatment weighting to control for confounding and multiple imputation using chained equations to assess the impact of missing data. On average, disability acquisition was associated with a 5-point decline in mental health score (estimated mean difference: -5.1, 95% CI -7.2 to -3.0). There was strong evidence that income and relationship status modified the effect, with more detrimental effects in the lowest (-12.5, 95% CI -18.5 to -6.5) compared with highest income quintile (-1.1, 95% CI -4.9 to 2.7) and for people not in a relationship (-8.8, 95% CI -12.9 to -4.8) compared with those who were (-3.7, 95% CI -6.1 to -1.4). Our results suggest that the detrimental effect of disability acquisition on mental health is substantially greater for socioeconomic

  4. The Effect of Doctor-Consumer Interaction on Social Media on Consumers' Health Behaviors: Cross-Sectional Study.

    Science.gov (United States)

    Wu, Tailai; Deng, Zhaohua; Feng, Zhanchun; Gaskin, Darrell J; Zhang, Donglan; Wang, Ruoxi

    2018-02-28

    Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers' health behaviors. The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers' health behaviors. On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers' health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. Instrumental doctor-consumer interaction was found to influence consumers' DK (t 294 =5.763, Pinteraction also impacted consumers' DK (t 294 =4.025, Pinteraction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers' health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction. ©Tailai Wu, Zhaohua Deng, Zhanchun Feng, Darrell J Gaskin, Donglan Zhang, Ruoxi Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2018.

  5. The Effect of Doctor-Consumer Interaction on Social Media on Consumers’ Health Behaviors: Cross-Sectional Study

    Science.gov (United States)

    Wu, Tailai; Deng, Zhaohua; Gaskin, Darrell J; Zhang, Donglan; Wang, Ruoxi

    2018-01-01

    Background Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers’ health behaviors. Objective The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers’ health behaviors. Methods On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers’ health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. Results Instrumental doctor-consumer interaction was found to influence consumers’ DK (t294=5.763, Pinteraction also impacted consumers’ DK (t294=4.025, Peffect of instrumental interaction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. Conclusions Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers’ health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction. PMID:29490892

  6. Monitoring air pollution effects on children for supporting public health policy: the protocol of the prospective cohort MAPEC study.

    Science.gov (United States)

    Feretti, D; Ceretti, E; De Donno, A; Moretti, M; Carducci, A; Bonetta, S; Marrese, M R; Bonetti, A; Covolo, L; Bagordo, F; Villarini, M; Verani, M; Schilirò, T; Limina, R M; Grassi, T; Monarca, S; Casini, B; Carraro, E; Zani, C; Mazzoleni, G; Levaggi, R; Gelatti, U

    2014-09-16

    Genotoxic biomarkers have been studied largely in adult population, but few studies so far have investigated them in children exposed to air pollution. Children are a high-risk group as regards the health effects of air pollution and some studies suggest that early exposure during childhood can play an important role in the development of chronic diseases in adulthood. The objective of the project is to evaluate the associations between the concentration of urban air pollutants and biomarkers of early biological effect in children, and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. Two biomarkers of early biological effects, DNA damage by the comet assay and the micronuclei (MN) test, will be investigated in oral mucosa cells of 6-8-year-old children. Concurrently, some toxic airborne pollutants (polycyclic aromatic hydrocarbon (PAH) and nitro-PAH) and in vitro air mutagenicity and toxicity in ultra-fine air particulates (PM0.5) will be evaluated. Furthermore, demographic and socioeconomic variables, other sources of exposures to air pollutants and lifestyle variables will be assessed by a structured questionnaire. The associations between sociodemographic, environmental and other exposure variables and biomarkers of early biological effect using univariate and multivariate models will be analysed. A tentative model for calculating the global absolute risk of having early biological effects caused by air pollution and other variables will be proposed. The project has been approved by the Ethics Committees of the local Health Authorities. The results will be communicated to local Public Health Agencies, for supporting educational programmes and health policy strategies. LIFE+2012 Environment Policy and Governance. LIFE12 ENV/IT/000614. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. 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.

  8. Can the Medical-nursing Combined Care Promote the Accessibility of Health Services for the Elderly in Nursing Home? A Study Protocol of Analysis of the Effectiveness Regarding Health Service Utilization, Health Status and Satisfaction with Care.

    Science.gov (United States)

    Bao, J; Wang, X-J; Yang, Y; Dong, R-Q; Mao, Z-F

    2015-12-01

    Currently, segmentation of healthcare and daily care for the elderly living in nursing homes usually results in the elderly not getting medical treatment timely and effectively. The medical-nursing combined care, which has been put into practice in several areas in China, is developed to enhance the accessibility of healthcare for the elderly. The aim of the study is to explore the effectiveness of the new care service, based on Andersen model, regarding health service utilization, health status and service satisfaction. The effectiveness of medical-nursing combined care will be measured in a cross-sectional study in nine nursing homes in Jianghan District, Wuhan, China, with 1067 old residents expected to participate. The questionnaire containing items of demographics, health service use, service satisfaction and instrument of SF-36 V2 is developed based on the conceptual framework of Andersen behaviour model of health service utilization. Descriptive analysis, variance analysis, multiple factors analysis, and correlation analysis will be performed to compare the sociological characteristics, health service use, health status and service satisfaction of the elderly living in different modes of nursing homes, to explore the influence factors of care effectiveness, as well as to study the relationship between health behaviour and health outcomes. The study design of analysing the effects of medical-nursing combined care and performing the horizontal comparison among the nursing homes under the framework of Andersen model is blazing new trails. Recruitment and design of questionnaire are important issues. Successful data collection and quality control are also necessary. Taking these into account, this study is estimated to provide evidence for the effectiveness of medical-nursing combined care service in China.

  9. The French-German initiative for Chernobyl. Programme 3 study of the health effects

    International Nuclear Information System (INIS)

    Becker, S.; Kellerer, A.; Pott-Born, R.; Gagniere, B.; Mansoux, H.; Rutschkowsky, N.; Valenty, M.; Calmont, I.; Brun-Yaba, Ch.; Verger, P.; Franc, B.; Robert-Gnansia, E.; Briend, A.

    2006-03-01

    The results of the French-German Initiative Health Effects project, conducted over a period of four years, were presented to the international authorities at a congress held in October 2004 in Kiev and are summarised below. Thyroid cancer increase in children and young adults seems clearly related to exposure at young ages in 1986. For the other cancers sites, the observed results do not add any decisive elements that would make it possible to quantify the impact of post-Chernobyl irradiation: the trend observed in time is similar in both exposed and non-exposed areas in most situations. These observations do not exclude the fact that an increase of leukaemia may exist for those exposed as children; it may be too low to be detectable in a statistically significant way. Similarly, the higher rate of congenital malformations observed during recent years cannot be attributed to radiation, because the same trend over time is observed both in contaminated and non-contaminated areas in Belarus. Reliable and up-to-date knowledge has been collected in a H.E.D.A.C. database, it should facilitate communication concerning the health impact of the Chernobyl accident. The main results published at national or international level, will be made available to the public and the international scientific community via modern distribution methods and will contribute to the development of a necessary cohesion between international research programmes and work carried out locally. Contact the web site: www.fgi.icc.gov.ua For detailed information, final reports are available: contact with mentioned investigators is proposed (see authors of final reports) or contact scientific coordinator M. Tirmarche at I.R.S.N. (France) D. Bazyka at R.C.R.M., Kiev in charge of the database and communication of scientific results at Chernobyl Center

  10. The French-German initiative for Chernobyl. Programme 3 study of the health effects

    Energy Technology Data Exchange (ETDEWEB)

    Becker, S.; Kellerer, A.; Pott-Born, R. [Munich Univ., Radiobiological Institute (Germany); Gagniere, B. [CIRE Ouest, 35 - Rennes (France); Mansoux, H.; Rutschkowsky, N.; Valenty, M.; Calmont, I.; Brun-Yaba, Ch. [Institut de Radioprotection et de Surete Nucleaire, 92 - Fontenay-aux-Roses (France); Verger, P. [ORS PACA, 13 - Marseille (France); Franc, B. [Hopital Ambroise-Pare, 92 - Boulogne (France); Robert-Gnansia, E. [European Instituteof Genomutations, 69 - Lyon (France); Briend, A. [Scientific and Technical Institute of Nutrition and Alimentation/CNAM, 75 - Paris (France)

    2006-03-15

    The results of the French-German Initiative Health Effects project, conducted over a period of four years, were presented to the international authorities at a congress held in October 2004 in Kiev and are summarised below. Thyroid cancer increase in children and young adults seems clearly related to exposure at young ages in 1986. For the other cancers sites, the observed results do not add any decisive elements that would make it possible to quantify the impact of post-Chernobyl irradiation: the trend observed in time is similar in both exposed and non-exposed areas in most situations. These observations do not exclude the fact that an increase of leukaemia may exist for those exposed as children; it may be too low to be detectable in a statistically significant way. Similarly, the higher rate of congenital malformations observed during recent years cannot be attributed to radiation, because the same trend over time is observed both in contaminated and non-contaminated areas in Belarus. Reliable and up-to-date knowledge has been collected in a H.E.D.A.C. database, it should facilitate communication concerning the health impact of the Chernobyl accident. The main results published at national or international level, will be made available to the public and the international scientific community via modern distribution methods and will contribute to the development of a necessary cohesion between international research programmes and work carried out locally. Contact the web site: www.fgi.icc.gov.ua For detailed information, final reports are available: contact with mentioned investigators is proposed (see authors of final reports) or contact scientific coordinator M. Tirmarche at I.R.S.N. (France) D. Bazyka at R.C.R.M., Kiev in charge of the database and communication of scientific results at Chernobyl Center.

  11. Cumulative effects of negative life events and family stress on children's mental health: the Bergen Child Study.

    Science.gov (United States)

    Bøe, Tormod; Serlachius, Anna Sofia; Sivertsen, Børge; Petrie, Keith J; Hysing, Mari

    2018-01-01

    Numerous studies have documented that lower socioeconomic status (SES) is associated with increased mental health problems in children. One proposed pathway for this association has been differential exposure to accumulated risk factors in children of lower SES. The aim of the current study was to investigate the socioeconomic distribution of exposure to negative life events and family stress and to examine the direct and interactive association between lower SES and exposure to life events and family stress in relation with mental health problems. Using cross-sectional data from the second wave of the Bergen Child Study (conducted in 2006), the current study investigated the association between lower SES and exposure to negative life events, family life stressors, and mental health problems in a sample of 2043 Norwegian 11-13 years and their parents. Information about mental health was self-reported by the children using the Strengths and Difficulties Questionnaire, whereas information about SES and exposure to negative life events and family stressors were provided by their parents. The findings showed that lower SES was associated with more symptoms of emotional-, conduct-, hyperactivity/inattention-, and peer problems and that exposure to life events and family stress explained some of this association (10-29% of the total effects). Low SES and higher prevalence of negative life events and family stressors were associated with more symptoms of mental health problems. Overall, the effect sizes were smaller than previous investigations (f 2 s = 0.015-0.031), perhaps suggesting a buffering effect of the social safety net in place in Norway.

  12. Physical activity initiated by employer and its health effects; an eight week follow-up study

    Directory of Open Access Journals (Sweden)

    Marit Skogstad

    2016-05-01

    Full Text Available Abstract Background While the health benefits of physical activity are well established, little is known about health effects of physical activity programs initiated by employer. Methods Background data and level of physical activity were collected by questionnaire among 78 men and 43 women working in road maintenance pre and post an 8-week physical activity motivational program. As a part of the program steps measured by accelerometer were registered online where team and individual performances could be continuously monitored. The physical activity levels were registered as 1 those physical active ≤1 time per week, 2 2–3 times per week and 3 ≥4 times a week. Maximal oxygen uptake (VO2max, blood pressure, resting heart rate (RHR and blood samples (glycosylated hemoglobin, lipids and C-reactive protein were obtained at baseline and after eight weeks. Mixed models were applied to evaluate associations between physical activity and health parameters. Results With ≤1 time per week as reference, exercising 2–3 times per week at baseline was associated with higher levels of VO2max. During follow-up, VO2max increased with 2.8 mL ∙ kg−1∙ min−1 (95 % CI = 1.4, 4.3. Women had more favorable body mass index (BMI, blood pressure, RHR and lipid profile than men. Total cholesterol, low density lipoprotein (LDL, RHR and diastolic blood pressure (dBP were lower among participants who exercised 2–3 times per week or ≥4 times a week, compared with those with ≤1 time per week. Half of the participants reported increased daily PA during follow-up, with high intensity PA such as jogging by 8.6 min (SD 14.6 and 8.3 min (SD 18.2, among women and men, respectively. During follow-up dBP increased among men. Further, total cholesterol and LDL were reduced by 0.12 mmol/L and 0.13 mmol/L, respectively (95 % CI = −022, –0.01 and −0.22,–0.04. Conclusions Exercise several times a week was associated with lower blood pressure and a

  13. Chernobyl Studies Project: Working group 7.0, Environmental transport and health effects. Progress report, March--September 1994

    Energy Technology Data Exchange (ETDEWEB)

    Anspaugh, L.R.; Hendrickson, S.M. [eds.

    1994-12-01

    In April 1988, the US and the former-USSR signed a Memorandum of Cooperation (MOC) for Civilian Nuclear Reactor Safety; this MOC was a direct result of the accident at the Chernobyl Nuclear Power Plant Unit 4 and the following efforts by the two countries to implement a joint program to improve the safety of nuclear power plants and to understand the implications of environmental releases. A Joint Coordinating Committee for Civilian Nuclear Reactor Safety (JCCCNRS) was formed to implement the MOC. The JCCCNRS established many working groups; most of these were the responsibility of the Nuclear Regulatory Commission, as far as the US participation was concerned. The lone exception was Working Group 7 on Environmental Transport and Health Effects, for which the US participation was the responsibility of the US Department of Energy (DOE). The purpose of Working Group 7 was succintly stated to be, ``To develop jointly methods to project rapidly the health effects of any future nuclear reactor accident.`` To implement the work DOE then formed two subworking groups: 7.1 to address Environmental Transport and 7.2 to address Health Effects. Thus, the DOE-funded Chernobyl Studies Project began. The majority of the initial tasks for this project are completed or near completion. The focus is now turned to the issue of health effects from the Chernobyl accident. Currently, we are involved in and making progress on the case-control and co-hort studies of thyroid diseases among Belarussian children. Dosimetric aspects are a fundamental part of these studies. We are currently working to implement similar studies in Ukraine. A major part of the effort of these projects is supporting these studies, both by providing methods and applications of dose reconstruction and by providing support and equipment for the medical teams.

  14. A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies

    OpenAIRE

    Eric Coker; Samuel Kizito

    2018-01-01

    An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the re...

  15. Exploration of Effective Persuasive Strategies Used in Resisting Product Advertising: A Case Study of Adult Health Check-Ups.

    Science.gov (United States)

    Tien, Han-Kuang; Chung, Wen

    2018-05-10

    This research addressed adults' health check-ups through the lens of Role Transportation Theory. This theory is applied to narrative advertising that lures adults into seeking health check-ups by causing audiences to empathize with the advertisement's character. This study explored the persuasive mechanism behind narrative advertising and reinforced the Protection Motivation Theory model. We added two key perturbation variables: optimistic bias and truth avoidance. To complete the verification hypothesis, we performed two experiments. In Experiment 1, we recruited 77 respondents online for testing. We used analyses of variance to verify the effectiveness of narrative and informative advertising. Then, in Experiment 2, we recruited 228 respondents to perform offline physical experiments and conducted a path analysis through structural equation modelling. The findings showed that narrative advertising positively impacted participants' disease prevention intentions. The use of Role Transportation Theory in advertising enables the audience to be emotionally connected with the character, which enhances persuasiveness. In Experiment 2, we found that the degree of role transference can interfere with optimistic bias, improve perceived health risk, and promote behavioral intentions for health check-ups. Furthermore, truth avoidance can interfere with perceived health risks, which, in turn, reduce behavioral intentions for health check-ups.

  16. Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city

    Directory of Open Access Journals (Sweden)

    Ameel F Al-Shawi

    2015-01-01

    Full Text Available Background: Studies have revealed a powerful relationship between adverse childhood experiences (ACEs and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. Objective: The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. Subjects and Methods: A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. Results: Logistic regression model showed that a higher level of bonding to family (fourth quartile is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57 and exposure to a high level of household dysfunction and abuse (fourth quartile is expected to increase the risk of chronic physical diseases by 81%. Conclusion: Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life.

  17. [Presenteeism and workers' health: effects of mediation on psycho-physical stress in a longitudinal study].

    Science.gov (United States)

    Falco, Alessandra; Girardi, Damiano; Parmiani, Gianluca; Bortolato, Stefano; Piccirelli, Alessandra; Bartolucci, Giovanni Battista; De Carlo, Nicola A

    2013-01-01

    The present work aims to investigate the phenomenon of presenteeism, a construct still little studied, especially in Italy, in its medical, psychological, social and economic implications. In the first part we propose a review of the international literature, and of the meanings, causes and consequences of the phenomenon on individual and organizational health. In the second part, we present a study which involved, for a period of about a year, 326 workers of a company in the engineering industry. This study is, in this writers' knowledge, the first survey--characterized by a longitudinal design and a multi-method approach, both not very present also in the international literature--carried out in our country on the phenomenon of presenteeism. The survey examines the mediating role of presenteeism in the relationship between specific risk factors of work context and content--career growth, conflict with colleagues, social rewards--and the psycho-physical strain. The risk factors were detected through a self-report instrument at the beginning of the year. The workers, at the end of the same year, were subjected to a healthcare surveillance visit in which the competent physician evaluated the psycho-physical strain. The hypothesized relations have been tested by estimating a structural equation model with observed variables. What emerged was a negative association between social rewards and presenteeism and a positive relation between conflict with colleagues and presenteeism. Instead, no association between growth and presenteeism emerged. Presenteeism, in turn, predicts psycho-physical strain. Overall, presenteeism mediates the relationship between social rewards and strain, as well as between interpersonal conflict and strain, but not between growth and strain. This work is characterized by some innovative aspects compared to previous studies conducted on the subject, both in theory and methodology. From a theoretical point of view the hypothesized model aims to

  18. A parametric study of MELCOR Accident Consequence Code System 2 (MACCS2) Input Values for the Predicted Health Effect

    International Nuclear Information System (INIS)

    Kim, So Ra; Min, Byung Il; Park, Ki Hyun; Yang, Byung Mo; Suh, Kyung Suk

    2016-01-01

    The MELCOR Accident Consequence Code System 2, MACCS2, has been the most widely used through the world among the off-site consequence analysis codes. MACCS2 code is used to estimate the radionuclide concentrations, radiological doses, health effects, and economic consequences that could result from the hypothetical nuclear accidents. Most of the MACCS model parameter values are defined by the user and those input parameters can make a significant impact on the output. A limited parametric study was performed to identify the relative importance of the values of each input parameters in determining the predicted early and latent health effects in MACCS2. These results would not be applicable to every case of the nuclear accidents, because only the limited calculation was performed with Kori-specific data. The endpoints of the assessment were early- and latent cancer-risk in the exposed population, therefore it might produce the different results with the parametric studies for other endpoints, such as contamination level, absorbed dose, and economic cost. Accident consequence assessment is important for decision making to minimize the health effect from radiation exposure, accordingly the sufficient parametric studies are required for the various endpoints and input parameters in further research

  19. Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    V. Brown

    2017-05-01

    Full Text Available Abstract Background Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. Methods A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs were reported and results were tested through sensitivity analysis. Results Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings, measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention

  20. Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study.

    Science.gov (United States)

    Brown, V; Moodie, M; Cobiac, L; Mantilla Herrera, A M; Carter, R

    2017-05-04

    Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2

  1. Study-design selection criteria in systematic reviews of effectiveness of health systems interventions and reforms: A meta-review.

    Science.gov (United States)

    Rockers, Peter C; Feigl, Andrea B; Røttingen, John-Arne; Fretheim, Atle; de Ferranti, David; Lavis, John N; Melberg, Hans Olav; Bärnighausen, Till

    2012-03-01

    At present, there exists no widely agreed upon set of study-design selection criteria for systematic reviews of health systems research, except for those proposed by the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) review group (which comprises randomized controlled trials, controlled clinical trials, controlled before-after studies, and interrupted time series). We conducted a meta-review of the study-design selection criteria used in systematic reviews available in the McMaster University's Health Systems Evidence or the EPOC database. Of 414 systematic reviews, 13% did not indicate any study-design selection criteria. Of the 359 studies that described such criteria, 50% limited their synthesis to controlled trials and 68% to some or all of the designs defined by the EPOC criteria. Seven out of eight reviews identified at least one controlled trial that was relevant for the review topic. Seven percent of the reviews included either no or only one relevant primary study. Our meta-review reveals reviewers' preferences for restricting synthesis to controlled experiments or study designs that comply with the EPOC criteria. We discuss the advantages and disadvantages of the current practices regarding study-design selection in systematic reviews of health systems research as well as alternative approaches. Copyright © 2012. Published by Elsevier Ireland Ltd.

  2. Clinical Comparative Study of the Effects of Helicobacter Pylori Colonization on Oral Health in Children.

    Science.gov (United States)

    Dane, Asim; Gurbuz, Taskin

    2016-01-01

    To isolate Helicobacter pylori (HP) from the dental plaque of a selected group of children and to compare the oral and salivary findings of patients with those of a healthy control group. A total of 70 children aged 5-15 years were included in this study. An intraoral examination was performed for each patient, and dental plaque and saliva specimens were collected for analysis. Oral health conditions, nutritional habits, tooth brushing frequency, saliva pH levels, flow velocity, and buffering capacities were noted. The Kruskal-Wallis test was used for comparison of the DMFT and dft index. The significance level was set at p=0.05. The prevalence of HP in dental plaque was higher in study group than controls (p0.05). Meanwhile, the buffering capacity of saliva was lower in HP gastritis patients (pdental plaque; thus, the oral cavity may be an important reservoir for HP. Good oral hygiene could be a positive contributor to the treatment of gastritis.

  3. The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

    Directory of Open Access Journals (Sweden)

    Pantip Sangprasert

    2016-11-01

    Full Text Available This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perception and preventive behavior questionnaires and home behavior records collected data according to individual hypertension risk factors. The study was carried out for four months. Descriptive statistics and a paired t-test were used. Results showed a statistical significance difference with increased total mean scores with the following variances:healthstatus,self-efficacyanddecreasedbarrierperception(p=.000, .008and.022, respectively. There was noticeable improvement in exercise and stress management, but no significant change in overall preventive behavior for hypertension (p >.05. Systolic and diastolic blood pressure and heart rate were lower (p .05. Primary healthcare services should also be a strategic development, especially focus socially-supported on mental wellbeing whichis beneficial for riskandhypertensive groups.

  4. The Hotel Study-Clinical and Health Service Effectiveness in a Cohort of Homeless or Marginally Housed Persons.

    Science.gov (United States)

    Honer, William G; Cervantes-Larios, Alejandro; Jones, Andrea A; Vila-Rodriguez, Fidel; Montaner, Julio S; Tran, Howard; Nham, Jimmy; Panenka, William J; Lang, Donna J; Thornton, Allen E; Vertinsky, Talia; Barr, Alasdair M; Procyshyn, Ric M; Smith, Geoffrey N; Buchanan, Tari; Krajden, Mel; Krausz, Michael; MacEwan, G William; Gicas, Kristina M; Leonova, Olga; Langheimer, Verena; Rauscher, Alexander; Schultz, Krista

    2017-07-01

    The Hotel Study was initiated in Vancouver's Downtown East Side (DTES) neighborhood to investigate multimorbidity in homeless or marginally housed people. We evaluated the clinical effectiveness of existing, illness-specific treatment strategies and assessed the effectiveness of health care delivery for multimorbid illnesses. For context, we mapped the housing locations of patients presenting for 552,062 visits to the catchment hospital emergency department (2005-2013). Aggregate data on 22,519 apprehensions of mentally ill people were provided by the Vancouver Police Department (2009-2015). The primary strategy was a longitudinal cohort study of 375 people living in the DTES (2008-2015). We analysed mortality and evaluated the clinical and health service delivery effectiveness for infection with human immunodeficiency virus or hepatitis C virus, opioid dependence, and psychosis. Mapping confirmed the association between poverty and greater number of emergency visits related to substance use and mental illness. The annual change in police apprehensions did not differ between the DTES and other policing districts. During 1581 person-years of cohort observation, the standardized mortality ratio was 8.43 (95% confidence interval, 6.19 to 11.50). Physician visits were common (84.3% of participants over 6 months). Clinical treatment effectiveness was highest for HIV/AIDS, intermediate for opioid dependence, and lowest for psychosis. Health service delivery mechanisms provided examples of poor access, poor treatment adherence, and little effect on multimorbid illnesses. Clinical effectiveness was variable, and illness-specific service delivery appeared to have little effect on multimorbidity. New models of care may need to be implemented.

  5. Study on Dendrobium officinale O-Acetyl-glucomannan (Dendronan). 7. Improving Effects on Colonic Health of Mice.

    Science.gov (United States)

    Zhang, Guan-ya; Nie, Shao-ping; Huang, Xiao-jun; Hu, Jie-lun; Cui, Steve W; Xie, Ming-yong; Phillips, Glyn O

    2016-03-30

    This research was aimed to study the effect of Dendrobium officinale polysaccharide (Dendronan) on colonic health. Mice were fed Dendronan at doses of 40, 80, and 160 mg/kg body weight for 0, 10, 20, and 30 days, respectively. Results showed that Dendronan, which has a special structure formed by mannose and glucose, rich in O-acetyl groups, exhibited improving effects on colonic and fecal parameters of Balb/c mice. After Dendronan feeding, the content of short-chain fatty acids (SCFAs), colon length and index, and fecal moisture were increased, whereas colonic pH was decreased and defecation time was shortened. All of these changes were significantly different between polysaccharide-treated groups and the control group (p < 0.05). These findings suggested that an adequate intake of Dendronan is beneficial to the process of fermentation and regulation of colonic microenvironment, thus playing a role in the maintenance of colonic health.

  6. The effects of the Omagh bomb on adolescent mental health: a school-based study.

    Science.gov (United States)

    Duffy, Michael; McDermott, Maura; Percy, Andrew; Ehlers, Anke; Clark, David M; Fitzgerald, Michael; Moriarty, John

    2015-02-06

    The main objective of this study was to assess psychiatric morbidity among adolescents following the Omagh car bombing in Northern Ireland in 1998. Data was collected within schools from adolescents aged between 14 and 18 years via a self-completion booklet comprised of established predictors of PTSD; type of exposure, initial emotional response, long-term adverse physical problems, predictors derived from Ehlers and Clark's (2000) cognitive model, a PTSD symptoms measure (PDS) and the General Health Questionnaire (GHQ). Those with more direct physical exposure were significantly more likely to meet caseness on the GHQ and the PDS. The combined pre and peri trauma risk factors highlighted in previous meta-analyses accounted for 20% of the variance in PDS scores but the amount of variance accounted for increased to 56% when the variables highlighted in Ehlers and Clark's cognitive model for PTSD were added. High rates of chronic PTSD were observed in adolescents exposed to the bombing. Whilst increased exposure was associated with increased psychiatric morbidity, the best predictors of PTSD were specific aspects of the trauma ('seeing someone you think is dying'), what you are thinking during the event ('think you are going to die') and the cognitive mechanisms employed after the trauma. As these variables are in principle amenable to treatment the results have implications for teams planning treatment interventions after future traumas.

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

    Science.gov (United States)

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

    2018-01-10

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

  8. Acute effect of ambient air pollution on stroke mortality in the China air pollution and health effects study.

    Science.gov (United States)

    Chen, Renjie; Zhang, Yuhao; Yang, Chunxue; Zhao, Zhuohui; Xu, Xiaohui; Kan, Haidong

    2013-04-01

    There have been no multicity studies on the acute effects of air pollution on stroke mortality in China. This study was undertaken to examine the associations between daily stroke mortality and outdoor air pollution (particulate matter air pollution with daily stroke mortality. Air pollution was associated with daily stroke mortality in 8 Chinese cities. In the combined analysis, an increase of 10 μg/m(3) of 2-day moving average concentrations of particulate matter air pollution and risk of stroke mortality. To our knowledge, this is the first multicity study in China, or even in other developing countries, to report the acute effect of air pollution on stroke mortality. Our results contribute to very limited data on the effect of air pollution on stroke for high-exposure settings typical in developing countries.

  9. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study.

    Science.gov (United States)

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-06-07

    In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.

  10. Feasibility of studies on health effects in western Europe due to the reactor accident at Chernobyl and Recommendations for research

    International Nuclear Information System (INIS)

    Breckow, J.; Kellerer, A.M.; Knox, E.G.; Richardson, S.; Doll, R.; Boice, J.D.; Esteve, J.; Thiessen, J.W.; Silini, G.

    1990-01-01

    The report considers whether studies of health effects related to the radioactive contamination of western Europe caused by the releases from the Chernobyl reactor accident would be useful. The report evaluates the exposure patterns and the dose levels within the European Community, the different health effects that might be induced by such doses, and the likelihood that epidemiological studies could produce scientifically useful information. The report concludes that at the exposure levels experienced in the European Community the study of post-Chernobyl cancer rates in adults and the study of heritable genetic effects in the offspring of those exposed would be unproductive. It also concludes that even a study of childhood cancer following in utero exposure would be unlikely to demonstrate any attributable increase in risk. However, the report recommends that a small epidemiologic survey of childhood cancer be conducted within areas where selected cancer registration was in existence at the time of the Chernobyl accident to check the ability to predict risks from doses of the order received, to contribute to the understanding of the occurrence of childhood leukemia and to allay public anxiety

  11. Accountability studies of air pollution and health effects: lessons learned and recommendations for future natural experiment opportunities

    Science.gov (United States)

    Rich, David Q.

    2017-01-01

    To address limitations of observational epidemiology studies of air pollution and health effects, including residual confounding by temporal and spatial factors, several studies have taken advantage of ‘natural experiments’, where an environmental policy or air quality intervention has resulted in reductions in ambient air pollution concentrations. Researchers have examined whether the population impacted by these air quality improvements, also experienced improvements in various health indices (e.g. reduced morbidity/mortality). In this paper, I review key accountability studies done previously and new studies done over the past several years in Beijing, Atlanta, London, Ireland, and other locations, describing study design and analysis strengths and limitations of each. As new ‘natural experiment’ opportunities arise, several lessons learned from these studies should be applied when planning a new accountability study. Comparison of health outcomes during the intervention to both before and after the intervention in the population of interest, as well as use of a control population to assess whether any temporal changes in the population of interest were also seen in populations not impacted by air quality improvements, should aid in minimizing residual confounding by these long term time trends. Use of either detailed health records for a population, or prospectively collected data on relevant mechanistic biomarkers coupled with such morbidity/mortality data may provide a more thorough assessment of if the intervention beneficially impacted the health of the community, and if so by what mechanism(s). Further, prospective measurement of a large suite of air pollutants may allow a more thorough understanding of what pollutant source(s) is/are responsible for any health benefit observed. The importance of using multiple statistical analysis methods in each paper and the difference in how the timing of the air pollution/outcome association may impact which

  12. Accountability studies of air pollution and health effects: lessons learned and recommendations for future natural experiment opportunities.

    Science.gov (United States)

    Rich, David Q

    2017-03-01

    To address limitations of observational epidemiology studies of air pollution and health effects, including residual confounding by temporal and spatial factors, several studies have taken advantage of 'natural experiments', where an environmental policy or air quality intervention has resulted in reductions in ambient air pollution concentrations. Researchers have examined whether the population impacted by these air quality improvements, also experienced improvements in various health indices (e.g. reduced morbidity/mortality). In this paper, I review key accountability studies done previously and new studies done over the past several years in Beijing, Atlanta, London, Ireland, and other locations, describing study design and analysis strengths and limitations of each. As new 'natural experiment' opportunities arise, several lessons learned from these studies should be applied when planning a new accountability study. Comparison of health outcomes during the intervention to both before and after the intervention in the population of interest, as well as use of a control population to assess whether any temporal changes in the population of interest were also seen in populations not impacted by air quality improvements, should aid in minimizing residual confounding by these long term time trends. Use of either detailed health records for a population, or prospectively collected data on relevant mechanistic biomarkers coupled with such morbidity/mortality data may provide a more thorough assessment of if the intervention beneficially impacted the health of the community, and if so by what mechanism(s). Further, prospective measurement of a large suite of air pollutants may allow a more thorough understanding of what pollutant source(s) is/are responsible for any health benefit observed. The importance of using multiple statistical analysis methods in each paper and the difference in how the timing of the air pollution/outcome association may impact which of these

  13. Social and emotional training in Swedish classrooms for the promotion of mental health: results from an effectiveness study in Sweden.

    Science.gov (United States)

    Kimber, Birgitta; Sandell, Rolf; Bremberg, Sven

    2008-06-01

    Mental ill-health is a major problem worldwide. It includes depression, aggressive behavior, feeling down and alcohol and drug abuse. Since all children go to school, the school is an obvious arena for health interventions. A set of educational techniques named Social and Emotional Learning, based on the use by teachers of cognitive and behavioral methods, which teaches students self-control, social competence, empathy, motivation and self-awareness, has shown promising results in the USA. This paper reports on the application of similar techniques in Sweden (the Social and Emotional Training [SET] program). The study has a quasi-experimental longitudinal design, with two intervention and two control schools. A wide range of instruments, both Swedish and international, are employed. In this paper, results from the school years 1999-2000 (baseline) through to 2001-2002 are reported. Both the intervention and the data collection were performed by ordinary school staff in a routine school setting. Independent bi-annual ratings of teachers' performance were moderate to high, and teachers' perceptions of the program were generally, although by no means universally, high. However, their performance was poorer with regard to the collection of data. In terms of promotion, findings with regard to the impact of the program on mental health are generally favorable-in particular through the promotion of aspects of self-image, including well-being and the hindering of aggressiveness, bullying, attention-seeking and alcohol use. There was, however, no differential effect on social skills. It seems that SET has the potential to operate effectively as a health-promoting intervention during the school period, although its main impact may rather be to act as a brake on the deterioration in some aspects of mental health that is common during adolescence. Positively significant relationships were found on some but not all of the instrument scales, and effect sizes were medium.

  14. Effects of Internet Use on Health and Depression: A Longitudinal Study

    OpenAIRE

    Bessi?re, Katie; Pressman, Sarah; Kiesler, Sara; Kraut, Robert

    2010-01-01

    Background The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information itself or examined its impact on clinical populations. Little is known about the consequences of its use by the general population. Objective Is use of the Internet by the general population for health purposes associated with a subsequent change in psychological...

  15. The imperative for systems thinking to promote access to medicines, efficient delivery, and cost-effectiveness when implementing health financing reforms: a qualitative study.

    Science.gov (United States)

    Achoki, Tom; Lesego, Abaleng

    2017-03-21

    Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana. The objective was to determine the potential health system impacts that would result from expanding the health insurance scheme covering public sector employees. Study participants were selected through purposeful sampling, stakeholder mapping, and snowballing. We thematically synthesized their views, focusing on the key health system areas of access to medicines, efficiency and cost-effectiveness, as intermediate milestones towards universal health coverage. Participants suggested that expansion of health insurance would be characterized by increased financial resources for health and catalyze an upsurge in utilization of health services particularly among those with health insurance cover. As a result, the health system, particularly within the private sector, would be expected to see higher demand for medicines and other health technologies. However, majority of the respondents cautioned that, realizing the full benefits of improved population health, equitable distribution and financial risk protection, would be wholly dependent on having sound policies, regulations and functional accountability systems in place. It was recommended that, health system stewards should embrace efficient and cost-effective delivery, in order to make progress towards universal health coverage. Despite the prospects of increasing financial resources available for health service delivery, expansion of health insurance

  16. Effect of education and health locus of control on safe use of pesticides: a cross sectional random study

    Directory of Open Access Journals (Sweden)

    Gaber Sherine

    2012-02-01

    Full Text Available Abstract Background In Egypt, many pesticides are used to control pests in agricultural farms. Our study aimed to investigate knowledge and behaviors of farmers related to pesticide use and their relation to educational level and health locus of control. Health locus of control is the degree to which individuals believe that their health is controlled by internal or external factors. Methods A cross-sectional randomized approach was used to collect data from 335 farmers in Mahmoudiya region, Egypt using an interview questionnaire. Results were analyzed using Pearson Chi-square test, Fisher's exact test, Student t-test and ANOVA. Results The average age of farmers was 34 years and 61% of them didn't receive school education. School education was related to higher levels of knowledge and behaviors. Farmers who received school education had more knowledge about the negative effects of pesticides on health and routes of contamination with pesticides. They also had higher scores on reading labels of pesticides containers and taking precautions after coming in contact with pesticides. Regarding health locus of control, higher internal beliefs were significantly related to higher knowledge and behaviors scores, while there was no significant relation between chance and powerful others beliefs with knowledge or behaviors. Conclusion In the present study, higher level of education and lower level of internal beliefs were related to better knowledge and safer use of pesticides among Egyptian farmers. We recommend that strategies for raising internal beliefs must be included in health education programs that aim to ameliorate pesticides use among farmers.

  17. Work characteristics, socioeconomic position and health: a systematic review of mediation and moderation effects in prospective studies.

    Science.gov (United States)

    Hoven, Hanno; Siegrist, Johannes

    2013-09-01

    Social inequalities in health persist in modern societies. The contribution of adverse work and employment conditions towards their explanation is analysed by two approaches, mediation and moderation. Yet the relative significance of each approach remains unclear in respective research. We set out to study this question by conducting a systematic literature review. We included all original papers based on prospective observational studies of employed cohorts that were published between January 1980 and October 2012 meeting our search criteria, by using major databases and by observing established quality criteria. 26 reports were included after quality assessment. 17 studies examined the mediation hypothesis and nine studies tested the moderation hypothesis. Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models. Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP. Despite some support in favour of the two hypotheses future research should aim at reducing the heterogeneity in defining and measuring core variables and at applying advanced statistical analyses. Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

  18. A comparative study on the effectiveness of one-way printed communication versus videophone interactive interviews on health promotion.

    Science.gov (United States)

    Homma, Satoki; Imamura, Haruhiko; Nakamura, Toru; Fujimura, Kaori; Ito, Yoshihiro; Maeda, Yuji; Kaneko, Ikuyo

    2016-01-01

    We performed a comparative study of a health education programme that was delivered either through one-way communication with printed media, or through interactive videophone interviews. We aimed to ascertain which mode of counselling, when used in combination with telemonitoring, is more effective at lifestyle modification intended to improve health status. Participants, who were residents of Kurihara city in Miyagi prefecture, Japan, were randomized into two groups: one group received individualized monthly documented reports (n = 33; 22 females; average age: 67.2 years), and the other received interactive videophone communication (n = 35; 22 females; average age: 65.1 years) for three months. Telemonitoring was conducted on both groups, using a pedometer, weighing scale and a sphygmomanometer. Pre- and post-intervention, anthropometric measurements and blood tests were performed; the participants also completed self-administered questionnaires. The two groups showed similar degrees of health status improvement and satisfaction levels. However, the participants in the videophone group were more aware of improvements in their lifestyles than were the participants in the document group. The individualized printed communication programme was less time-consuming compared to videophone communication. Further studies are needed to formulate a balanced protocol for a counselling-cum-telemonitoring programme that provides optimal health improvement and cost performance with the available human resources. © The Author(s) 2015.

  19. 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

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

    OpenAIRE

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

    2016-01-01

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

  1. Effects of Prenatal Methylmercury Exposure: From Minamata Disease to Environmental Health Studies.

    Science.gov (United States)

    Sakamoto, Mineshi; Itai, Takaaki; Murata, Katsuyuki

    2017-01-01

    Methylmercury, the causative agent of Minamata disease, can easily penetrate the brain, and adult-type Minamata disease patients showed neurological symptoms according to the brain regions where the neurons, mainly in the cerebrum and cerebellum, were damaged. In addition, fetuses are exposed to methylmercury via the placenta from maternal fish consumption, and high-level exposure to methylmercury causes damage to the brains of infants. Typical patients with fetal-type Minamata disease (i.e., serious poisoning caused by in utero exposure to methylmercury) were born during the period of severe methylmercury pollution in 1955-1959, although they showed no abnormality during gestation nor at delivery. However, they showed difficulties in head control, sitting, and walking, and showed disturbances in mental development, these symptoms that are similar to those of cerebral palsy, during the growth periods after birth. The impaired development of fetal-type Minamata disease patients was one of the most tragic and characteristic feature of Minamata disease. In this review, we first summarize 1) the effects of prenatal methylmercury exposure in Minamata disease. Then, we introduce the studies that were conducted mainly by Sakamoto et al. as follows: 2) a retrospective study on temporal and regional variations of methylmercury pollution in Minamata area using preserved umbilical cord methylmercury, 3) decline in male sex ratio observed in Minamata area, 4) characteristics of hand tremor and postural sway in fetal-type Minamata disease patients, 5) methylmercury transfer from mothers to infants during gestation and lactation (the role of placenta), 6) extrapolation studies using rat models on the effects of prenatal methylmercury exposure on the human brain, and 7) risks and benefits of fish consumption.

  2. Healthcare provider views on the health effects of biomass fuel collection and use in rural Eastern Cape, South Africa: an ethnographic study

    NARCIS (Netherlands)

    Matinga, Margaret Njirambo; Annegarn, Harold J.; Clancy, Joy S.

    2013-01-01

    Policymakers at global level recognise that household biomass use in developing countries has significant health consequences. However, it is unclear how local-level health professionals perceive and respond to such health effects. This paper which is derived from the findings of a larger study on

  3. 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

  4. 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.

  5. Long term effects of exposure to ionizing irradiation on periodontal health status – the Tinea Capitis cohort study

    Directory of Open Access Journals (Sweden)

    Siegal eSadetzki

    2015-10-01

    Full Text Available Studies among long term survivors of childhood cancer who had received high dose irradiation therapy of 4-60 Gy, demonstrated acute and chronic dental effects including periodontal diseases. However, the possible effects of low to moderate doses of radiation on dental health are sparse. The aim of this study is to investigate the association between childhood exposure to low-moderate doses of ionizing radiation and periodontal health following 50 years from the exposure. The study population included 253 irradiated subjects (treated for Tinea Capitis in the 1950s and, 162 non-irradiated subjects, treated for Tinea Capitis in the 1950s. The estimated dose to the teeth was 0.2-0.4Gy. Dental examination was performed according to the Community Periodontal Index (CPI. Socio-economic and health behavior variables were obtained through a personal questionnaire. Periodontal disease was operationally defined as deep periodontal pockets. A multivariate logistic regression model was used for the association of irradiation status and other independent variables with periodontal status.The results showed that among the irradiated subjects, 23% (95% CI 18%-28% demonstrated complete edentulousness or insufficient teeth for CPI scoring as compared to 13% (95% CI 8%-19% among the non-irradiated subjects (p=0.01. Periodontal disease was detected among 54% of the irradiated subjects as compared to 40% of the non-irradiated (p=0.008. Controlling for education and smoking, the ORs for the association between radiation and periodontal disease were 1.61 (95% CI 1.01-2.57 and 1.95 (95% CI 1.1-3.5 for ever never and per 1 Gy absorbed in the salivary gland, respectively. In line with other studies, a protective effect for periodontal diseases among those with high education and an increased risk for ever smokers were observed. In conclusion, childhood exposure to low-moderate doses of ionizing radiation might be associated with later outcomes of dental health. The

  6. The Effect of Antiretroviral Treatment on Health Care Utilization in Rural South Africa: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Jan A C Hontelez

    Full Text Available The effect of the rapid scale-up of vertical antiretroviral treatment (ART programs for HIV in sub-Saharan Africa on the overall health system is under intense debate. Some have argued that these programs have reduced access for people suffering from diseases unrelated to HIV because ART programs have drained human and physical resources from other parts of the health system; others have claimed that the investments through ART programs have strengthened the general health system and the population health impacts of ART have freed up health care capacity for the treatment of diseases that are not related to HIV. To establish the population-level impact of ART programs on health care utilization in the public-sector health system, we compared trends in health care utilization among HIV-infected people receiving and not receiving ART with HIV-uninfected people during a period of rapid ART scale-up.We used data from the Wellcome Trust Africa Centre for Population Health, which annually elicited information on health care utilization from all surveillance participants over the period 2009-2012 (N = 32,319. We determined trends in hospitalization, and public-sector and private-sector primary health care (PHC clinic visits for HIV-infected and -uninfected people over a time period of rapid ART scale-up (2009-2012 in this community. We regressed health care utilization on HIV status and ART status in different calendar years, controlling for sex, age, and area of residence. The proportion of people who reported to have visited a public-sector primary health care (PHC clinic in the last 6 months increased significantly over the period 2009-2012, for both HIV-infected people (from 59% to 67%; p<0.001, and HIV-uninfected people (from 41% to 47%; p<0.001. In contrast, the proportion of HIV-infected people visiting a private-sector PHC clinic declined from 22% to 12% (p<0.001 and hospitalization rates declined from 128 to 82 per 1000 PY (p<0.001. For HIV

  7. The Effect of Antiretroviral Treatment on Health Care Utilization in Rural South Africa: A Population-Based Cohort Study.

    Science.gov (United States)

    Hontelez, Jan A C; Tanser, Frank C; Naidu, Kevindra K; Pillay, Deenan; Bärnighausen, Till

    2016-01-01

    The effect of the rapid scale-up of vertical antiretroviral treatment (ART) programs for HIV in sub-Saharan Africa on the overall health system is under intense debate. Some have argued that these programs have reduced access for people suffering from diseases unrelated to HIV because ART programs have drained human and physical resources from other parts of the health system; others have claimed that the investments through ART programs have strengthened the general health system and the population health impacts of ART have freed up health care capacity for the treatment of diseases that are not related to HIV. To establish the population-level impact of ART programs on health care utilization in the public-sector health system, we compared trends in health care utilization among HIV-infected people receiving and not receiving ART with HIV-uninfected people during a period of rapid ART scale-up. We used data from the Wellcome Trust Africa Centre for Population Health, which annually elicited information on health care utilization from all surveillance participants over the period 2009-2012 (N = 32,319). We determined trends in hospitalization, and public-sector and private-sector primary health care (PHC) clinic visits for HIV-infected and -uninfected people over a time period of rapid ART scale-up (2009-2012) in this community. We regressed health care utilization on HIV status and ART status in different calendar years, controlling for sex, age, and area of residence. The proportion of people who reported to have visited a public-sector primary health care (PHC) clinic in the last 6 months increased significantly over the period 2009-2012, for both HIV-infected people (from 59% to 67%; p<0.001), and HIV-uninfected people (from 41% to 47%; p<0.001). In contrast, the proportion of HIV-infected people visiting a private-sector PHC clinic declined from 22% to 12% (p<0.001) and hospitalization rates declined from 128 to 82 per 1000 PY (p<0.001). For HIV

  8. Relative health effects of education, socioeconomic status and domestic gender inequity in Sweden: a cohort study.

    Science.gov (United States)

    Phillips, Susan P; Hammarström, Anne

    2011-01-01

    Limited existing research on gender inequities suggests that for men workplace atmosphere shapes wellbeing while women are less susceptible to socioeconomic or work status but vulnerable to home inequities. Using the 2007 Northern Swedish Cohort (n = 773) we identified relative contributions of perceived gender inequities in relationships, financial strain, and education to self-reported health to determine whether controlling for sex, examining interactions between sex and other social variables, or sex-disaggregating data yielded most information about sex differences. Men had lower education but also less financial strain, and experienced less gender inequity. Overall, low education and financial strain detracted from health. However, sex-disaggregated data showed this to be true for women, whereas for men only gender inequity at home affected health. In the relatively egalitarian Swedish environment where women more readily enter all work arenas and men often provide parenting, traditional primacy of the home environment (for women) and the work environment (for men) in shaping health is reversing such that perceived domestic gender inequity has a significant health impact on men, while for women only education and financial strain are contributory. These outcomes were identified only when data were sex-disaggregated.

  9. Relative health effects of education, socioeconomic status and domestic gender inequity in Sweden: a cohort study.

    Directory of Open Access Journals (Sweden)

    Susan P Phillips

    Full Text Available INTRODUCTION: Limited existing research on gender inequities suggests that for men workplace atmosphere shapes wellbeing while women are less susceptible to socioeconomic or work status but vulnerable to home inequities. METHODS: Using the 2007 Northern Swedish Cohort (n = 773 we identified relative contributions of perceived gender inequities in relationships, financial strain, and education to self-reported health to determine whether controlling for sex, examining interactions between sex and other social variables, or sex-disaggregating data yielded most information about sex differences. RESULTS AND DISCUSSION: Men had lower education but also less financial strain, and experienced less gender inequity. Overall, low education and financial strain detracted from health. However, sex-disaggregated data showed this to be true for women, whereas for men only gender inequity at home affected health. In the relatively egalitarian Swedish environment where women more readily enter all work arenas and men often provide parenting, traditional primacy of the home environment (for women and the work environment (for men in shaping health is reversing such that perceived domestic gender inequity has a significant health impact on men, while for women only education and financial strain are contributory. These outcomes were identified only when data were sex-disaggregated.

  10. An examination of the effects of intra and inter-individual changes in wellbeing and mental health on self-rated health in a population study of middle and older-aged adults.

    Science.gov (United States)

    Burns, Richard A; Sargent-Cox, Kerry; Mitchell, Paul; Anstey, Kaarin J

    2014-11-01

    Self-rated health is frequently used as an indicator of health and quality of life in epidemiological studies. While the association between self-rated health and negative mental health is well established, associations with indictors of positive wellbeing are less clear. Data from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project were used to compare the effects of vitality and mental health on self-rated health. Participants (n = 40,712) provided information on vitality, mental health and self-rated health, were aged 45-95 years at baseline, and were followed between 1 and 10 years (M = 5.6; SD = 2.9). In comparison with mental health, multi-level modelling indicated between- and within-person change in vitality was more strongly associated with self-rated health. Bivariate dual change score modelling of the cross-lagged associations between vitality and self-rated health indicated vitality to be a stronger predictor of change in self-rated health. Self-rated health was unrelated to change in vitality. Vitality accounted for most of the mental health effect on self-rated health and was identified as a significant predictor of change in self-rated health over a 10-year period. Promoting wellbeing and psychological functioning may have significant protective effects on negative health outcomes throughout the adult lifespan and into late life.

  11. Effect of a smoking ban on respiratory health in nonsmoking hospitality workers: a prospective cohort study.

    Science.gov (United States)

    Rajkumar, Sarah; Stolz, Daiana; Hammer, Jürg; Moeller, Alexander; Bauer, Georg F; Huynh, Cong Khanh; Röösli, Martin

    2014-10-01

    The aim of this study was to examine the effect of a smoking ban on lung function, fractional exhaled nitric oxide, and respiratory symptoms in nonsmoking hospitality workers. Secondhand smoke exposure at the workplace, spirometry, and fractional exhaled nitric oxide were measured in 92 nonsmoking hospitality workers before as well as twice after a smoking ban. At baseline, secondhand smoke-exposed hospitality workers had lung function values significantly below the population average. After the smoking ban, the covariate-adjusted odds ratio for cough was 0.59 (95% confidence interval, 0.36 to 0.93) and for chronic bronchitis 0.75 (95% confidence interval, 0.55 to 1.02) compared with the preban period. The below-average lung function before the smoking ban indicates chronic damages from long-term exposure. Respiratory symptoms such as cough decreased within 12 months after the ban.

  12. Study of vibration and its effect on health of the motorcycle rider

    Directory of Open Access Journals (Sweden)

    Shivakumara BS

    2010-07-01

    Full Text Available The motorcycle riders are subjected to extreme vibrations due to the vibrations of its engine, improper structural design of the motorcycle and the bad road conditions. The literature review reveals that the vibrations are most hazardous to the health if it exceeds the limit. The experiments were conducted to measure the magnitude of the vibrations acting on the rider during motorcycle riding under various road conditions. Experimental values of accelerations and frequencies which are beyond permissible limits according to the literature confirm that vibration certainly affects health of the motorcycle rider

  13. Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study.

    Science.gov (United States)

    Mattei, Giorgio; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco

    2014-06-01

    To report on the effects on health that the 2008 Great Recession is producing in Italy, by comparing the consistency of Italian data with general observations reported in the scientific literature, and by pointing out consequences on the rates of all-cause mortality, cardiovascular mortality, male suicidal behaviours, daytime alcohol drinking and traffic fatalities. This is an ecological study in which MEDLINE, PsycINFO and PubMed were searched for the literature with combinations of the following keywords: economic recession, financial crisis, unemployment, health, suicide and mental health. Data from two Italian government agencies (Italian Institute of Statistics, ISTAT, and Italian Agency of Drugs, AIFA) in the years from 2000 to 2010 were obtained and analysed, by producing models of multiple linear regressions. After the recession onset, all-cause mortality remained stable, and was not associated with the economic fluctuations. Differently, cardiovascular mortality was associated with the rate of unemployment, and showed a significant increase in 2010. Alcohol consumption increased in 2009, the year with the worst real GDP decrease (-5.1 %). Though the total rate of suicide was not associated with the economic situation, male completed and attempted suicides due to financial crisis were significantly associated with the rate of unemployment and the real GDP. The increasing diffusion of antidepressants was not associated with a lowering of the rate of suicide. The data on the Italian situation here discussed are sufficiently reliable to conclude that a link exists between the ongoing economic recession and health and mental health of Italians. Further research is needed to understand more in detail and with stronger reliability such link, to support primary and secondary preventive interventions and orient the development of effective sociopolitical interventions.

  14. The effect of post-traumatic stress disorder on refugees' parenting and their children's mental health: a cohort study

    Directory of Open Access Journals (Sweden)

    Richard A Bryant, ProfPhD

    2018-05-01

    Full Text Available Summary: Background: Children and adolescents, who account for most of the world's refugees, have an increased prevalence of psychological disorders. The mental health of refugee children is often associated with the severity of post-traumatic stress disorder (PTSD in their caregivers. Despite the potential for refugee caregivers' PTSD to affect child mental health, little evidence exists concerning the underlying mechanisms of this association. This study tested the effect of refugee caregivers' previous trauma and levels of ongoing stressors on current PTSD, and in turn how this influences parenting behaviour and consequent child psychological health. Methods: This cohort study recruited participants from the Building a New Life in Australia study, a population-based prospective cohort study of refugees admitted to 11 sites in Australia between October, 2013, and February, 2014. Eligible participants were aged 18 years or older and the principal or secondary applicant (ie, the refugee applicant within a migrating family unit for a humanitarian visa awarded between May, 2013, and December, 2013. Primary caregiver PTSD and postmigration difficulties were assessed at Wave 1 (in 2013, and caregiver PTSD was reassessed at Wave 2 (in 2014. At Wave 3, between October, 2015, and February, 2016, primary caregivers repeated measures of trauma history, postmigration difficulties, probable PTSD, and harsh and warm parenting style, and completed the Strengths and Difficulties Questionnaire for their child. We used path analysis to investigate temporal patterns in PTSD, trauma history, postmigration stressors, parenting style, and children's psychological difficulties. Findings: The current data comprised 411 primary caregivers who provided responses in relation to at least one child (660 children. 394 primary caregivers with 639 children had data on independent variables and were included in the final model. Path analyses revealed that caregivers' trauma

  15. EPA Research on Health Effects of Biofuels: Studies with inhaled ethanol in rats.

    Science.gov (United States)

    The Energy Independence and Security Act of 2007 mandates increased use of alternative fuels in the American automobile fleet. Currently, the primary alternative to petroleum fuels is ethanol, and the public health risk associated with adding ethanol to gasoline at concentrations...

  16. The prospective study of the effect of the low-dosage radiation on the health of the staff members

    International Nuclear Information System (INIS)

    Zhang Shicheng; Jing Luwei; Tian Guang; Liu Linxiu; Wu Wentao

    2008-01-01

    Objective: To study the effect of the long term low-dosage radiation on the health of the staff members in order to provide a scientific basis for the rational protective measures to be taken. Methods: Dynamic observations were made for 15 years of the conditions of the staff members exposed to radiation. The inherent changes and the affecting factors were analyzed. Group of people free from radiation were chosen to the control group. Results: Sighs of nervous breakdown, damages of the eye crystal, hand skin and nails are much more frequently seen among medical radiation workers than these in the control group. There are differences between radiation workers and the control in the positive rates of the objective indices such as leukocytes, erythrocytes, blood platelets, immune functions, the minute nuclei and the chromosome fission. Conclusion: Persistent low-dose radiation can cause damages to the health of radiation workers in many respects, Measures of radiation protection and persistant health monitoring should be taken. Thisis of great importance in implementing the state's relative laws and regulations to protect the health of the radiation workers. (authors)

  17. The effect of explosive remnants of war on global public health: a systematic mixed-studies review using narrative synthesis.

    Science.gov (United States)

    Frost, Alexandra; Boyle, Peter; Autier, Philippe; King, Colin; Zwijnenburg, Wim; Hewitson, David; Sullivan, Richard

    2017-06-01

    Explosive remnants of war (ERW)-landmines, unexploded ordnance (UXO), and abandoned explosive ordnance (AXO)-have been recognised as a threat to health since the 1990s. We aimed to study the effect of ERW on global public health. In this systematic mixed-studies review, we searched the Web of Science, Scopus, PubMed, and ProQuest databases, and hand searched relevant websites, for articles published between Jan 1, 1990, and Aug 31, 2015. We used keywords and Medical Subject Headings related to ERW, landmines, UXO, and AXO to locate original peer-reviewed quantitative, qualitative, or mixed-methods studies in English of the direct physical or psychological effects of ERW on direct victims of the explosive device or reverberating social and economic effects on direct victims and indirect victims (their families and the wider at-risk community). We excluded studies if more than 20% of participants were military, if they were of deminers, if they were from high-income countries, or if they were of chemical weapons. We identified no peer-reviewed studies of AXO effects, so we extended the search to include grey literature. We critically appraised study quality using a mixed methods appraisal tool. We used a narrative synthesis approach to categorise and synthesise the literature. We extracted quantitative data and calculated means and percentages. The initial search identified 10 226 studies, leaving 8378 (82%) after removal of duplicates, of which we reviewed 54 (26 [48%] were quantitative descriptive studies, 20 [37%] were quantitative non-randomised studies, four [7%] were mixed-methods studies, and four [7%] were grey literature). The direct psychological effects of landmines or UXO appear high. We identified comorbidity of anxiety and depression in landmine or UXO victims in four studies, more women presented with post-traumatic stress disorder than did men in two studies, and landmine or UXO victims reported a greater prevalence of post-traumatic stress disorder

  18. Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study.

    Science.gov (United States)

    Arnason, Terra G; Bowen, Matthew W; Mansell, Kerry D

    2017-04-15

    To determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM). We describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase. At baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m 2 ]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase ( P 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical

  19. 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.)

  20. The Breast Health Intervention Evaluation Study

    National Research Council Canada - National Science Library

    Blumenthal, Daniel

    1997-01-01

    The Breast Health Intervention Evaluation (BRIE) Study will evaluate the relative effectiveness of three different approaches to breast health messages--a fear appeal, a positive affect appeal, and an affectively neutral, cognitive appeal...

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

    Science.gov (United States)

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

    2016-01-01

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

  2. The effect of ill health and socioeconomic status on labor force exit and re-employment: A prospective study with ten years follow-up in the Netherlands

    NARCIS (Netherlands)

    M. Schuring (Merel); S.J.W. Robroek (Suzan); F.W.J. Otten (Ferdy); C.H. Arts (Coos); A. Burdorf (Alex)

    2013-01-01

    textabstractObjectives The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming economically inactive. A secondary objective was to investigate the effect of ill health and

  3. Study of the health effects of low-level exposure to environmental radiation contamination in Port Hope, Ontario

    International Nuclear Information System (INIS)

    Steele, R.; Lees, R.E.M.; Roberts, J.H.

    1984-06-01

    From 1939 to 1948 residues from radium production at Eldorado Nuclear Ltd.'s plant in Port Hope, Ontario were disposed of in and around the town of Port Hope. In 1980 a study was set up to determine the health effects of these residues. This report concerns phase two a case- control study of lung cancer in the exposed population. Doses for the 118 cases and controls were reconstructed to give the final year of exposure, the residences occupied during the period of exposure, and the total estimated exposure for various latency periods. Statistical analysis of the data gathered could not give coherent results or show an identifiable increased risk of lung cancer from elevated alpha radiation levels due to the confounding effect of cigarette smoking. Ninety percent of the cases of lung cancer found were attributable to smoking

  4. Comparing Effectiveness of Treatments for Borderline Personality Disorder in Communal Mental Health Care: The Oulu BPD Study.

    Science.gov (United States)

    Leppänen, V; Hakko, H; Sintonen, H; Lindeman, S

    2016-02-01

    The implementation of effective psychotherapies in community mental health care is challenging. This study aimed to create a well-structured and easily applicable treatment model for patients with severe borderline personality disorder (BPD). We integrated a schema therapy based psycho-educational group into an available individual therapy. Two groups were formed: (1) community treatment by experts (CTBE) patients (n = 24) receiving new treatment and (2) treatment as usual (TAU) patients (n = 47). Changes in symptoms were measured by Borderline Personality Disorder Severity Index-IV interview and quality of life by the 15D health-related quality of life questionnaire. After 1 year the CTBE patients showed a significant reduction in a wider range of BPD symptoms and better quality of life than TAU patients. The results of this study are encouraging. A well-structured treatment model was successfully implemented into community mental health care with improved patient adherence to treatment and superior treatment outcomes compared to TAU patients.

  5. Respiratory health effects and exposure to superabsorbent polymer and paper dust - an epidemiological study

    Directory of Open Access Journals (Sweden)

    Torén Kjell

    2011-07-01

    Full Text Available Abstract Background The primary aim of the present study was to investigate if exposure to dust from absorbent hygiene products containing superabsorbent polymer is related to symptoms from the airways and from the eyes. The secondary aim was to estimate the current exposure to superabsorbent polymer among production and maintenance workers in a plant producing hygiene products. Methods The cohort comprised 1043 workers of whom 689 were exposed to super absorbent polymer and 804 were exposed to paper dust (overlapping groups. There was 186 workers not exposed to either superabsorbent polymer or to paper dust They were investigated with a comprehensive questionnaire about exposure, asthma, rhinitis and symptoms from eyes and airways. The results were analyzed with logistic regression models adjusting for sex, age, atopy and smoking habits. An aerosol sampler equipped with a polytetrafluoroethylene filter with 1 μm pore size was used for personal samplings in order to measure inhalable dust and superabsorbent polymer. Results The prevalence of nasal crusts (OR 1.4, 95% CI 1.01-2.0 and nose-bleeding (OR 1.7, 95% CI 1.2-2.4 was increased among the paper dust exposed workers (adjusted for superabsorbent polymer exposure. There were no significant effects associated with exposure to superabsorbent polymer (adjusted for paper dust exposure. The average exposure to inhalable levels of total dust (paper dust varied between 0.40 and 1.37 mg/m3. For superabsorbent polymer dust the average exposure varied between 0.02 and 0.81 mg/m3. Conclusions In conclusion, our study shows that workers manufacturing diapers in the hygiene industry have an increased prevalence of symptoms from the nose, especially nose-bleeding. There was no relation between exposure to superabsorbent polymer and symptoms from eyes, nose or respiratory tract, but exposure to paper dust was associated with nose-bleeding and nasal crusts. This group of workers had also a considerable

  6. Awareness of health effects of exposure to secondhand smoke from cigarettes: A cross-sectional study of never-smoked adult primary care patients in Eastern Nigeria

    OpenAIRE

    Pascal Iloh, Gabriel Uche; Collins, Peace Ifeoma

    2017-01-01

    Background: Cigarette smoking whether actively or passively is a growing public health problem. Despite the wealth of information on the hazards of active cigarette smoking, awareness of the health effects of passive smoking on human population is often neglected in Nigeria. Aim: The study was aimed at describing the awareness of health effects of exposure to secondhand smoke from cigarettes among never-smoked adult primary care patients in Eastern Nigeria. Materials and Methods: A hospital-b...

  7. How the tobacco industry responded to an influential study of the health effects of secondhand smoke

    OpenAIRE

    Hong, Mi-Kyung; Bero, Lisa A

    2002-01-01

    In 1981 an influential Japanese study showed an association between passive smoking and lung cancer. This article documents the tobacco industry's attempts to refute this study by producing a credible alternative study.

  8. Costs and Outcomes of Increasing Access to Bariatric Surgery: Cohort Study and Cost-Effectiveness Analysis Using Electronic Health Records.

    Science.gov (United States)

    Gulliford, Martin C; Charlton, Judith; Prevost, Toby; Booth, Helen; Fildes, Alison; Ashworth, Mark; Littlejohns, Peter; Reddy, Marcus; Khan, Omar; Rudisill, Caroline

    2017-01-01

    To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity. Outcomes were quality-adjusted life-years (QALYs) and net monetary benefits at a threshold of £30,000 per QALY. In a UK population of 250,000 adults, there may be 7,163 people with morbid obesity including 1,406 with diabetes. The immediate cost of 1,000 bariatric surgical procedures is £9.16 million, with incremental discounted lifetime health care costs of £15.26 million (95% confidence interval £15.18-£15.36 million). Patient-years with diabetes mellitus will decrease by 8,320 (range 8,123-8,502). Incremental QALYs will increase by 2,142 (range 2,032-2,256). The estimated cost per QALY gained is £7,129 (range £6,775-£7,506). Net monetary benefits will be £49.02 million (range £45.72-£52.41 million). Estimates are similar for subgroups of age, sex, and deprivation. Bariatric surgery remains cost-effective if the procedure is twice as costly, or if intervention effect declines over time. Diverse obese individuals may benefit from bariatric surgery at acceptable cost. Bariatric surgery is not cost-saving, but increased health care costs are exceeded by health benefits to obese individuals. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. The Effect of Smartphones on Human Health Relative to User's Addiction: A Study on a Wide Range of Audiences in Jordan

    OpenAIRE

    T. Qasim; M. Obeidat; S. Al-Sharairi

    2017-01-01

    The objective of this study is to investigate the effect of the excessive use of smartphones. Smartphones have enormous effects on the human body in that some musculoskeletal disorders (MSDs) and health problems might evolve. These days, there is a wide use of the smartphones among all age groups of society, thus, the focus on smartphone effects on human behavior and health, especially on the young and elderly people, becomes a crucial issue. This study was conducted in Jordan on smartphone u...

  10. The Effect of a Community Health Worker Utilized Mobile Health Application on Maternal Health Knowledge and Behavior: A Quasi-Experimental Study

    NARCIS (Netherlands)

    Ilozumba, Onaedo; Dieleman, M.A.; Broerse, J.E.W.; Van Belle, Sara

    2018-01-01

    Background: Mobile technology (mHealth) is increasingly being used to achieve improved access and quality of maternal care, particularly in rural areas of low- and middle-income countries. In 2011, a mobile application—Mobile for Mothers (MfM)—was implemented in Jharkhand, India to support home

  11. Kazakhstan-Japan joint study on health effects of radiation in residents in and around former Semipalatinsk Nuclear Test Site

    International Nuclear Information System (INIS)

    Toshiaki Ogiu; Yoshiro Aoki; Sadayoshi Kobayashi; Shizuyo Kusumi; Jiro Inaba; Kenzhina, G.; Berezin, S.; Zhotabaev, Zh.; Berezina, M.; Sekerbayev, A.; Lukashenko, S.

    2008-01-01

    Full text: The National Nuclear Center of the Republic of Kazakhstan (NNC RK) and the Radiation Effects Association (REA, Japan) are now jointly carrying out 'Study on Health Effects of Radiation in Residents in and around the Former Semipalatinsk Nuclear Test Site (STS)' commissioned by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japanese Government. This joint study between Kazakhstan and Japan was initiated in 2001 in response to the request from the government of the Republic of Kazakhstan and to the resolution of the 53rd United Nations General Assembly in 1998 for providing the Kazakhstan with medical, environmental, economical and humanitarian assistance to the residents in and around Semipalatinsk Test Site. The purpose of the study is to obtain scientific evidence on the health effects of chronic and repeated long-term exposure to low level mixed (external and internal) radiation in residents in and around Semipalatinsk Test Site, and thereby to provide fundamental scientific information on the nature and extent of health effects that might have been incurred by such exposures. The mode of this type of exposure (chronic long-term mixed radiation) is conceivable in the current situation of exposure such as occupational exposure, but different from those of Hiroshima and Nagasaki in Japan where the exposure was mainly acute and external. In this study, exposed populations are consisting of residents of Dolon, Znamenka, Karaul, and Kainar (Semipalatinsk population - 1) and that of Southern Beskaragai Region including Mostik, Cheremushki, Bol'shaya Vladimirovka, Malaya Vladimirovka, Budene, Semenovka, etc. (Semipalatinsk population - 2). Control populations are consisting of residents of Kenzhekol, Kenes and Zhanaaul (Pavlodar Population - 1) and that of Kachiry, Irtyshsk and Sherbakty (Pavlodar Population - 2). As of the end of July, 2008, personal data (date of birth, gender, race, etc.) were collected for 117,300 persons

  12. Applicability of the Environmental Relative Moldiness Index for Quantification of Residential Mold Contamination in an Air Pollution Health Effects Study

    Directory of Open Access Journals (Sweden)

    Ali Kamal

    2014-01-01

    Full Text Available The Near-Road Exposures and Effects of Urban Air Pollutants Study (NEXUS investigated the impact of exposure to traffic-related air pollution on the respiratory health of asthmatic children in Detroit, Michigan. Since indoor mold exposure may also contribute to asthma, floor dust samples were collected in participants homes (n=112 to assess mold contamination using the Environmental Relative Moldiness Index (ERMI. The repeatability of the ERMI over time, as well as ERMI differences between rooms and dust collection methods, was evaluated for insights into the application of the ERMI metric. ERMI values for the standard settled floor dust samples had a mean ± standard deviation of 14.5±7.9, indicating high levels of mold contamination. ERMI values for samples collected from the same home 1 to 7 months apart (n=52 were consistent and without systematic bias. ERMI values for separate bedroom and living room samples were highly correlated (r=0.69, n=66. Vacuum bag dust ERMI values were lower than for floor dust but correlated (r=0.58, n=28. These results support the use of the ERMI to evaluate residential mold exposure as a confounder in air pollution health effects studies.

  13. Costs and health effects of screening and delivery of hearing aids in Tamil Nadu, India: an observational study

    Directory of Open Access Journals (Sweden)

    Job Anand

    2009-05-01

    Full Text Available Abstract Background The burden of disease of hearing disorders among adults is high, but a significant part goes undetected. Screening programs in combination with the delivery of hearing aids can alleviate this situation, but the economic attractiveness of such programs is unknown. This study aims to evaluate the population-level costs, effects and cost-effectiveness of alternative delivering hearing aids models in Tamil Nadu, India Methods In an observational study design, we estimated total costs and effects of two active screening programs in the community in combination with the provision of hearing aids at secondary care level, and the costs and effects of the provision of hearing aids at tertiary care level. Screening and hearing aid delivery costs were estimated on the basis of program records and an empirical assessment of health personnel time input. Household costs for seeking and undergoing hearing health care were collected with a questionnaire (see Additional file 2. Health effects were estimated on the basis of compliance with the hearing aid, and associated changes in disability, and were expressed in disability-adjusted life years (DALYs averted. Results Active screening and provision of hearing aids at the secondary care level costs around Rs.7,000 (US$152 per patient, whereas provision of hearing aids at the tertiary care level costs Rs 5,693 (US$122 per patient. The cost per DALY averted was around RS 42,200 (US$900 at secondary care level and Rs 33,900 (US$720 at tertiary care level. The majority of people did consult other providers before being screened in the community. Costs of food and transport ranged between Rs. 2 (US$0,04 and Rs. 39 (US$0,83. Conclusion Active screening and provision of hearing aids at the secondary care level is slightly more costly than passive screening and fitting of hearing aids at the tertiary care level, but seems also able to reach a higher coverage of hearing aids services. Although crude

  14. Does Mental Health Status Influence Susceptibility to the Physiologic Effects of Air Pollution? A Population Based Study of Canadian Children.

    Science.gov (United States)

    Dales, Robert E; Cakmak, Sabit

    2016-01-01

    Both air pollution exposure and the presence of mental illness are associated with an increased risk of physical illness. To determine whether or not children with less favourable mental health are more susceptible to pulmonary and cardiovascular effects of ambient air pollution, compared to those who are mentally healthy. We carried out a cross-sectional study of 1,883 children between the ages of 6 and 17 years of age who participated in the Canadian Health Measures population survey between 2007 and 2009. Subjects were assigned the air pollution values obtained from the National Air Pollution monitor closest to their neighborhood. Lung function, heart rate and blood pressure were stratified by indicators of mental health. The latter were ascertained by questions about feelings of happiness, a diagnosed mood disorder, and the emotional symptom subscale of the Strengths and Difficulties Questionnaire. Among those who reported a mood disorder, an interquartile increase in ozone was associated with increases in systolic and diastolic pressures of 3.8 mmHg (95% CI 1.6, 5.9) and 3.0mmHg (95%CI 0.9, 5.2) respectively, and a decreases in FVC of 7.6% (95% CI 2.9, 12.3). No significant changes in these variables were observed in those who did not report a mood disorder. Among those with unfavourable emotional symptoms, ozone was associated with a 6.4% (95% CI 1.7, 11.3) increase in heart rate, a 4.1% (95%CI 1.2, 7.1) increase in systolic blood pressure, and a 6.0% (95% CI 1.4, 10.6) decrease in FEVl. No significant effect was seen in these variables among those with no emotional symptoms. In the Canadian population, children who report mood disorders or unfavourable emotional symptoms appear to be more vulnerable to the adverse physiologic effects of air pollution.

  15. Effects of Improving Primary Health Care Workers' Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning.

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng; Yan, Weirong

    2017-05-01

    Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs' competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers' education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs-the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs-the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses' knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; Plearning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02). Among PHCWs in

  16. Effects of Improving Primary Health Care Workers’ Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning

    Science.gov (United States)

    Zhan, Xingxin; Zhang, Zhixia; Sun, Fang; Liu, Qian; Peng, Weijun; Zhang, Heng

    2017-01-01

    Background Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs’ competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers’ education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning. Objective The aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach. Methods The study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs—the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs—the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses’ knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). Results The experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; Plearning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1

  17. Healthcare provider views on the health effects of biomass fuel collection and use in rural Eastern Cape, South Africa: an ethnographic study.

    Science.gov (United States)

    Matinga, Margaret Njirambo; Annegarn, Harold J; Clancy, Joy S

    2013-11-01

    Policymakers at global level recognise that household biomass use in developing countries has significant health consequences. However, it is unclear how local-level health professionals perceive and respond to such health effects. This paper which is derived from the findings of a larger study on perceptions and responses to the harmful health effects of carrying heavy firewood loads and to smoke from cooking fires is based on a study conducted in South Africa among managers of health programmes and community nurses of Qaukeni and Mhlontlo municipalities in rural Eastern Cape. Interviews and participant observations were conducted in 2009 using ethnographic grounded theory approaches. In addition to a 10-month period of ethnographic fieldwork, ten programme managers and nurses in two villages were interviewed about health patterns in the villages that they serve, their perceptions of, and responses to the health effects of carrying heavy firewood loads, and inhalation of smoke from wood and dung cooking fires, their professional qualifications and experience, their own household energy use; and observations made as they served clinic clients. Results show that these programme managers and nurses perceive the health effects of carrying heavy loads of firewood and of cooking smoke as minor. Sometimes, nurses give women symptomatic relief for musculoskeletal pain resulting from carrying heavy loads. We posit that their perceptions are derived from customary neglect of work-related health and non-communicable diseases, cultural interpretations of womanhood, limited access to relevant information, and limited interactions between health and energy sector professionals. We conclude that culturally and gender-sensitive awareness programmes are needed for local-level health professionals to effectively address health effects of biomass collection and use. This paper provides new insights into overlooked differences between globally-driven initiatives to address health

  18. Nationwide survey on pediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects

    International Nuclear Information System (INIS)

    Ono, K.; Ban, N.; Ojima, M.; Yoshinaga, S.; Akahane, K.; Fujii, K.; Toyota, M.; Hamada, F.; Kouriyama, C.; Akiba, S.; Kunugita, N.; Shimada, Y.; Kai, M.

    2011-01-01

    A nationwide survey was conducted in Japan on paediatric CT among children of public health and school nurses to examine a possibility for a follow-up study on radiation effects. A survey questionnaire was sent out to 3173 public primary and junior high schools and 317 public health centres during October to December in 2009. According to the collected responses, 410 (16.2 %) children received the CT scans and the total number of CT scans was 585. Most of respondents expressed a high interest in radiation health effects and an intent to participate in the epidemiological study that will follow-up the health conditions of children. This study provides information to discuss the feasibility of the epidemiological study on health effects in children who received CT scans. (authors)

  19. Effects of traffic policies on air pollution and health - an intervention study

    NARCIS (Netherlands)

    Boogaard, J.M.C.

    2012-01-01

    In the past decades substantial efforts have been taken to reduce air pollution emissions. However, increases in urban populations, number of cars and vehicle km travelled are a few trends that may partly offset their effectiveness. The EU has set air quality standards of which the standards for

  20. Guided online treatment in routine mental health care: an observational study on uptake, drop-out and effects

    Directory of Open Access Journals (Sweden)

    Kenter Robin

    2013-01-01

    Full Text Available Abstract Background Due to limited resources patients in the Netherlands often have to wait for a minimum of six weeks after registration for mental health care to receive their first treatment session. Offering guided online treatment might be an effective solution to reduce waiting time and to increase patient outcomes at relatively low cost. In this study we report on uptake, drop-out and effects of online problem solving treatment that was implemented in a mental health center. Methods We studied all 104 consecutive patients aged 18–65 years with elevated symptoms of depression, anxiety and/or burnout who registered at the center during the first six months after implementation. They were offered a five week guided online treatment. At baseline, five weeks and twelve weeks we measured depressive (BDI-II, anxiety (HADS-A and burnout symptoms (MBI. Results A total of 55 patients (53% agreed to start with the online treatment. Patients who accepted the online treatment were more often female, younger and lower educated than those who refused. There were no baseline differences in clinical symptoms between the groups. There were large between group effect sizes after five weeks for online treatment for depression (d = 0.94 and anxiety (d = 1.07, but not for burnout (d = −.07. At twelve weeks, when both groups had started regular face-to-face treatments, we no longer found significant differences between the groups, except for anxiety (d = 0.69. Conclusion The results of this study show that the majority of patients prefer online guided online treatment instead of waiting for face-to-face treatment. Furthermore, online PST increases speed of recovery and can therefore be offered as a first step of treatment in mental healthcare.

  1. Cognitive, health and psychosocial effects of melatonin and light therapy in childhood insomnia. Double-blind placebo-controlled study

    NARCIS (Netherlands)

    Smits, M.; van Maanen, A.; Meijer, A.M.; van der Heijden, K.; Oort, F.

    2017-01-01

    Introduction: To examine effects of melatonin and light therapy on cognitive, health and psychosocial outcomes in children with chronic sleep onset insomnia; and to disentangle direct effects from indirect effects through sleep improvement. Methods: A randomized, double-blind placebo-controlled

  2. The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City.

    Science.gov (United States)

    Melis, Giulia; Gelormino, Elena; Marra, Giulia; Ferracin, Elisa; Costa, Giuseppe

    2015-11-20

    Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)-a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.

  3. The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City

    Directory of Open Access Journals (Sweden)

    Giulia Melis

    2015-11-01

    Full Text Available Mental health (MH has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment and contextual social environment (SE variables (social and physical disorder, crime rates. Data was extracted from the Turin Longitudinal Study (TLS—a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl, could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Effects of oral health care on salivary flow rate in patients with type 2 diabetes: preliminary study.

    Science.gov (United States)

    Ibayashi, Haruhisa; Nishiyama, Tomohiro; Tanaka, Masayuki; Pham, Truong-Minh; Yano, Junko; Sakai, Kazuyo; Kobayashi, Atsushi; Yakura, Naonori; Matsuda, Shinya

    2009-07-01

    The purpose of this study is to evaluate the effects of the authors' oral health care program on the stimulated whole salivary flow rate and buffer capacity before and after a 6-month intervention. The authors conducted the intervention study among 25 participants with diabetes. The salivary flow rate and buffer capacity were evaluated before and after this intervention. Overall, the results showed a significant increase in salivary flow rate and no significant change in buffer capacity. Also, it was likely that salivary flow rate significantly increased among patients with more than 20 remaining teeth and patients with well-controlled diabetes. The findings suggest that this program for type 2 diabetes led to an increase in the stimulated whole salivary flow rate.

  6. 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

  7. 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.

  8. 249 The study examined the effect of climate change on the health ...

    African Journals Online (AJOL)

    Osondu

    cloud cover and precipitation (Ebong, 2010). In Nigeria just as in ... Ethiopian Journal of Environmental Studies and Management Vol. 6 No.3 2013 ... Technology, Federal University of Technology Minna, Nigeria. .... There is need for green.

  9. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Science.gov (United States)

    2011-01-01

    Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction. PMID:21981753

  10. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece.

    Science.gov (United States)

    Iliopoulos, Efthymios; Priporas, Constantinos-Vasilios

    2011-10-09

    The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction.

  11. Western Canada study of animal health effects associated with exposure to emissions from oil and gas field facilities : technical summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    The impact of exposure to emissions from oil and gas field facilities on animal and human health has been a long-standing concern in western Canada. This technical summary presented highlights of the 17 major research appendices of a study examining associations between emissions and important reproductive parameters in beef cattle, including pregnancy rates, frequencies of abortions and stillbirths, and the risk of death among young calves. The effect of exposure to emissions on the respiratory, immune and nervous systems of calves and yearlings was also evaluated. The study was an epidemiological investigation that drew on large blocks of data collected from privately owned cow-calf operations, laboratory analyses of biological samples and samplers from air monitors. Mixed effect regression models were used to investigate whether measures of reproductive, immunological, and pathology outcomes were associated with emissions from the petroleum industry. Appropriate statistical adjustments were made to correct for multiple comparisons following standard statistical practice. An overview of the methods used to analyze the data was presented, as well as an examination of the methods of epidemiology in determining a causal effect, and the limitations of a single study in determining causation with certainty. Information on water quality testing and feeding management and forage testing was provided. 15 tabs., 26 figs.

  12. Western Canada study of animal health effects associated with exposure to emissions from oil and gas field facilities : technical summary

    International Nuclear Information System (INIS)

    2006-01-01

    The impact of exposure to emissions from oil and gas field facilities on animal and human health has been a long-standing concern in western Canada. This technical summary presented highlights of the 17 major research appendices of a study examining associations between emissions and important reproductive parameters in beef cattle, including pregnancy rates, frequencies of abortions and stillbirths, and the risk of death among young calves. The effect of exposure to emissions on the respiratory, immune and nervous systems of calves and yearlings was also evaluated. The study was an epidemiological investigation that drew on large blocks of data collected from privately owned cow-calf operations, laboratory analyses of biological samples and samplers from air monitors. Mixed effect regression models were used to investigate whether measures of reproductive, immunological, and pathology outcomes were associated with emissions from the petroleum industry. Appropriate statistical adjustments were made to correct for multiple comparisons following standard statistical practice. An overview of the methods used to analyze the data was presented, as well as an examination of the methods of epidemiology in determining a causal effect, and the limitations of a single study in determining causation with certainty. Information on water quality testing and feeding management and forage testing was provided. 15 tabs., 26 figs

  13. Correlates of Cortisol in Human Hair: Implications for Epidemiologic Studies on Health Effects of Chronic Stress

    Science.gov (United States)

    Wosu, Adaeze C.; Valdimarsdóttir, Unnur; Shields, Alexandra E.; Williams, David R.; Williams, Michelle A.

    2013-01-01

    Assessment of cortisol concentrations in hair is one of the latest innovations for measuring long-term cortisol exposure. We performed a systematic review of correlates of cortisol in human hair to inform the design, analysis and interpretation of future epidemiologic studies. Relevant publications were identified through electronic searches on PubMed, WorldCat, and Web of Science using keywords, “cortisol” “hair” “confounders” “chronic” “stress” and “correlates.” Thirty-nine studies were included in this review. Notwithstanding scarce data and some inconsistencies, investigators have found hair cortisol concentrations to be associated with stress-related psychiatric symptoms and disorders (e.g., PTSD), medical conditions indicating chronic activation of the hypothalamic-pituitary-adrenal axis (e.g., Cushing´s syndrome) and other life situations associated with elevated risk of chronic stress (e.g., shiftwork). Results from some studies suggest that physical activity, adiposity, and substance abuse may be correlates of hair cortisol concentrations. In contrast to measures of short-term cortisol release (saliva, blood, and urine), cigarette smoking and use of oral contraceptives appear to not be associated with hair cortisol concentrations. Studies of pregnant women indicate increased hair cortisol concentrations across successive trimesters. The study of hair cortisol presents a unique opportunity to assess chronic alterations in cortisol concentrations in epidemiologic studies. PMID:24184029

  14. Correlates of cortisol in human hair: implications for epidemiologic studies on health effects of chronic stress.

    Science.gov (United States)

    Wosu, Adaeze C; Valdimarsdóttir, Unnur; Shields, Alexandra E; Williams, David R; Williams, Michelle A

    2013-12-01

    Assessment of cortisol concentrations in hair is one of the latest innovations for measuring long-term cortisol exposure. We performed a systematic review of correlates of cortisol in human hair to inform the design, analysis, and interpretation of future epidemiologic studies. Relevant publications were identified through electronic searches on PubMed, WorldCat, and Web of Science using keywords, "cortisol," "hair," "confounders," "chronic," "stress," and "correlates." Thirty-nine studies were included in this review. Notwithstanding scarce data and some inconsistencies, investigators have found hair cortisol concentrations to be associated with stress-related psychiatric symptoms and disorders (e.g., post-traumatic stress disorder), medical conditions indicating chronic activation of the hypothalamic-pituitary-adrenal axis (e.g., Cushing's syndrome), and other life situations associated with elevated risk of chronic stress (e.g., shiftwork). Results from some studies suggest that physical activity, adiposity, and substance abuse may be correlates of hair cortisol concentrations. In contrast to measures of short-term cortisol release (saliva, blood, and urine), cigarette smoking and use of oral contraceptives appear not to be associated with hair cortisol concentrations. Studies of pregnant women indicate increased hair cortisol concentrations across successive trimesters. The study of hair cortisol presents a unique opportunity to assess chronic alterations in cortisol concentrations in epidemiologic studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Effect of anterior crowding or spacing on oral health-related quality of life: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hassan AH

    2018-03-01

    Full Text Available Ali H Hassan,1 Nour M Hobani,2 Sara M Almokri,3 Nour M Almokri,1 Faiza G Alotibi,4 Ehab N Alshouibi5 1Department of Orthodontics, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia; 2Department of Periodontolgy, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia; 3Saudi Board of Prosthodontics, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia; 4Department of Orthodontics, King Saud University, Riyadh, Saudi Arabia; 5Department of Dental Public Health, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia Introduction: Oral health-related quality of life (OHRQoL involves many aspects such as chewing ability, sleeping, social interactions, self-esteem, and satisfaction with life and oral health. The increasing research interest in OHRQoL began only after the shortcomings of previous approaches of treating symptoms only and neglecting the patient’s self-perception were revealed.Patients and methods: The current study design is a cross-sectional study of patients who attended King Abdulaziz University Dental Hospital (Jeddah, Saudi Arabia and King Saud University Dental Hospital (Riyadh, Saudi Arabia. After obtaining their verbal consent, young adult and adult patients (mean age 25.19±7.29 years old with anterior spacing or crowding were recruited to participate in the study. They filled the Arabic short version of the oral-health impact profile-14 questionnaire after a clinical evaluation of the severity of their spacing or crowding. Parameters of spacing/crowding severity assessment were as follows: <4, mild; 4–8, moderate; and >8, severe. Data were analyzed using the chi-square test in SPSS statistical package. The level of significance was set to <0.05.Results: The sample size of this study was 308 subjects. Findings indicated a statistically significant (p=0.001 association between anterior spacing malocclusion (ASM with Q5 “self-consciousness”, since 64.2% of

  16. Effects of a training program for home health care workers on the provision of preventive activities and on the health-related behavior of their clients: A quasi-experimental study.

    Science.gov (United States)

    Walters, Maaike E; Reijneveld, Sijmen A; van der Meulen, Anja; Dijkstra, Arie; de Winter, Andrea F

    2017-09-01

    Because home health care workers repeatedly visit the same older adults, they are in an excellent position to improve the health-related behavior of older adults, their clients, by providing preventive activities. The objective of this study was to determine the short- and medium term effects of an intervention to support workers in providing preventive activities for older adults. To do this, the number of activities undertaken by workers and the health-related behavior of their clients were assessed. A quasi-experimental study was performed with a pre-post design and inclusion of one control group. The study took place in a deprived, semi-rural area in The Netherlands (2011-2013). Data in three districts served by one home health care organization were gathered. The participants were home health care workers (registered nurses and nurse aides) and home health care clients aged 55 and over (community-dwelling, dependent older adults receiving home health care). 205 home health care workers participated in the study, 97 of them in the first effect measurement; and 83 of them in the second effect measurement. A total of 304 home health care clients participated, 214 of them in the first effect measurement; and 186 of them in the second effect measurement. Differences in change were determined in health-related behavior between groups of older adults as a result of training home health care workers in preventive activities RESULTS: In the control group of home health care professionals a significant increase was found regarding the provision of preventive activities for the domain 'weight' (partial eta squared: 0.05 and 0.08 at first and second effect measurements, respectively). We found preventive activities performed by home health care professionals to have no significant effects on older adult-reported health-related behavior, but observed in the intervention group a non-significant trend in improvement of physical activity of, respectively, 85 and 207min for

  17. The effect of post-traumatic stress disorder on refugees' parenting and their children's mental health: a cohort study.

    Science.gov (United States)

    Bryant, Richard A; Edwards, Ben; Creamer, Mark; O'Donnell, Meaghan; Forbes, David; Felmingham, Kim L; Silove, Derrick; Steel, Zachary; Nickerson, Angela; McFarlane, Alexander C; Van Hooff, Miranda; Hadzi-Pavlovic, Dusan

    2018-05-01

    Children and adolescents, who account for most of the world's refugees, have an increased prevalence of psychological disorders. The mental health of refugee children is often associated with the severity of post-traumatic stress disorder (PTSD) in their caregivers. Despite the potential for refugee caregivers' PTSD to affect child mental health, little evidence exists concerning the underlying mechanisms of this association. This study tested the effect of refugee caregivers' previous trauma and levels of ongoing stressors on current PTSD, and in turn how this influences parenting behaviour and consequent child psychological health. This cohort study recruited participants from the Building a New Life in Australia study, a population-based prospective cohort study of refugees admitted to 11 sites in Australia between October, 2013, and February, 2014. Eligible participants were aged 18 years or older and the principal or secondary applicant (ie, the refugee applicant within a migrating family unit) for a humanitarian visa awarded between May, 2013, and December, 2013. Primary caregiver PTSD and postmigration difficulties were assessed at Wave 1 (in 2013), and caregiver PTSD was reassessed at Wave 2 (in 2014). At Wave 3, between October, 2015, and February, 2016, primary caregivers repeated measures of trauma history, postmigration difficulties, probable PTSD, and harsh and warm parenting style, and completed the Strengths and Difficulties Questionnaire for their child. We used path analysis to investigate temporal patterns in PTSD, trauma history, postmigration stressors, parenting style, and children's psychological difficulties. The current data comprised 411 primary caregivers who provided responses in relation to at least one child (660 children). 394 primary caregivers with 639 children had data on independent variables and were included in the final model. Path analyses revealed that caregivers' trauma history and postmigration difficulties were associated

  18. Effects of concurrent respiratory resistance training on health-related quality of life in wheelchair rugby athletes: a pilot study.

    Science.gov (United States)

    Litchke, Lyn G; Lloyd, Lisa K; Schmidt, Eric A; Russian, Christopher J; Reardon, Robert F

    2012-01-01

    To compare the effects of 9 weeks of training with a concurrent flow resistance (CFR) device versus a concurrent pressure threshold resistance (CPTR) device on health-related quality of life (HRQoL) in wheelchair rugby (WR) athletes. Twenty-four male WR athletes (22 with tetraplegia, 1 with a spastic cerebral palsy, and 1 with congenital upper and lower limb deformities) were matched by lesion level, completeness of injury, and rugby classification prior to being randomly assigned to 1 of 3 groups: (1) CPTR (n=8), (2) CFR (n=8), or (3) controls (CON, n=8). Pre/post testing included assessment of HRQoL as measured by the Short-Form Health Survey Version 2.0 (SF-36v2). Manufacturer protocol guidelines for the CFR and CPTR groups were followed for breathing exercises. Sixteen participants completed the study (CPTR=4, CFR=5, CON=7). The Mann-Whitney U rank order revealed significantly greater reductions in bodily pain (P = .038) and improvements in vitality (P = .028) for CFR versus CON. Results from this study suggest that training with a CFR device improves some aspects of HRQoL (eg, vitality and bodily pain) in WR athletes. Further research with a larger sample size is needed to examine the impact of these devices on improving HRQoL for wheelchair athletes.

  19. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

    Science.gov (United States)

    de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

    2015-02-01

    A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

  20. 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 ...

  1. Combining fixed effects and instrumental variable approaches for estimating the effect of psychosocial job quality on mental health: evidence from 13 waves of a nationally representative cohort study.

    Science.gov (United States)

    Milner, Allison; Aitken, Zoe; Kavanagh, Anne; LaMontagne, Anthony D; Pega, Frank; Petrie, Dennis

    2017-06-23

    Previous studies suggest that poor psychosocial job quality is a risk factor for mental health problems, but they use conventional regression analytic methods that cannot rule out reverse causation, unmeasured time-invariant confounding and reporting bias. This study combines two quasi-experimental approaches to improve causal inference by better accounting for these biases: (i) linear fixed effects regression analysis and (ii) linear instrumental variable analysis. We extract 13 annual waves of national cohort data including 13 260 working-age (18-64 years) employees. The exposure variable is self-reported level of psychosocial job quality. The instruments used are two common workplace entitlements. The outcome variable is the Mental Health Inventory (MHI-5). We adjust for measured time-varying confounders. In the fixed effects regression analysis adjusted for time-varying confounders, a 1-point increase in psychosocial job quality is associated with a 1.28-point improvement in mental health on the MHI-5 scale (95% CI: 1.17, 1.40; P variable analysis, a 1-point increase psychosocial job quality is related to 1.62-point improvement on the MHI-5 scale (95% CI: -0.24, 3.48; P = 0.088). Our quasi-experimental results provide evidence to confirm job stressors as risk factors for mental ill health using methods that improve causal inference. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. The potential effects of Ocimum basilicum on health: a review of pharmacological and toxicological studies.

    Science.gov (United States)

    Sestili, Piero; Ismail, Tariq; Calcabrini, Cinzia; Guescini, Michele; Catanzaro, Elena; Turrini, Eleonora; Layla, Anam; Akhtar, Saeed; Fimognari, Carmela

    2018-06-11

    Basil (Ocimum basilicum L., OB) is a plant world widely used as a spice and a typical ingredient of the healthy Mediterranean diet. In traditional medicine, OB is indicated for many maladies and conditions; OB-containing nutritional supplements are increasingly sold. Conversely, safety concerns have been raised about the promutagens and procarcinogens alkenylbenzenes contained in OB. Areas covered: A critical review of the current status of OB as a nutraceutical, the pharmacology of its bioactive components, the rationale for its indications, and its safety. Expert opinion: Due to the polyphenolic and flavonoidic content, OB can be considered as an important ingredient in healthy diets; OB preparations may be effective as chemopreventive agents or adjunctive therapy in the treatment of different clinical conditions. From a toxicological perspective, since the tumorigenic potential of alkenylbenzenes is counteracted by other OB constituents such as nevadensin, it can be concluded that OB consumption in food and preparations is safe. The only concern relates to OB essential oils: in this case, a concentration limit for alkenylbenzenes should be precautionary defined, and the use of plant chemotypes with no or low levels of these alkylbenzenes for the preparation of essential oils should be made compulsory.

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

    Directory of Open Access Journals (Sweden)

    Trattler WB

    2017-08-01

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

  4. 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

  5. Interpreting the quality of health care database studies on the comparative effectiveness of oral anticoagulants in routine care

    Directory of Open Access Journals (Sweden)

    Schneeweiss S

    2013-09-01

    Full Text Available Sebastian Schneeweiss, Krista F Huybrechts, Joshua J Gagne Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Background: Dabigatran, an oral direct thrombin inhibitor, has now been available for 2 years in the US for the prevention of stroke in patients with nonvalvular atrial fibrillation, and direct Xa inhibitors are also starting to enter the market. Studies examining the effects of new oral anticoagulants in health care databases are beginning to emerge. The purpose of this study was to describe the validity of early published observational studies on the comparative safety and effectiveness of new oral anticoagulants in patients with atrial fibrillation. Methods: We identified published nonrandomized post-marketing studies (articles or conference abstracts or posters and critically appraised their internal validity, with a particular focus on their ability to control confounding and other biases. Results: Two full-length journal articles, three conference posters, two conference presentation abstracts, and a US Food and Drug Administration analysis form the basis of the early comparative effectiveness and safety experience with new oral anticoagulants. Some published studies exhibit substantial biases and have insufficient precision for several important endpoints. Several studies suffer from biases arising from comparing ongoing users of the older drug, warfarin, who seem to tolerate it, to initiators of the new treatment who may have switched from warfarin or have had no prior experience with anticoagulants. Analyses tended to not adjust or not adjust adequately for confounding, and unsound propensity score application was also observed. Several studies introduced selection bias by excluding patients who died during follow-up and by restricting the study population to those with continuous database enrollment following cohort entry. We

  6. 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...

  7. An ecological study for Sri Lanka about health effects of coconut.

    Science.gov (United States)

    Athauda, L K; Wickremasinghe, A R; Kumarendran, B; Kasturiratne, A

    2015-09-01

    An ecological correlation study was conducted to determine the association between consumption of coconut products and cardiovascular disease (CVD) deaths in Sri Lanka. Data on coconut consumption patterns from 1961 to 2006 were abstracted from the FAO database, and mortality data from reports of the Department of Census and Statistics, and UN databases. Correlational and regression analyses were carried out. There was no increase in the per capita consumption of coconut products from 1961 to 2006 (range 54.1-76.2kg/ capita/year). The CVD death rates and the proportionate mortality rate due to CVD increased from 1961 to 2006. CVD death rates were significantly associated with per capita GDP, percentage of urban population, and elderly dependency ratio but not consumption of coconut products after adjusting for the other variables (R2=0.94). The results do not provide evidence at the population level that consumption of coconut products increases mortality due to cardiovascular diseases.

  8. National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Research Methodology and Study Design Working Group Report.

    Science.gov (United States)

    Shaw, Bronwen E; Hahn, Theresa; Martin, Paul J; Mitchell, Sandra A; Petersdorf, Effie W; Armstrong, Gregory T; Shelburne, Nonniekaye; Storer, Barry E; Bhatia, Smita

    2017-01-01

    The increasing numbers of hematopoietic cell transplantations (HCTs) performed each year, the changing demographics of HCT recipients, the introduction of new transplantation strategies, incremental improvement in survival, and the growing population of HCT survivors demand a comprehensive approach to examining the health and well-being of patients throughout life after HCT. This report summarizes strategies for the conduct of research on late effects after transplantation, including consideration of the study design and analytic approaches; methodologic challenges in handling complex phenotype data; an appreciation of the changing trends in the practice of transplantation; and the availability of biospecimens to support laboratory-based research. It is hoped that these concepts will promote continued research and facilitate the development of new approaches to address fundamental questions in transplantation outcomes. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  9. Health Effects of Occupational Exposure to Electromagnetic Fields in View of Studies Performed in Poland and Abroad

    International Nuclear Information System (INIS)

    Sobiczewska, E.; Szmigielski, S.

    2007-01-01

    The review presents modern views on the assessment of bio effects and health risk in workers exposed to different intensities of electromagnetic fields (EMFs). The review of studies carried out in Poland and abroad reveals that non-specific symptoms and functional disturbances of various physiological systems may develop in persons exposed to EMF of intensities below international safety recommendations, however exact EMF threshold values responsible for inducing these responses are not known. There areno valid data on the possibility of increased risk of various diseases, including cancer, in workers exposed to EMFs. However, hints that the increased morbidity is possible in small groups of workers with long-term exposure to high intensities of EMFs do exist. (author)

  10. Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study.

    Science.gov (United States)

    Delamou, Alexandre; El Ayadi, Alison M; Sidibe, Sidikiba; Delvaux, Therese; Camara, Bienvenu S; Sandouno, Sah D; Beavogui, Abdoul H; Rutherford, Georges W; Okumura, Junko; Zhang, Wei-Hong; De Brouwere, Vincent

    2017-04-01

    The 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea. We did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N'Zérékoré). We examined monthly service use data for eight maternal and child health services indicators: antenatal care (≥1 antenatal care visit and ≥3 antenatal care visits), institutional delivery, and receipt of five infant vaccines: polio, pentavalent (diphtheria, tetanus, pertussis, hepatitis B virus, and Haemophilus influenzae type b), yellow fever, measles, and tuberculosis. We used interrupted time series models to estimate trends in each indicator across three time periods: pre-Ebola virus disease epidemic (January, 2013, to February, 2014), during-epidemic (March, 2014, to February, 2015) and post-epidemic (March, 2015, to Feb, 2016). We used segmented ordinary least-squares (OLS) regression using Newey-West standard errors to accommodate for serial autocorrelation, and adjusted for any potential effect of birth seasonality on our outcomes. In the months before the Ebola virus disease outbreak, all three maternal indicators showed a significantly positive change in trend, ranging from a monthly average increase of 61 (95% CI 38-84) institutional deliveries to 119 (95% CI 79-158) women achieving at least three antenatal care visits. These increasing trends were reversed during the epidemic: fewer institutional deliveries occurred (-240, 95% CI -293 to -187), and fewer women achieved at least one antenatal care visit (-418, 95% CI -535 to -300) or at least three antenatal care visits (-363, 95% CI -485

  11. The Start2Bike program is effective in increasing health-enhancing physical activity: a controlled study.

    Science.gov (United States)

    Ooms, Linda; Veenhof, Cindy; de Bakker, Dinny H

    2017-06-29

    The sports club is seen as a new relevant setting to promote health-enhancing physical activity (HEPA) among inactive population groups. Little is known about the effectiveness of strategies and activities implemented in the sports club setting on increasing HEPA levels. This study investigated the effects of Start2Bike, a six-week training program for inactive adults and adult novice cyclers, on HEPA levels of participants in the Netherlands. To measure physical activity, the Short QUestionnaire to ASsess Health-enhancing physical activity was used (SQUASH). Start2Bike participants were measured at baseline, six weeks and six months. A matched control group was measured at baseline and six months. The main outcome measure was whether participants met the Dutch Norm for Health-enhancing Physical Activity (DNHPA: 30 min of moderate-intensity activity on five days a week); Fit-norm (20 min of vigorous-intensity activity on three days a week); and Combi-norm (meeting the DNHPA and/or Fit-norm). Other outcome measures included: total minutes of physical activity per week; and minutes of physical activity per week per domain and intensity category. Statistical analyses consisted of McNemar tests and paired t-tests (within-group changes); and multiple logistic and linear regression analyses (between-group changes). In the Start2Bike group, compliance with Dutch physical activity norms increased significantly, both after six weeks and six months. Control group members did not alter their physical activity behavior. Between-group analyses showed that participants in the Start2Bike group were more likely to meet the Fit-norm at the six-month measurement compared to the control group (odds ratio = 2.5; 95% confidence interval (CI) = 1.1-5.8, p = 0.03). This was due to the Start2Bike participants spending on average 193 min/week more in vigorous-intensity activities (b = 193; 95% CI = 94-293, p Bike positively influences HEPA levels of participants by increasing

  12. Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications: Part III--Mental health and psychosocial effects.

    Science.gov (United States)

    Woersching, Joanna C; Snyder, Audrey E

    2004-01-01

    In 2001, the mountain town of San Sebastian, El Salvador experienced a series of earthquakes that affected the livelihood of its people. A convenience sample of 100 households of 594 inhabitants of San Sebastian and the surrounding rural farming areas was completed. One study participant for each household was evaluated for mental health and psychosocial changes after the earthquakes. The participant's questionnaire was used to investigate the relationship between physical health, access to health care, housing, food and water, and the occurrence of negative mental health markers six months after the disasters. Findings indicate that the majority (67%) of respondents experienced 6 or more mental health complaints. Risk factors associated with multiple negative mental health symptoms included change in household income and loss of job, a new illness or a new injury in the household, reliance on healthcare services since the earthquake, and managing a chronic illness. Findings indicate a need for rapid, acute mental health screening with at-risk groups and the need to educate the entire community regarding what medical and mental health treatments are available to reduce barriers to treatment and increase public awareness.

  13. Recruitment and enrollment of African Americans into health promoting programs: the effects of health promoting programs on cardiovascular disease risk study.

    Science.gov (United States)

    Okhomina, Victoria I; Seals, Samantha R; Marshall, Gailen D

    2018-04-03

    Randomized controlled trials (RCT) often employ multiple recruitment methods to attract participants, however, special care must be taken to be inclusive of under-represented populations. We examine how recruiting from an existing observational study affected the recruitment of African Americans into a RCT that included yoga-based interventions. In particular, we report the recruitment success of The Effects of Health Promoting Programs (HPP) on Cardiovascular Disease Risk (NCT02019953), the first yoga-based clinical trial to focus only on African Americans. To recruit participants, a multifaceted recruitment strategy was implemented exclusively in the Jackson Heart Study (JHS) cohort. The HPP recruited from the JHS cohort using direct mailings, signs and flyers placed around JHS study facilities, and through JHS annual follow-up interviews. Enrollment into HPP was open to all active JHS participants that were eligible to return for the third clinic exam (n = 4644). The target sample size was 375 JHS participants over a 24 month recruitment and enrollment period. From the active members of the JHS cohort, 503 were pre-screened for eligibility in HPP. More than 90% of those pre-screened were provisionally eligible for the study. The enrollment goal of 375 was completed after a 16-month enrollment period with over 25% (n = 97) of the required sample size enrolling during the second month of recruitment. The findings show that participants in observational studies can be successfully recruited into RCT. Observational studies provide researchers with a well-defined population that may be of interest when designing clinical trials. This is particularly useful in the recruitment of a high-risk, traditionally underrepresented populations for non-pharmacological clinical trials where traditional recruitment methods may prolong enrollment periods and extend study budgets.

  14. The effect of gender differences on dentist’s performance (a study in health centers in East Java

    Directory of Open Access Journals (Sweden)

    Titiek Berniyanti

    2007-12-01

    Full Text Available Gender is a social relationship concept that differentiates role and function between man and women. Equality of rights and obligations between man and woman have been normatively guaranteed and the Constitution does not explicitly discriminate the rights and obligations of woman in law and government, in occupation and decent life, in politics, in religion and beliefs, and in national defend. Related with gender perspective, the need of health worker especially dentist worker has to be determined and planned properly. The productivity is one of the factor on dentist worker, that affect on the quality of health delivary. Some companies try to increase efficiency in performing their activities and try to measure activities they do. In this case, time & motion study method is one of the solutions to help the company measuring their activity. Using these techniques, company can measure the productivity of resources used for every activity. In order to get better performance in cost reduction, the company should assign their cost to the product resulted. Determination of the Standart time to work is one of the method that contain high value of efeciency to gain the productivity. The aim of this study was to learn how gender has an effect on dentist’s work performance. The time of completing dentist’s task i.e: teeth extraction were measured and the standard time were determined. In addition the patient’s respond were measured through questionair. This study was conducted in East Java. The conclusion of this study revealed that there was no difference of work performance between male and female dentist’s.

  15. Using Multiple Control Groups and Matching to Address Unobserved Biases in Comparative Effectiveness Research: An Observational Study of the Effectiveness of Mental Health Parity.

    Science.gov (United States)

    Yoon, Frank B; Huskamp, Haiden A; Busch, Alisa B; Normand, Sharon-Lise T

    2011-06-21

    Studies of large policy interventions typically do not involve randomization. Adjustments, such as matching, can remove the bias due to observed covariates, but residual confounding remains a concern. In this paper we introduce two analytical strategies to bolster inferences of the effectiveness of policy interventions based on observational data. First, we identify how study groups may differ and then select a second comparison group on this source of difference. Second, we match subjects using a strategy that finely balances the distributions of key categorical covariates and stochastically balances on other covariates. An observational study of the effect of parity on the severely ill subjects enrolled in the Federal Employees Health Benefits (FEHB) Program illustrates our methods.

  16. Indoor air pollution from biomass combustion and its adverse health effects in central India: An exposure-response study

    Directory of Open Access Journals (Sweden)

    Neelam D Sukhsohale

    2013-01-01

    Full Text Available Background: Some of the highest exposures to air pollutants in developing countries occur inside homes where biofuels are used for daily cooking. Inhalation of these pollutants may cause deleterious effects on health. Objectives: To assess the respiratory and other morbidities associated with use of various types of cooking fuels in rural area of Nagpur and to study the relationship between the duration of exposure (exposure index [EI] and various morbidities. Materials and Methods: A total of 760 non-smoking, non-pregnant women aged 15 years and above (mean age 32.51 ΁ 14.90 years exposed to domestic smoke from cooking fuels from an early age, working in poorly ventilated kitchen were selected and on examination presented with various health problems. Exposure was calculated as the average hours spent daily for cooking multiplied by the number of years. Symptoms were enquired by means of a standard questionnaire adopted from that of the British Medical Research Council. Lung function was assessed by the measurement of peak expiratory flow rate (PEFR. PEFR less than 80% of the predicted was considered as abnormal pulmonary function. Results and Conclusions: Symptoms like eye irritation, headache, and diminution of vision were found to be significantly higher in biomass users (P < 0.05. Abnormal pulmonary function, chronic bronchitis, and cataract in biomass users was significantly higher than other fuel users (P < 0.05. Moreover an increasing trend in prevalence of symptoms/morbid conditions was observed with increase in EI. The presence of respiratory symptoms/morbid conditions was associated with lower values of both observed and percent predicted PEFR (P < 0.05 to 0.001. Thus women exposed to biofuels smoke suffer more from health problems and respiratory illnesses when compared with other fuel users.

  17. Does social support modify the effect of disability acquisition on mental health? A longitudinal study of Australian adults.

    Science.gov (United States)

    Aitken, Zoe; Krnjacki, Lauren; Kavanagh, Anne Marie; LaMontagne, Anthony Daniel; Milner, Allison

    2017-10-01

    Disability acquisition in adulthood is associated with deterioration in mental health. Social support may act as a "buffer" against poor mental health following disability acquisition. We tested the hypothesis that women and men with low social support experienced larger declines in mental health on acquisition of a disability compared to women and men with high social support. We assessed whether social support, measured both prior and subsequent to disability acquisition, modified the association between disability acquisition and mental health using 14 annual waves of data from the Household, Income and Labour Dynamics in Australia Survey. Participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (2200 participants, 15,724 observations). Fixed-effects linear regression models were used to estimate average differences in mental health between waves with and without disability, for women and men separately. We tested for effect measure modification of the association by social support, including a three-way interaction between disability and social support prior and subsequent to disability acquisition. Though the effects of disability acquisition on mental health were much larger for women, for both women and men there was a consistent pattern of association with social support. There was evidence that social support modified the association between disability acquisition and mental health, with the largest effects for those experiencing a change from high to low social support subsequent to disability and for people with consistently low social support. These findings highlight the importance of developing new policy and practice strategies to improve the mental health of people with disabilities, including interventions to promote social support at the time of disability acquisition.

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

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2016-05-01

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

  19. Determinants of internal migrant health and the healthy migrant effect in South India: a mixed methods study.

    Science.gov (United States)

    Dodd, Warren; Humphries, Sally; Patel, Kirit; Majowicz, Shannon; Little, Matthew; Dewey, Cate

    2017-09-12

    Internal labour migration is an important and necessary livelihood strategy for millions of individuals and households in India. However, the precarious position of migrant workers within Indian society may have consequences for the health of these individuals. Previous research on the connections between health and labour mobility within India have primarily focused on the negative health outcomes associated with this practice. Thus, there is a need to better identify the determinants of internal migrant health and how these determinants shape migrant health outcomes. An exploratory mixed methods study was conducted in 26 villages in the Krishnagiri district of Tamil Nadu. Sixty-six semi-structured interviews were completed using snowball sampling, followed by 300 household surveys using multi-stage random sampling. For qualitative data, an analysis of themes and content was completed. For quantitative data, information on current participation in internal labour migration, in addition to self-reported morbidity and determinants of internal migrant health, was collected. Morbidity categories were compared between migrant and non-migrant adults (age 14-65 years) using a Fisher's exact test. Of the 300 households surveyed, 137 households (45.7%) had at least one current migrant member, with 205 migrant and 1012 non-migrant adults (age 14-65 years) included in this study. The health profile of migrant and non-migrants was similar in this setting, with 53 migrants (25.9%) currently suffering from a health problem compared to 273 non-migrants (27.0%). Migrant households identified both occupational and livelihood factors that contributed to changes in the health of their migrant members. These determinants of internal migrant health were corroborated and further expanded on through the semi-structured interviews. Internal labour migration in and of itself is not a determinant of health, as participation in labour mobility can contribute to an improvement in health, a

  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. Preclinical and Clinical Studies Demonstrate That the Proprietary Herbal Extract DA-5512 Effectively Stimulates Hair Growth and Promotes Hair Health

    Directory of Open Access Journals (Sweden)

    Jae Young Yu

    2017-01-01

    Full Text Available The proprietary DA-5512 formulation comprises six herbal extracts from traditional oriental plants historically associated with therapeutic and other applications related to hair. Here, we investigated the effects of DA-5512 on the proliferation of human dermal papilla cells (hDPCs in vitro and on hair growth in C57BL/6 mice and conducted a clinical study to evaluate the efficacy and safety of DA-5512. DA-5512 significantly enhanced the viability of hDPCs in a dose-dependent manner (p<0.05, and 100 ppm of DA-5512 and 1 μM minoxidil (MXD significantly increased the number of Ki-67-positive cells, compared with the control group (p<0.05. MXD (3% and DA-5512 (1%, 5% significantly stimulated hair growth and increased the number and length of hair follicles (HFs versus the controls (each p<0.05. The groups treated with DA-5512 exhibited hair growth comparable to that induced by MXD. In clinical study, we detected a statistically significant increase in the efficacy of DA-5512 after 16 weeks compared with the groups treated with placebo or 3% MXD (p<0.05. In conclusion, DA-5512 might promote hair growth and enhance hair health and can therefore be considered an effective option for treating hair loss.

  3. Ambient carbon monoxide and daily mortality in three Chinese cities: the China Air Pollution and Health Effects Study (CAPES).

    Science.gov (United States)

    Chen, Renjie; Pan, Guowei; Zhang, Yanping; Xu, Qun; Zeng, Guang; Xu, Xiaohui; Chen, Bingheng; Kan, Haidong

    2011-11-01

    Ambient carbon monoxide (CO) is an air pollutant primarily generated by traffic. CO has been associated with increased mortality and morbidity in developed countries, but few studies have been conducted in Asian developing countries. In the China Air Pollution and Health Effects Study (CAPES), the short-term associations between ambient CO and daily mortality were examined in three Chinese cities: Shanghai, Anshan and Taiyuan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for long-term and seasonal trend of mortality, as well as other time-varying covariates. Effect estimates were obtained for each city and then for the cities combined. In both individual-city and combined analysis, significant associations of CO with both total non-accidental and cardiovascular mortality were observed. In the combined analysis, a 1 mg/m(3) increase of 2-day moving average concentrations of CO corresponded to 2.89% (95%CI: 1.68, 4.11) and 4.17% (95%CI: 2.66, 5.68) increase of total and cardiovascular mortality, respectively. CO was not significantly associated with respiratory mortality. Sensitivity analyses showed that our findings were generally insensitive to alternative model specifications. In conclusion, ambient CO was associated with increased risk of daily mortality in these three cities. Our findings suggest that the role of exposure to CO and other traffic-related air pollutants should be further investigated in China. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

    Science.gov (United States)

    Wang, Chao; Hua, Yujie; Fu, Hua; Cheng, Longfeng; Qian, Wen; Liu, Junyang; Crawford, Paul; Dai, Junming

    2017-01-03

    The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups

  5. Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study

    Directory of Open Access Journals (Sweden)

    Chao Wang

    2017-01-01

    Full Text Available Abstract Background The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Methods Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237 into either the intervention group (3 communities, n = 105 or to a wait-list control group (3 communities, n = 132. All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15. From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1, before intervention at 24 weeks (T2, and immediately after intervention at 32 weeks (T3. Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5 and the Self-administered Sleep Questionnaire (SSQ. Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. Results There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there

  6. The Effects of Urban Form on Ambient Air Pollution and Public Health Risk: A Case Study in Raleigh, North Carolina

    Science.gov (United States)

    Rodriguez, Daniel A.; Huegy, Joseph; Gibson, Jacqueline MacDonald

    2014-01-01

    Since motor vehicles are a major air pollution source, urban designs that decrease private automobile use could improve air quality and decrease air pollution health risks. Yet, the relationships among urban form, air quality, and health are complex and not fully understood. To explore these relationships, we model the effects of three alternative development scenarios on annual average fine particulate matter (PM2.5) concentrations in ambient air and associated health risks from PM2.5 exposure in North Carolina’s Raleigh-Durham-Chapel Hill area. We integrate transportation demand, land-use regression, and health risk assessment models to predict air quality and health impacts for three development scenarios: current conditions, compact development, and sprawling development. Compact development slightly decreases (−0.2%) point estimates of regional annual average PM2.5 concentrations, while sprawling development slightly increases (+1%) concentrations. However, point estimates of health impacts are in opposite directions: compact development increases (+39%) and sprawling development decreases (−33%) PM2.5-attributable mortality. Further, compactness increases local variation in PM2.5 concentrations and increases the severity of local air pollution hotspots. Hence, this research suggests that while compact development may improve air quality from a regional perspective, it may also increase the concentration of PM2.5 in local hotspots and increase population exposure to PM2.5. Health effects may be magnified if compact neighborhoods and PM2.5 hotspots are spatially co-located. We conclude that compactness alone is an insufficient means of reducing the public health impacts of transportation emissions in automobile-dependent regions. Rather, additional measures are needed to decrease automobile dependence and the health risks of transportation emissions. PMID:25490890

  7. 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

  8. 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

  9. Long-term effects of psychosocial work stress in midlife on health functioning after labor market exit--results from the GAZEL study.

    Science.gov (United States)

    Wahrendorf, Morten; Sembajwe, Grace; Zins, Marie; Berkman, Lisa; Goldberg, Marcel; Siegrist, Johannes

    2012-07-01

    To study long-term effects of psychosocial work stress in mid-life on health functioning after labor market exit using two established work stress models. In the frame of the prospective French Gazel cohort study, data on psychosocial work stress were assessed using the full questionnaires measuring the demand-control-support model (in 1997 and 1999) and the effort-reward imbalance model (in 1998). In 2007, health functioning was assessed, using the Short Form 36 mental and physical component scores. Multivariate regressions were calculated to predict health functioning in 2007, controlling for age, gender, social position, and baseline self-perceived health. Consistent effects of both work stress models and their single components on mental and physical health functioning during retirement were observed. Effects remained significant after adjustment including baseline self-perceived health. Whereas the predictive power of both work stress models was similar in the case of the physical composite score, in the case of the mental health score, values of model fit were slightly higher for the effort-reward imbalance model (R(2): 0.13) compared with the demand-control model (R²: 0.11). Findings underline the importance of working conditions in midlife not only for health in midlife but also for health functioning after labor market exit.

  10. Long-term Effects of Psychosocial Work Stress in Midlife on Health Functioning After Labor Market Exit—Results From the GAZEL Study

    Science.gov (United States)

    Sembajwe, Grace; Zins, Marie; Berkman, Lisa; Goldberg, Marcel; Siegrist, Johannes

    2012-01-01

    Objectives. To study long-term effects of psychosocial work stress in mid-life on health functioning after labor market exit using two established work stress models. Methods. In the frame of the prospective French Gazel cohort study, data on psychosocial work stress were assessed using the full questionnaires measuring the demand-control-support model (in 1997 and 1999) and the effort–reward imbalance model (in 1998). In 2007, health functioning was assessed, using the Short Form 36 mental and physical component scores. Multivariate regressions were calculated to predict health functioning in 2007, controlling for age, gender, social position, and baseline self-perceived health. Results. Consistent effects of both work stress models and their single components on mental and physical health functioning during retirement were observed. Effects remained significant after adjustment including baseline self-perceived health. Whereas the predictive power of both work stress models was similar in the case of the physical composite score, in the case of the mental health score, values of model fit were slightly higher for the effort–reward imbalance model (R²: 0.13) compared with the demand-control model (R²: 0.11). Conclusions. Findings underline the importance of working conditions in midlife not only for health in midlife but also for health functioning after labor market exit. PMID:22546992

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

    Science.gov (United States)

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

    2018-03-30

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

  12. Mediating and Moderating Effects of Social Support in the Study of Child Abuse and Adult Physical and Mental Health

    Science.gov (United States)

    Herrenkohl, Todd I.; Jung, Hyunzee; Klika, J. Bart; Mason, W. Alex; Brown, Eric C.; Leeb, Rebecca T.; Herrenkohl, Roy. C.

    2016-01-01

    A number of cross-sectional and a few longitudinal studies have shown a developmental relationship between child abuse and adult physical and mental health. Published findings also suggest that social support can lessen the risk of adverse outcomes for some abused children. However, few studies have investigated whether social support mediates or moderates the relationship between child abuse and adult physical and mental health. Structural equation modeling was used to examine data on these topics from a longitudinal study of more than 30 years. While a latent construct of physical and emotional child abuse did not predict adult health outcomes directly, child abuse did predict outcomes indirectly through social support. A test of variable moderation for child abuse and social support was nonsignificant. Results suggest that social support may help explain the association between child abuse and health outcomes at midlife. Implications of the findings for prevention and treatment are discussed. PMID:26845043

  13. 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...

  14. Health effects following long-term exposure to thorium dusts: a twenty-year follow-up study in China

    International Nuclear Information System (INIS)

    Chen, X.A.; Cheng, Y.E.; Xiao, H.; Chen, L.; Yang, Y.J.; Dong, Z.H.; Zheng, R.; Feng, G.; Deng, Y.H.; Feng, Z.L.; Han, X.M.

    2004-01-01

    A twenty-year follow-up study was carried out at Baiyun Obo Rare-earth Iron Mine in China, This mine has been mined since 1958. Its ore contains 0.04% of ThO 2 and 10% of SiO 2 . The purpose of this study is to investigate possible health effects in dust-exposed miners following long-term exposure to thorium-containing dusts and thoron progeny. By using the negative high voltage exhaled thoron progeny measurement system to estimate the miner's thorium lung burden. The highest thorium lung burden among 1 158 measurements of 638 miners was 11.11 Bq. The incidence of stage 0 + pneumoconiosis was increased among dust-exposed miners. An epidemiological study showed that the lung cancer mortality of the dust-exposed miners was significantly (p 2 and SiO 2 ) and thoron progeny. This is the first evidence in humans of the carcinogenicity after long-term inhalation of thorium-containing dusts and thoron progeny. The total person-years of observation for the dust-exposed miners and the controls were 62 712 and 34 672 respectively. (author)

  15. Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

    Science.gov (United States)

    Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

    2014-10-08

    Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of

  16. 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 ...

  17. Persistent and contemporaneous effects of job stressors on mental health: a study testing multiple analytic approaches across 13 waves of annually collected cohort data.

    Science.gov (United States)

    Milner, Allison; Aitken, Zoe; Kavanagh, Anne; LaMontagne, Anthony D; Petrie, Dennis

    2016-11-01

    This study investigated the extent that psychosocial job stressors had lasting effects on a scaled measure of mental health. We applied econometric approaches to a longitudinal cohort to: (1) control for unmeasured individual effects; (2) assess the role of prior (lagged) exposures of job stressors on mental health and (3) the persistence of mental health. We used a panel study with 13 annual waves and applied fixed-effects, first-difference and fixed-effects Arellano-Bond models. The Short Form 36 (SF-36) Mental Health Component Summary score was the outcome variable and the key exposures included: job control, job demands, job insecurity and fairness of pay. Results from the Arellano-Bond models suggest that greater fairness of pay (β-coefficient 0.34, 95% CI 0.23 to 0.45), job control (β-coefficient 0.15, 95% CI 0.10 to 0.20) and job security (β-coefficient 0.37, 95% CI 0.32 to 0.42) were contemporaneously associated with better mental health. Similar results were found for the fixed-effects and first-difference models. The Arellano-Bond model also showed persistent effects of individual mental health, whereby individuals' previous reports of mental health were related to their reporting in subsequent waves. The estimated long-run impact of job demands on mental health increased after accounting for time-related dynamics, while there were more minimal impacts for the other job stressor variables. Our results showed that the majority of the effects of psychosocial job stressors on a scaled measure of mental health are contemporaneous except for job demands where accounting for the lagged dynamics was important. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Effects of health education for migrant females with psychosomatic complaints treated by general practitioners. A randomised controlled evaluation study

    NARCIS (Netherlands)

    Kocken, P.L.; Zwanenburg, E.J.-v.; Hoop, T.de

    2008-01-01

    Objective: : The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients. Methods: : A randomised controlled trial (RCT) design was used. A total

  19. 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

  20. Considerations for the analysis of longitudinal electronic health records linked to claims data to study the effectiveness and safety of drugs.

    Science.gov (United States)

    Lin, K J; Schneeweiss, S

    2016-08-01

    Health insurance claims and electronic health records (EHR) databases have been considered the preferred data sources with which to study drug safety and effectiveness in routine care. Linking claims data to EHR allows researchers to leverage the complementary advantages of each data source to enhance study validity. We propose a framework to evaluate the need for supplementing claims data with EHR and vice versa to optimize outcome ascertainment, exposure assessment, and confounding adjustment. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  1. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  2. Effects of interactive teaching on university students’ knowledge and attitude toward reproductive health: a pilot study in Jordan

    Directory of Open Access Journals (Sweden)

    Ali RA

    2018-04-01

    Full Text Available Reem A Ali,1 Ahlam Alnatour,2 Karimeh Alnuaimi,1 Fatmeh Alzoubi,1 Maysa Almomani,3 Areej Othman4 1Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Maternal and Child Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan Background: Youths in Jordan lack knowledge related to reproductive health (RH. Interactive teaching methods showed positive results in enhancing health awareness and adopting healthy practices among students. Objectives: The objective of this study was to examine the usefulness of interactive teaching in promoting health awareness of RH among nonmedical university students in Jordan.Methods: We employed a quasi-experimental one group pretest and posttest design for a purposive sample of 210 students (18–24 years. Knowledge and attitudes regarding RH issues were assessed using a questionnaire developed by the researchers. Results: A significant improvement in students’ knowledge and attitudes toward RH was evident. Female students had higher scores on knowledge than male students in the pretest; this difference was smaller in the posttest. Also, female students had significantly more positive attitudes toward RH in pretest than males, although this difference vanished in the posttest. Study results indicated that students benefit from study intervention regardless their gender. Conclusion: Integrating RH into university’s curriculum coupled with interactive learning approach is a powerful way to promote RH awareness among youths. Keywords: STIs, young adult, family planning, premarital examination, health promotion

  3. Implementing a Mobile Health System to Integrate the Treatment of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study.

    Science.gov (United States)

    Quanbeck, Andrew; Gustafson, David H; Marsch, Lisa A; Chih, Ming-Yuan; Kornfield, Rachel; McTavish, Fiona; Johnson, Roberta; Brown, Randall T; Mares, Marie-Louise; Shah, Dhavan V

    2018-01-30

    Despite the near ubiquity of mobile phones, little research has been conducted on the implementation of mobile health (mHealth) apps to treat patients in primary care. Although primary care clinicians routinely treat chronic conditions such as asthma and diabetes, they rarely treat addiction, a common chronic condition. Instead, addiction is most often treated in the US health care system, if it is treated at all, in a separate behavioral health system. mHealth could help integrate addiction treatment in primary care. The objective of this paper was to report the effects of implementing an mHealth system for addiction in primary care on both patients and clinicians. In this implementation research trial, an evidence-based mHealth system named Seva was introduced sequentially over 36 months to a maximum of 100 patients with substance use disorders (SUDs) in each of three federally qualified health centers (FQHCs; primary care clinics that serve patients regardless of their ability to pay). This paper reports on patient and clinician outcomes organized according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The outcomes according to the RE-AIM framework are as follows: Reach-Seva reached 8.31% (268/3226) of appropriate patients. Reach was limited by our ability to pay for phones and data plans for a maximum of 100 patients per clinic. Effectiveness-Patients who were given Seva had significant improvements in their risky drinking days (44% reduction, (0.7-1.25)/1.25, P=.04), illicit drug-use days (34% reduction, (2.14-3.22)/3.22, P=.01), quality of life, human immunodeficiency virus screening rates, and number of hospitalizations. Through Seva, patients also provided peer support to one another in ways that are novel in primary care settings. Adoption-Patients sustained high levels of Seva use-between 53% and 60% of the patients at the 3 sites accessed Seva during the last week of the 12-month implementation period. Among

  4. Association between arsenic exposure from drinking water and proteinuria: results from the Health Effects of Arsenic Longitudinal Study

    Science.gov (United States)

    Chen, Yu; Parvez, Faruque; Liu, Mengling; Pesola, Gene R; Gamble, Mary V; Slavkovich, Vesna; Islam, Tariqul; Ahmed, Alauddin; Hasan, Rabiul; Graziano, Joseph H; Ahsan, Habibul

    2011-01-01

    Background Proteinuria has been recognized as a marker for an increased risk of chronic renal disease. It is unclear whether arsenic (As) exposure from drinking water is associated with proteinuria. Methods We evaluated the association between As exposure from drinking water and proteinuria in 11 122 participants in the Health Effects of Arsenic Longitudinal Study (HEALS). Proteinuria was detected by urinary dipstick tests at baseline and at 2-year intervals. As exposure variables included baseline well As and changes in urinary As during follow-up modelled as time-dependent variables in the analyses. Results At baseline, well As was positively related to prevalence of proteinuria; prevalence odds ratios (PORs) for proteinuria in increasing quintiles of well As (≤7, 8–39, 40–91, 92–179 and 180–864 µg/l) were 1.00 (ref), POR 0.99 [95% confidence interval (CI) 0.77–1.27], POR 1.23 (95% CI 0.97–1.57), POR 1.50 (95% CI 1.18–1.89) and POR 1.59 (95% CI 1.26–2.00) (P for trend 70 and 17–70 µg/l in urinary As over time, respectively, and were POR 1.17 (95% CI 0.97–1.42) and POR 1.42 (95% CI 1.16–1.73) for participants with an increasing level of 16–68 and >68 µg/l in urinary As over time, respectively, compared with the group with relatively little changes in urinary As as the reference group (urinary As −16 to 15 µg/l). Conclusion The findings suggest that there are adverse effects of As exposure on the risk of proteinuria and the effects are modifiable by recent changes in As exposure. PMID:21343184

  5. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    OpenAIRE

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2013-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, p...

  6. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre: a cost comparison study.

    Science.gov (United States)

    Eichler, Klaus; Hess, Sascha; Chmiel, Corinne; Bögli, Karin; Sidler, Patrick; Senn, Oliver; Rosemann, Thomas; Brügger, Urs

    2014-10-01

    Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. From the health-economic point of view, our new service model shows 'dominance' over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Do social relations buffer the effect of neighborhood deprivation on health-related quality of life? Results from the LifeLines Cohort Study

    NARCIS (Netherlands)

    Klijs, Bart; de Leon, Carlos F. Mendes; Kibele, Eva U. B.; Smidt, Nynke

    We investigated whether social relations buffer the effect of neighborhood deprivation on mental and physical health-related quality of life. Baseline data from the LifeLines Cohort Study (N=68,111) and a neighborhood deprivation index were used to perform mixed effect linear regression analyses.

  8. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    Science.gov (United States)

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2014-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms. Results: Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms. Implications: The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving. PMID:23690056

  9. The Start2Bike program is effective in increasing health-enhancing physical activity: a controlled study

    Directory of Open Access Journals (Sweden)

    Linda Ooms

    2017-06-01

    Full Text Available Abstract Background The sports club is seen as a new relevant setting to promote health-enhancing physical activity (HEPA among inactive population groups. Little is known about the effectiveness of strategies and activities implemented in the sports club setting on increasing HEPA levels. This study investigated the effects of Start2Bike, a six-week training program for inactive adults and adult novice cyclers, on HEPA levels of participants in the Netherlands. Methods To measure physical activity, the Short QUestionnaire to ASsess Health-enhancing physical activity was used (SQUASH. Start2Bike participants were measured at baseline, six weeks and six months. A matched control group was measured at baseline and six months. The main outcome measure was whether participants met the Dutch Norm for Health-enhancing Physical Activity (DNHPA: 30 min of moderate-intensity activity on five days a week; Fit-norm (20 min of vigorous-intensity activity on three days a week; and Combi-norm (meeting the DNHPA and/or Fit-norm. Other outcome measures included: total minutes of physical activity per week; and minutes of physical activity per week per domain and intensity category. Statistical analyses consisted of McNemar tests and paired t-tests (within-group changes; and multiple logistic and linear regression analyses (between-group changes. Results In the Start2Bike group, compliance with Dutch physical activity norms increased significantly, both after six weeks and six months. Control group members did not alter their physical activity behavior. Between-group analyses showed that participants in the Start2Bike group were more likely to meet the Fit-norm at the six-month measurement compared to the control group (odds ratio = 2.5; 95% confidence interval (CI = 1.1–5.8, p = 0.03. This was due to the Start2Bike participants spending on average 193 min/week more in vigorous-intensity activities (b = 193; 95% CI = 94–293, p < 0.001 and 130

  10. Health Care Industry Study

    Science.gov (United States)

    2002-01-01

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

  11. Mobile phone base stations and adverse health effects: phase 1 of a population-based, cross-sectional study in Germany.

    Science.gov (United States)

    Blettner, M; Schlehofer, B; Breckenkamp, J; Kowall, B; Schmiedel, S; Reis, U; Potthoff, P; Schüz, J; Berg-Beckhoff, G

    2009-02-01

    The aim of this first phase of a cross-sectional study from Germany was to investigate whether proximity of residence to mobile phone base stations as well as risk perception is associated with health complaints. The researchers conducted a population-based, multi-phase, cross-sectional study within the context of a large panel survey regularly carried out by a private research institute in Germany. In the initial phase, reported on in this paper, 30,047 persons from a total of 51,444 who took part in the nationwide survey also answered questions on how mobile phone base stations affected their health. A list of 38 health complaints was used. A multiple linear regression model was used to identify predictors of health complaints including proximity of residence to mobile phone base stations and risk perception. Of the 30,047 participants (response rate 58.6%), 18.7% of participants were concerned about adverse health effects of mobile phone base stations, while an additional 10.3% attributed their personal adverse health effects to the exposure from them. Participants who were concerned about or attributed adverse health effects to mobile phone base stations and those living in the vicinity of a mobile phone base station (500 m) reported slightly more health complaints than others. A substantial proportion of the German population is concerned about adverse health effects caused by exposure from mobile phone base stations. The observed slightly higher prevalence of health complaints near base stations can not however be fully explained by attributions or concerns.

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

    International Nuclear Information System (INIS)

    Matanoski, G.M.

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

  13. 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.

  14. Field studies on health effects from the application of two organophosphorus insecticide formulations by hand-held ULV to cotton.

    Science.gov (United States)

    Kummer, R; van Sittert, N J

    1986-10-01

    Two field studies to assess the health implications for farmers applying two different formulations containing organophosphorus (OP) pesticides to cotton by hand-held ULV are described. The first study, carried out in the Ivory Coast, involved the application of an endrin/DDT/methylparathion (MEP) formulation in an aromatic hydrocarbon solvent. The second study took place in Indonesia with a 20% monocrotophos formulation in a mixture of a glycol and a glycol ether. Both studies were carried out under actual field conditions. The purpose of the studies was to get a good assessment of the health hazards of the particular formulation, used under the specific circumstances and agronomic requirements of the area of application and taking into account all local, climatic and cultural conditions that could be of possible influence. The results showed that in both studies skin exposures took place during application and especially during handling, filling and cleaning, and that inhalation of spray mist was negligible. Absorption was confirmed by the presence in urine of metabolites of endrin and methylparathion in the Ivory Coast study, and of dimethyl phosphate in the Indonesia study. No clinical signs or symptoms of intoxication were discovered in either study, nor were inhibitions of cholinesterase (ChE) activity of health significance established under the conditions of the studies. In addition, various practical aspects such as choice of apparatus, of formulation, the application procedures etc. are discussed.

  15. 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

  16. Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.

    Science.gov (United States)

    Morita, Tomohiro; Nomura, Shuhei; Tsubokura, Masaharu; Leppold, Claire; Gilmour, Stuart; Ochi, Sae; Ozaki, Akihiko; Shimada, Yuki; Yamamoto, Kana; Inoue, Manami; Kato, Shigeaki; Shibuya, Kenji; Kami, Masahiro

    2017-10-01

    Evidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan. The mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year. There were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006-2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44). Indirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Joint USNRC/EC consequence uncertainty study: The ingestion pathway, dosimetry and health effects expert judgment elicitations and results

    International Nuclear Information System (INIS)

    Harper, F.; Goossens, L.; Abbott, M.

    1996-01-01

    The US Nuclear Regulatory Commission (USNRC) and the European Commission (EC) have conducted a formal expert judgment elicitation jointly to systematically collect the quantitative information needed to perform consequence uncertainty analyses on a broad set of commercial nuclear power plants. Information from three sets of joint US/European expert panels was collected and processed. Information from the three sets of panels was collected in the following areas: in the phenomenological areas of atmospheric dispersion and deposition, in the areas of ingestion pathways and external dosimetry, and in the areas of health effects and internal dosimetry. This exercise has demonstrated that the uncertainty for particular issues as measured by the ratio of the 95th percentile to the 5th percentile can be extremely large (orders of magnitude), or rather small (factor of two). This information has already been used by many of the experts that were involved in this process in areas other than the consequence uncertainty field. The benefit to the field of radiological consequences is just beginning as the results of this study are published and made available to the consequence community

  18. A cross section study on low-dose lonization radiation and health effects in different sex subgroups of occupational population

    International Nuclear Information System (INIS)

    Li Jiayuan; Yang Fei; Huang Zhonghang; Lu Xiaoqing; Liu Hui; Jiang Di; Yang Yuan

    2009-01-01

    Objective: To explore the relationship between long-time exposure to low-dose ionization radiation and health effects. Methods: 1052 occupational subjects exposed to ionization radiation in Chengdu city were recruited in monitoring cohort in 2007, including 785 men (74.62%) and 267 women (25.38%). Individual exposure dose were monitored by Thermoluminescent Measurement. Health effects include blood routine examination, Chromosomal aberration, eye lens test, etc. Variance Analysis (ANOVA), χ 2 Test and Univariate Procedure of General Liner Model (Covariance Analysis) were implemented to test the difference among subgroups with SPSS 13.0 software. Results: Annual average of exposure dose of male and female were (0.76 ± 0.65) mSv and (0.75 ± 0.64) mSv. There is no statistical significant between sex subgroups (F= (0.136, P = 0.712). In females subgroup, the frequencies and ratios with low WBC, Low platelet, high RBC and high HGB were 30 (11.2%), 45(16.9%), 4(1.5%) and 3(1.1%) respectively. And in male subgroup, frequencies and ratios of above index were 32 (4.1%), 147 (18.7%), 64 (8.2%) and 115 (14.6%) respectively. Except low platelet, the distribution differences of the rest three blood indexes between sex subgroups were statistically significant (χ 2 test, P<0.01). Either in male or in female subgroups, no statistically significant difference of all health indexes(RBC, WBC, Platelet, HGB, and Chromosomal aberration) was observed in different radiation dose teams. Conclusion: In this monitoring cohort, the health effects were related to hormesis and adaptive response as well as radiation damage accumulation effect of low-dose ionization radiation. Females were the sensitive group to suffer adverse effects, while blood indexes were the sensitive indexes for monitoring radiation exposure. (authors)

  19. 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

  20. Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study.

    Science.gov (United States)

    van Kampen, V; Hoffmeyer, F; Deckert, A; Kendzia, B; Casjens, S; Neumann, H D; Buxtrup, M; Willer, E; Felten, C; Schöneich, R; Brüning, T; Raulf, M; Bünger, J

    2016-12-01

    To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS study: systematic review of reviews and additional primary studies

    Directory of Open Access Journals (Sweden)

    Max Barnish

    2017-08-01

    Full Text Available Abstract Background High-heeled shoes (high heels are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. Methods We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. Results A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men’s behaviour associated with high heel wear. With regard to second

  2. Transport-related measures to mitigate climate change in Basel, Switzerland: A health-effectiveness comparison study.

    Science.gov (United States)

    Perez, L; Trüeb, S; Cowie, H; Keuken, M P; Mudu, P; Ragettli, M S; Sarigiannis, D A; Tobollik, M; Tuomisto, J; Vienneau, D; Sabel, C; Künzli, N

    2015-12-01

    Local strategies to reduce green-house gases (GHG) imply changes of non-climatic exposure patterns. To assess the health impacts of locally relevant transport-related climate change policies in Basel, Switzerland. We modelled change in mortality and morbidity for the year 2020 based on several locally relevant transport scenarios including all decided transport policies up to 2020, additional realistic and hypothesized traffic reductions, as well as ambitious diffusion levels of electric cars. The scenarios were compared to the reference condition in 2010 assumed as status quo. The changes in non-climatic population exposure included ambient air pollution, physical activity, and noise. As secondary outcome, changes in Disability-Adjusted Life Years (DALYs) were put into perspective with predicted changes of CO2 emissions and fuel consumption. Under the scenario that assumed a strict particle emissions standard in diesel cars and all planned transport measures, 3% of premature deaths could be prevented from projected PM2.5 exposure reduction. A traffic reduction scenario assuming more active trips provided only minor added health benefits for any of the changes in exposure considered. A hypothetical strong support to electric vehicles diffusion would have the largest health effectiveness given that the energy production in Basel comes from renewable sources. The planned local transport related GHG emission reduction policies in Basel are sensible for mitigating climate change and improving public health. In this context, the most effective policy remains increasing zero-emission vehicles. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Teamwork and Electronic Health Record Implementation: A Case Study of Preserving Effective Communication and Mutual Trust in a Changing Environment.

    Science.gov (United States)

    Gross, Anne H; Leib, Ryan K; Tonachel, Anne; Tonachel, Richard; Bowers, Danielle M; Burnard, Rachel A; Rhinehart, Catherine A; Valentim, Rahila; Bunnell, Craig A

    2016-11-01

    This article describes how trust among team members and in the technology supporting them was eroded during implementation of an electronic health record (EHR) in an adult outpatient oncology practice at a comprehensive cancer center. Delays in care of a 38-year-old woman with high-risk breast cancer occurred because of ineffective team communication and are illustrated in a case study. The case explores how the patient's trust and mutual trust between team members were disrupted because of inaccurate assumptions about the functionality of the EHR's communication tool, resultant miscommunications between team members and the patient, and the eventual recognition that care was not being effectively coordinated, as it had been previously. Despite a well-established, team-based culture and significant preparation for the EHR implementation, the challenges that occurred point to underlying human and system failures from which other organizations going through a similar process may learn. Through an analysis and evaluation of events that transpired before and during the EHR rollout, suggested interventions for preventing this experience are offered, which include: a thorough crosswalk between old and new communication mechanisms before implementation; understanding and mitigation of gaps in the communication tool's functionality; more robust training for staff, clinicians, and patients; greater consideration given to the pace of change expected of individuals; and development of models of collaboration between EHR users and vendors in developing products that support high-quality, team-based care in the oncology setting. These interventions are transferable to any organizational or system change that threatens mutual trust and effective communication.

  4. The healthy donor effect impacts self-reported physical and mental health - results from the Danish Blood Donor Study (DBDS)

    DEFF Research Database (Denmark)

    Rigas, A S; Skytthe, A; Erikstrup, C

    2017-01-01

    AIMS: This study aimed at quantifying the healthy donor effect by comparing self-perceived mental and physical health between blood donors and non-donors. BACKGROUND: In theory, the selection process known as the healthy donor effect should result in better self-perceived, health-related quality...... of life in donors than in non-donors. METHODS: The Short Form-12 data from the Danish Twin Registry (DTR) was compared with the data from the Danish Blood Donor Study (DBDS). Data on age, sex and smoking status were included in the analyses. The multivariable linear regression analysis was stratified......-perceived mental health was associated with a blood donor. With the increase in age, better self-perceived physical health was associated with blood donation....

  5. The effect of employment transitions on physical health among the elderly in South Korea: A longitudinal analysis of the Korean Retirement and Income Study.

    Science.gov (United States)

    Lee, Juyeon; Kim, Myoung-Hee

    2017-05-01

    This study aims to answer three research questions: First, is the positive effect of retirement on physical health replicated in Korea? Second, is there any difference in health effects of employment transition according to employment status? Third, to what extent do monetary, non-monetary and work-related factors explain the effects of employment transitions on changes in physical health? The longitudinal panel data from five waves of the Korea Retirement and Income Study was used. We conducted (a) the pooled cross-sectional analysis, which used five-wave pooled data; and (b) the fixed-effects analyses to investigate how within-individual changes in employment status correspond to changes in subjective physical health among older adults aged 55 to 84. Results show that transition into retirement leads to poor physical health in Korea, and such effect was moderately mediated by both monetary and non-monetary factors. Compared to respondents who moved to non-precarious employment, those who became employers, self-employers, precarious workers, and unpaid family workers experienced significantly greater odds of reporting subjective poor physical health. Job dissatisfaction seems to be the most important mechanism through which employment transitions were translated into increasing likelihood of poor physical health. In conclusion, the social cost of retirement should consider the negative effects of retirement on the well-being and psychological health of retired individuals and their relationships with family, friends and neighbors, as well as income loss and economic uncertainty. Improving employment quality and working conditions for older working adults may be crucial in accomplishing longer and healthier working lives. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 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).

  7. The effect of health insurance and health facility-upgrades on hospital deliveries in rural Nigeria: a controlled interrupted time-series study.

    Science.gov (United States)

    Brals, Daniëlla; Aderibigbe, Sunday A; Wit, Ferdinand W; van Ophem, Johannes C M; van der List, Marijn; Osagbemi, Gordon K; Hendriks, Marleen E; Akande, Tanimola M; Boele van Hensbroek, Michael; Schultsz, Constance

    2017-09-01

    Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities. We compared changes in hospital deliveries from 1 May 2005 to 30 April 2013 between the programme area and control area in a difference-in-differences analysis with multiple time periods, adjusting for observed confounders. Data were collected through household surveys. Eligible households ( n = 1500) were selected from a stratified probability sample of enumeration areas. All deliveries during the 4-year baseline period ( n = 460) and 4-year follow-up period ( n = 380) were included. Insurance coverage increased from 0% before the insurance was introduced to 70.2% in April 2013 in the programme area. In the control area insurance coverage remained 0% between May 2005 and April 2013. Although hospital deliveries followed a common stable trend over the 4 pre-programme years ( P = 0.89), the increase in hospital deliveries during the 4-year follow-up period in the programme area was 29.3 percentage points (95% CI: 16.1 to 42.6; P health insurance but who could make use of the upgraded care delivered significantly more often in a hospital during the follow-up period than women living in the control area ( P = 0.04). Voluntary health insurance combined with quality healthcare services is highly effective in increasing hospital deliveries in rural Nigeria, by improving access to healthcare for insured and uninsured women in the programme area. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and

  8. Genetic testing of newborns for type 1 diabetes susceptibility: a prospective cohort study on effects on maternal mental health

    Directory of Open Access Journals (Sweden)

    Magnus Per

    2010-07-01

    Full Text Available Abstract Background Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about their children. Methods The study was based on questionnaire data from the Norwegian Mother and Child Cohort (MoBa study conducted by the Norwegian Institute of Public Health. Many of the mothers in the MoBa study also took part in the MIDIA study, in which their newborn children were tested for HLA-conferred genetic susceptibility for type 1 diabetes. We used MoBa questionnaire data from the 30th week of pregnancy (baseline and 6 months post-partum (3-3.5 months after disclosure of test results. We measured maternal symptoms of anxiety and depression (SCL-8, maternal self-esteem (RSES, and satisfaction with life (SWLS. The mothers also reported whether they were seriously worried about their child 6 months post-partum. We compared questionnaire data from mothers who had received information about having a newborn with high genetic risk for type 1 diabetes (N = 166 with data from mothers who were informed that their baby did not have a high-risk genotype (N = 7224. The association between genetic risk information and maternal mental health was analysed using multiple linear regression analysis, controlling for baseline mental health scores. Results Information on genetic risk in newborns was found to have no significant impact on maternal symptoms of anxiety and depression (p = 0.9, self-esteem (p = 0.2, satisfaction with life (p = 0.2, or serious worry about their child (OR = 0.98, 95% CI 0.64-1.48. Mental health before birth was strongly associated with mental health after birth. In addition, an increased

  9. THE EFFECT OF INTERNET USING BEHAVIORS UPON THE PHYSICAL AND MENTAL HEALTH OF THAI CHILDREN AND YOUTHS: CASE STUDY IN BANGKOK

    OpenAIRE

    Ujsara Prasertsin; Prapimparn Suvarnakuta

    2011-01-01

    The purpose of the research was to study the behavior of children and youth related to using the internet. The sample consisted of 1,584 children and youths in Bangkok. The Canonical Correlation Analysis statistics method was applied to analyze the data. The research results revealed that using the internet for entertainment purposes exerted good effects on mental health at 0.52%; meanwhile, it negatively affected mental health at 6251%. Using the internet for education and business displayed...

  10. 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.

  11. Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994-2013.

    Directory of Open Access Journals (Sweden)

    Kayvan Bozorgmehr

    Full Text Available Access to health care for asylum-seekers and refugees (AS&R in Germany is initially restricted before regular access is granted, allegedly leading to delayed care and increasing costs of care. We analyse the effects of (a restricted access; and (b two major policy reforms (1997, 2007 on incident health expenditures for AS&R in 1994-2013.We used annual, nation-wide, aggregate data of the German Federal Statistics Office (1994-2013 to compare incident health expenditures among AS&R with restricted access (exposed to AS&R with regular access (unexposed. We calculated incidence rate differences (∆IRt and rate ratios (IRRt, as well as attributable fractions among the exposed (AFe and the total population (AFp. The effects of between-group differences in need, and of policy reforms, on differences in per capita expenditures were assessed in (segmented linear regression models. The exposed and unexposed groups comprised 4.16 and 1.53 million person-years. Per capita expenditures (1994-2013 were higher in the group with restricted access in absolute (∆IRt = 375.80 Euros [375.77; 375.89] and relative terms (IRR = 1.39. The AFe was 28.07% and the AFp 22.21%. Between-group differences in mean age and in the type of accommodation were the main independent predictors of between-group expenditure differences. Need variables explained 50-75% of the variation in between-group differences over time. The 1997 policy reform significantly increased ∆IRt adjusted for secular trends and between-group differences in age (by 600.0 Euros [212.6; 986.2] and sex (by 867.0 Euros [390.9; 1342.5]. The 2007 policy reform had no such effect.The cost of excluding AS&R from health care appears ultimately higher than granting regular access to care. Excess expenditures attributable to the restriction were substantial and could not be completely explained by differences in need. An evidence-informed discourse on access to health care for AS&R in Germany is needed; it

  12. Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness.

    Science.gov (United States)

    Protheroe, Joanne; Estacio, Emee Vida; Saidy-Khan, Sirandou

    2015-03-01

    Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. PILs were assessed for readability (Flesch Reading Ease and Flesch-Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as 'systems navigation' (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices. © British Journal of General Practice 2015.

  13. The effect of religion on the perception of health states among adults in the United Arab Emirates: a qualitative study.

    Science.gov (United States)

    Elbarazi, Iffat; Devlin, Nancy J; Katsaiti, Marina-Selini; Papadimitropoulos, Emmanuel A; Shah, Koonal K; Blair, Iain

    2017-10-05

    Investigate how religion may affect the perception of health states among adults in the United Arab Emirates and the implications for research on self-reported health and quality of life and the use of values in cost-effectiveness analysis. Qualitative analysis of short-structured interviews with adult Emiratis carried out by a market research agency.The COREQ criteria have been used where appropriate to guide the reporting of our findings. Participants were recruited from shopping malls and other public places in the cities of Al Ain and Abu Dhabi. Two hundred adult Emiratis broadly representative of the Emirati population in terms of age and gender. Eighty one per cent of participants said that their perception of health states was influenced by their spiritual or religious beliefs. The two overarching themes that seemed to explain or classify these influences were 'fatalism' and 'preservation of life'. Subthemes included powerlessness to change what is preordained by God, fear of disability (particularly diminished mobility) and appreciation of health and life and the requirement to look after one's health. A final theme was that of acceptance, with respondents expressing a willingness to endure suffering and disability with patience in the expectation of rewards in the hereafter. Our results emphasise the need for further work to establish locally relevant value sets for Muslim majority countries in the Middle East and elsewhere for use in health technology assessment decision-making, rather than relying on value sets from other regions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Quasi-experimental study designs series-paper 5: a checklist for classifying studies evaluating the effects on health interventions-a taxonomy without labels.

    Science.gov (United States)

    Reeves, Barnaby C; Wells, George A; Waddington, Hugh

    2017-09-01

    The aim of the study was to extend a previously published checklist of study design features to include study designs often used by health systems researchers and economists. Our intention is to help review authors in any field to set eligibility criteria for studies to include in a systematic review that relate directly to the intrinsic strength of the studies in inferring causality. We also seek to clarify key equivalences and differences in terminology used by different research communities. Expert consensus meeting. The checklist comprises seven questions, each with a list of response items, addressing: clustering of an intervention as an aspect of allocation or due to the intrinsic nature of the delivery of the intervention; for whom, and when, outcome data are available; how the intervention effect was estimated; the principle underlying control for confounding; how groups were formed; the features of a study carried out after it was designed; and the variables measured before intervention. The checklist clarifies the basis of credible quasi-experimental studies, reconciling different terminology used in different fields of investigation and facilitating communications across research communities. By applying the checklist, review authors' attention is also directed to the assumptions underpinning the methods for inferring causality. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. Short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health: results from the Whitehall II study.

    Science.gov (United States)

    Falkenberg, Helena; Fransson, Eleonor I; Westerlund, Hugo; Head, Jenny A

    2013-10-01

    To investigate short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health for women and men in different employment grades. Minor psychiatric disorder and self-rated health among 6710 British civil servants (1993 women and 4717 men) in three employment grades from the Whitehall II study were examined from 1985 to 1988 under stable employment conditions. The short-term effects of organisational change were investigated in 1991-1993 after a time of major restructuring aiming at increasing the influence of market forces in the civil service and the long-term effects were investigated in 1997-1999. Those who had experienced organisational change and those who anticipated organisational change reported more negative short-term health effects (minor psychiatric disorder and poor self-rated health) compared with those who reported no change. No major differences were found depending on employment grade or gender. The negative health effects had diminished during 1997-1999 for those who reported that a major change had happened before 1991-1993. Those who anticipated an organisational change in 1991-1993 still reported more ill-health in 1997-1999 (both minor psychiatric disorder and self-reported health) than those in the comparison group. The results indicate that organisational change affects employees' health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.

  1. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

    Science.gov (United States)

    Olmo, Neide Regina Simões; do Nascimento Saldiva, Paulo Hilário; Braga, Alfésio Luís Ferreira; Lin, Chin An; de Paula Santos, Ubiratan; Pereira, Luiz Alberto Amador

    2011-01-01

    The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies. PMID:21655765

  2. Seasonal variation in the acute effect of particulate air pollution on mortality in the China Air Pollution and Health Effects Study (CAPES)

    Science.gov (United States)

    Chen, Renjie; Peng, Roger D.; Meng, Xia; Zhou, Zhijun; Chen, Bingheng; Kan, Haidong

    2013-01-01

    Epidemiological findings concerning the seasonal variation in the acute effect of particulate matter (PM) are inconsistent. We investigated the seasonality in the association between PM with an aerodynamic diameter of less than 10 μm (PM10) and daily mortality in 17 Chinese cities. We fitted the “main” time-series model after adjustment for time-varying confounders using smooth functions with natural splines. We established a “seasonal” model to obtain the season-specific effect estimates of PM10, and a “harmonic” model to show the seasonal pattern that allows PM10 effects to vary smoothly with the day in a year. At the national level, a 10 μg/m3 increase in the two-day moving average concentrations (lag 01) of PM10 was associated with 0.45% [95% posterior interval (PI), 0.15% to 0.76%], 0.17% (95% PI, −0.09% to 0.43%), 0.55% (95% PI, 0.15% to 0.96%) and 0.25% (95%PI, −0.05% to 0.56%) increases in total mortality for winter, spring, summer and fall, respectively. For the smoothly-varying plots of seasonality, we identified a two-peak pattern in winter and summer. The observed seasonal pattern was generally insensitive to model specifications. Our analyses suggest that the acute effect of particulate air pollution could vary by seasons with the largest effect in winter and summer in China. To our knowledge, this is the first multicity study in developing countries to analyze the seasonal variations of PM-related health effects. PMID:23500824

  3. 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

  4. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

    Science.gov (United States)

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

    2017-01-01

    To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

  5. Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study.

    Science.gov (United States)

    Baptista, Liliana C; Dias, Gonçalo; Souza, Nelba R; Veríssimo, Manuel T; Martins, Raul A

    2017-08-01

    To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D). This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n = 279). Participants underwent one of two conditions: LTMEX (n = 241) trained three times per week; and unchanged lifestyle-the control group (CO; n = 38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO 2 peak). LTMEX improves HRQoL, specifically physical functioning (P health (P health (MH; P older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

  6. Does conflict between home and work explain the effect of multiple roles on mental health? A comparative study of Finland, Japan, and the UK.

    Science.gov (United States)

    Chandola, Tarani; Martikainen, Pekka; Bartley, Mel; Lahelma, Eero; Marmot, Michael; Michikazu, Sekine; Nasermoaddeli, Ali; Kagamimori, Sadanobu

    2004-08-01

    Although there have been a number of studies on the effects of multiple roles on health and how a combination of work and family roles may be either advantageous (role enhancement) or disadvantageous (role strain) for health, there has been relatively little investigation on the psychosocial content of such roles. Work-to-family conflict and family-to-work conflict could arise from inability to combine multiple roles and result in stress and ill health. The question of whether both types of conflict mediate between the association of multiple roles with health has not been analysed before. This paper sets out to investigate whether: (1) work-to-family conflict or family-to-work conflict contributes towards explaining the association of multiple roles with mental health; (2) the effect of work-to-family conflict and family-to-work conflict on mental health varies by gender; (3) the effect of work-to-family and family-to-work conflict on mental health vary between countries with different welfare state arrangements and social norms. Cross-sectional data of economically active male and female public sector employees aged 35-60 in London (UK), Helsinki (Finland), and the West Coast of Japan. Linear regression models (separate for each gender and cohort) of SF-36 mental component scores were analysed with role combinations, family-to-work and work-to-family conflict as explanatory variables. Single fathers in all three cohorts and of single mothers in the Helsinki cohort had poor mental health, and this was partly explained by their higher levels family-to-work conflict. Both types of conflict affect the mental health of men and women independently of each other. Japanese women had the greatest conflict and poorest mental health while Helsinki women had the lowest conflict and best mental health. Both work-to-family and family-to-work conflict affect the mental health of men and women in three different countries. Work and family roles and the balance between the two

  7. Effectiveness of supervised toothbrushing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study.

    Science.gov (United States)

    Damle, Satyawan G; Patil, Anil; Jain, Saru; Damle, Dhanashree; Chopal, Nilika

    2014-09-01

    To evaluate and compare the oral health status and the impact of supervised toothbrushing and oral health education among school children of urban and rural areas of Maharashtra, India. A total of 200 school children in the age group 12-15 years were selected by stratified random sampling technique from two schools and were further divided into two groups: Group A (urban school) and Group B (rural school). Both the groups were again subdivided into control group and study group. Supervised toothbrushing was recommended for both the groups. The toothbrushing teaching program included session on oral health education, individual toothbrushing instructions, and supervised toothbrushing. Dental caries increment, plaque scores, and gingival status were assessed as per the World Health Organization (WHO) criteria (1997), Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index, and Loe-Silness Gingival Index (1963), respectively. Cronbach's alpha, Chi-square test, paired t-test, and unpaired t-test were utilized for data analysis. The mean plaque and gingival score reduction was significantly higher in the study groups as compared to the control groups. An increase in the mean of Decayed, missing, filled teeth (DMFT) and Decayed, missing, filled teeth and surfaces (DMFS) scores throughout the study period was seen in children who participated in study. Oral health education was effective in establishing good oral health habits among school children and also in enhancing the knowledge of their parents about good oral health.

  8. Effect of high aluminum concentration in water resources on human health, case study: Biga Peninsula, northwest part of Turkey.

    Science.gov (United States)

    Bakar, Coşkun; Karaman, Handan Işin Ozişik; Baba, Alper; Sengünalp, Fatma

    2010-05-01

    Widespread and intense zones of silicified, propylitic, and argillic alteration exist as outcrop around the Biga Peninsula, NW Turkey. Most of the springs in the study area surface out from these altered volcanic rocks. The concentrations of aluminum (Al) in these springs ranged from 13.17 to 15.70 ppm in this region. These high levels of Al were found to exceed the maximum allowable limits (0.2 ppm) depicted in national and international standards of drinking water quality. Therefore, the effect of high Al in water resources on human health was evaluated in this research. A total of 273 people aged above 18 years and living in the Kirazli region (whose water supply is from springs emerging from these alteration zones) and in the Ciplak-Halileli region (whose water supply is provided from an alluvium aquifer) were selected as the research group. For this group, a questionnaire was completed that contained questions on descriptive characteristics of humans and a Mini-Mental State Examination (MMSE) was administered by the authors using the face-to-face interview technique. A neurological examination was then performed by the neurology specialist as a second-stage investigation. Finally, 10 ml of venous blood samples were obtained from these people as a third-stage analysis to determine the serum Al levels together with vitamin B(12), folic acid, and thyroid-stimulating hormone parameters. The result typically revealed that the MMSE score was less in 31.9% and there was no statistically significant difference between the two regions. However, the result also showed that neuropathy in the history (including a careful past medical history) was significantly higher in the Kirazli region.

  9. Economic Impacts from PM2.5 Pollution-Related Health Effects: A Case Study in Shanghai.

    Science.gov (United States)

    Wu, Rui; Dai, Hancheng; Geng, Yong; Xie, Yang; Masui, Toshihiko; Liu, Zhiqing; Qian, Yiying

    2017-05-02

    PM 2.5 pollution-related diseases cause additional medical expenses and work time loss, leading to macroeconomic impact in high PM 2.5 concentration areas. Previous economic impact assessments of air pollution focused on benefits from environmental regulations while ignoring climate policies. In this study, we examine the health and economic impacts from PM 2.5 pollution under various air pollution control strategies and climate policies scenarios in the megacity of Shanghai. The estimation adopts an integrated model combining a Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model, exposure-response functions (ERFs), and a computable general equilibrium (CGE) model. The results show that without control measures, Shanghai's mortality caused by PM 2.5 pollution are estimated to be 192 400 cases in 2030 and the work time loss to be 72.1 h/cap annually. The corresponding GDP values and welfare losses would be approximately 2.26% and 3.14%, respectively. With an estimated control cost of 0.76% of local GDP, Shanghai would gain approximately 1.01% of local GDP through local air pollution control measures and climate policies. Furthermore, the application of multiregional integrated control strategies in neighboring provinces would be the most effective in reducing PM 2.5 concentration in Shanghai, leading to only 0.34% of GDP loss. At the sectoral level, labor-intensive sectors suffer more output loss from PM 2.5 pollution. Sectors with the highest control costs include power generation, iron and steel, and transport. The results indicate that the combination of multiregional integrated air pollution control strategies and climate policies would be cost-beneficial for Shanghai.

  10. Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study.

    Science.gov (United States)

    Rapp, Stephen R; Luchsinger, Jose A; Baker, Laura D; Blackburn, George L; Hazuda, Helen P; Demos-McDermott, Kathryn E; Jeffery, Robert W; Keller, Jeffrey N; McCaffery, Jeanne M; Pajewski, Nicholas M; Evans, Mary; Wadden, Thomas A; Arnold, Steven E; Espeland, Mark A

    2017-05-01

    To assess whether randomization to 10 years of lifestyle intervention to induce and maintain weight loss improves cognitive function. Randomized controlled clinical trial. Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Continuation study (U01 DK057136-15). Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 (N = 3,751). Intensive lifestyle intervention (ILI) for weight loss through reduced caloric intake and increased physical activity compared with a control condition of diabetes support and education (DSE). Certified examiners who were masked to intervention assignment administered a standard battery of cognitive function tests (Modified Mini-Mental State Examination, Rey Auditory Verbal Learning Test, Digit Symbol Coding, Trail-Making Test, Modified Stroop Color-Word Test) to participants 10 to 13 years after enrollment. Assignment to lifestyle intervention was not associated with significantly different overall (P = .10) or domain-specific (all P > .10) cognitive function than assignment to diabetes support and education. Results were fairly consistent across prespecified groups, but there was some evidence of trends for differential intervention effects showing modest harm in ILI in participants with greater body mass index and in individuals with a history of cardiovascular disease. Cognitive function was not associated with changes in weight or fitness (all P > .05). A long-term behavioral weight loss intervention for overweight and obese adults with diabetes mellitus was not associated with cognitive benefit. Trial Registration clinicaltrials.gov Identifier: NCT00017953. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  11. Effectiveness of a multiple-strategy community intervention to reduce maternal and child health inequalities in Haryana, North India: a mixed-methods study protocol

    Directory of Open Access Journals (Sweden)

    Madhu Gupta

    2015-02-01

    Full Text Available Background: A multiple-strategy community intervention, known as National Rural Health Mission (NRHM, launched in India to improve the availability of and access to better-quality healthcare, especially for rural, poor mothers and children. The final goal of the intervention is to reduce maternal and child health inequalities across geographical areas, socioeconomic status groups, and sex of the child. Extensive, in-depth research is necessary to assess the effectiveness of NRHM, on multiple outcome dimensions. This paper presents the design of a new study, able to overcome the shortcomings of previous research. Objective: To propose a comprehensive, methodologically sound protocol to assess the extent of implementation and the effectiveness of NRHM measures to improve maternal and child health outcomes and reduce maternal and child health inequalities. Design: A mixed-methods approach (quantitative and qualitative is proposed for this study in Haryana, a state in North India. NRHM's health sector plans included health system strengthening, specific maternal and child healthcare strategies, and communitization. Mission documents and reports on progress, financial monitoring, and common and joint review will be reviewed in-depth to assess the extent of the implementation of plans. Data on maternal and child health indicators will be obtained from demographic health surveys held before, during, and after the implementation of the first phase of the NRHM (2005–2012 and compared over time. Differences in maternal and child health indicators will be used to measure maternal and child health inequalities; these will be compared pre- and post-NRHM. Focus group discussions (FGDs with service providers and in-depth interviews with program managers, community representatives, and mothers will be conducted until data saturation is achieved, in two districts of Haryana. Using Nvivo software, an inductive qualitative content analysis will be performed to

  12. The mental health effects of multiple work and family demands. A prospective study of psychiatric sickness absence in the French GAZEL study.

    Science.gov (United States)

    Melchior, Maria; Berkman, Lisa F; Niedhammer, Isabelle; Zins, Marie; Goldberg, Marcel

    2007-07-01

    Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men. We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8,869 men, 2,671 women) over a period of 9 years (1995-2003). Work stress and family demands were measured by questionnaire. Medically certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline. Participants simultaneously exposed to high levels of work and family demands (> or =2 work stress factors and > or =4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0-1 work stress factors and with 1-3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02-5.52) in men and 6.36 (95% CI 3.38-11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86-3.87) in men, 5.04 (95% CI 2.84-8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression: age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96-11.24) in men, 8.57 (4.26-17.22) in women; fully adjusted RRs: 3.55 (95% CI 1.62-7.77) in men, 6.58 (95%CI 3.46-12.50) in women. Men and women simultaneously exposed to high levels of work stress and family demands are at high risk of experiencing mental health problems

  13. The Medical Humanities Effect: a Pilot Study of Pre-Health Professions Students at the University of Rochester.

    Science.gov (United States)

    Baker, Clayton J; Shaw, Margie Hodges; Mooney, Christopher J; Daiss, Susan Dodge-Peters; Clark, Stephanie Brown

    2017-12-01

    Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students' responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches.

  14. The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study.

    Science.gov (United States)

    Koch, Peter; Kersten, Jan Felix; Stranzinger, Johanna; Nienhaus, Albert

    2017-01-01

    The prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis. In 2014 childcare workers ( N  = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later ( N  = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression. At baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points ( p  = 0.034). ERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.

  15. Multi-country willingness to pay study on road-traffic environmental health effects: are people willing and able to provide a number?

    Science.gov (United States)

    Istamto, Tifanny; Houthuijs, Danny; Lebret, Erik

    2014-05-09

    The health impacts from traffic-related pollutants bring costs to society, which are often not reflected in market prices for transportation. We set out to simultaneously assess the willingness-to-pay (WTP) for traffic-related air pollution and noise effect on health, using a single measurement instrument and approach. We investigated the proportion and determinants of "protest vote/PV responses (people who were against valuing their health in terms of money)" and "don't know"/DK answers, and explored the effect of DK on the WTP distributions. Within the framework of the EU-funded project INTARESE, we asked over 5,200 respondents in five European countries to state their WTP to avoid health effects from road traffic-related air pollution and noise in an open-ended web-based questionnaire. Determinants of PV and DK were studied by logistic regression using variables concerning socio-demographics, income, health and environmental concern, and risk perception. About 10% of the respondents indicated a PV response and between 47-56% of respondents gave DK responses. About one-third of PV respondents thought that costs should be included in transportation prices, i.e. the polluter should pay. Logistic regression analyses showed associations of PV and DK with several factors. In addition to social-demographic, economic and health factors known to affect WTP, environmental concern, awareness of health effects, respondent's ability to relax in polluted places, and their view on the government's role to reduce pollution and on policy to improve wellbeing, also affected the PV and DK response. An exploratory weighting and imputation exercise did not show substantial effects of DK on the WTP distribution. With a proportion of about 50%, DK answers may be a more relevant issue affecting WTP than PV's. The likelihood to give PV and DK response were influenced by socio-demographic, economic and health factors, as well as environmental concerns and appreciation of environmental

  16. Effects of Health Literacy and Social Capital on Health Information Behavior.

    Science.gov (United States)

    Kim, Yong-Chan; Lim, Ji Young; Park, Keeho

    2015-01-01

    This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.

  17. Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

    International Nuclear Information System (INIS)

    McClintock, Tyler R.; Chen, Yu; Parvez, Faruque; Makarov, Danil V.; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A.; Graziano, Joseph H.

    2014-01-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (− 10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by > 47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and > 41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. - Highlights: • Hematuria is the most common symptom of urinary tract disease. • Arsenic exposure is associated with renal dysfunction and urologic malignancy. • Water arsenic was positively associated with prevalence and incidence of hematuria. • Reduction in exposure lowered hematuria risk especially in low-to-moderate exposed

  18. Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

    Energy Technology Data Exchange (ETDEWEB)

    McClintock, Tyler R. [Department of Population Health, New York University School of Medicine, New York, NY (United States); Department of Environmental Medicine, New York University School of Medicine, New York, NY (United States); Department of Urology, New York University School of Medicine, New York, NY (United States); Chen, Yu, E-mail: yu.chen@nyumc.org [Department of Population Health, New York University School of Medicine, New York, NY (United States); Department of Environmental Medicine, New York University School of Medicine, New York, NY (United States); Parvez, Faruque [Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY (United States); Makarov, Danil V. [Department of Urology, New York University School of Medicine, New York, NY (United States); Robert F. Wagner Graduate School of Public Service, New York University, New York, NY (United States); United States Department of Veterans Affairs Harbor Healthcare System, New York, NY (United States); New York University Cancer Institute, New York, NY (United States); Ge, Wenzhen [Department of Population Health, New York University School of Medicine, New York, NY (United States); Department of Environmental Medicine, New York University School of Medicine, New York, NY (United States); Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam [U-Chicago Research Bangladesh, Ltd., Dhaka (Bangladesh); Slavkovich, Vesna [Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY (United States); Bjurlin, Marc A. [Department of Urology, New York University School of Medicine, New York, NY (United States); Graziano, Joseph H. [Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY (United States); and others

    2014-04-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (− 10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by > 47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and > 41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. - Highlights: • Hematuria is the most common symptom of urinary tract disease. • Arsenic exposure is associated with renal dysfunction and urologic malignancy. • Water arsenic was positively associated with prevalence and incidence of hematuria. • Reduction in exposure lowered hematuria risk especially in low-to-moderate exposed

  19. The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh.

    Science.gov (United States)

    Haque, Syed Emdadul; Rahman, Mosiur; Itsuko, Kawashima; Mutahara, Mahmuda; Sakisaka, Kayako

    2014-07-03

    To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents. Intervention study. Araihazar area, Bangladesh. 416 adolescent female students aged 11-16 years, in grade 6-8, and living with their parents. A school-based health education study conducted from April 2012 to April 2013. We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments. After health education, participants reported a significant improvement (pmenstruation (78.6% vs 59.6%). The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. 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

  1. Synergistic effect of interaction between perceived health and social activity on depressive symptoms in the middle-aged and elderly: a population-based longitudinal study.

    Science.gov (United States)

    Chun, Sung-Youn; Han, Kyu-Tae; Lee, Seo Yoon; Kim, Chan Ok; Park, Eun-Cheol

    2015-03-13

    To examine the synergistic effect of interaction between perceived health and social activity on depressive symptoms. We investigated whether the interaction between perceived health and social activity has a synergistic effect on depressive symptoms in the middle-aged and elderly using data from 6590 respondents aged 45 and older in the Korean Longitudinal Study on Aging (KLoSA), 2006-2012. A generalised linear mixed-effects model was used to investigate the association in a longitudinal data form. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 10 Scale (CES-D10). Perceived health and level of social activity were categorical variables with three values. Participation in six social activities was assessed. Interactions between perceived health status and social activity were statistically significant for almost all social activity/perceived health combinations. Addition of the interaction term significantly decreased CES-D10 scores, confirming the synergistic effect of the interaction between perceived health status and social activity ('normal×moderate', β=-0.1826; 'poor×moderate', β=-0.5739; 'poor×active', β=-0.8935). In addition, we performed stratified analyses by region: urban or rural. In urban respondents, the additional effect of the interaction term decreased CES-D10 scores and all social activity/perceived health combinations were statistically significant ('normal×moderate', β=-0.2578; 'normal×active', β=-0.3945; 'poor×moderate', β=-0.5739; 'poor×active', β=-0.8935). In rural respondents, only one social activity/perceived health combination was statistically significant, and the additional effect of the interaction term showed no consistent trend on CES-D10 scores. The interaction between perceived health and social activity has a synergistic effect on depressive symptoms; the additional effect of the interaction term significantly decreased CES-D10 scores in our models. Published by the BMJ

  2. Effect of phenotype on health care costs in Crohn's disease: A European study using the Montreal classification.

    Science.gov (United States)

    Odes, Selwyn; Vardi, Hillel; Friger, Michael; Wolters, Frank; Hoie, Ole; Moum, Bjørn; Bernklev, Tomm; Yona, Hagit; Russel, Maurice; Munkholm, Pia; Langholz, Ebbe; Riis, Lene; Politi, Patrizia; Bondini, Paolo; Tsianos, Epameinondas; Katsanos, Kostas; Clofent, Juan; Vermeire, Severine; Freitas, João; Mouzas, Iannis; Limonard, Charles; O'Morain, Colm; Monteiro, Estela; Fornaciari, Giovanni; Vatn, Morten; Stockbrugger, Reinhold

    2007-12-01

    Crohn's disease (CD) is a chronic inflammation of the gastrointestinal tract associated with life-long high health care costs. We aimed to determine the effect of disease phenotype on cost. Clinical and economic data of a community-based CD cohort with 10-year follow-up were analyzed retrospectively in relation to Montreal classification phenotypes. In 418 patients, mean total costs of health care for the behavior phenotypes were: nonstricturing-nonpenetrating 1690, stricturing 2081, penetrating 3133 and penetrating-with-perianal-fistula 3356 €/patient-phenotype-year (P<0.001), and mean costs of surgical hospitalization 215, 751, 1293 and 1275 €/patient-phenotype-year respectively (P<0.001). Penetrating-with-perianal-fistula patients incurred significantly greater expenses than penetrating patients for total care, diagnosis and drugs, but not surgical hospitalization. Total costs were similar in the location phenotypes: ileum 1893, colon 1748, ileo-colonic 2010 and upper gastrointestinal tract 1758 €/patient-phenotype-year, but surgical hospitalization costs differed significantly, 558, 209, 492 and 542 €/patient-phenotype-year respectively (P<0.001). By multivariate analysis, the behavior phenotype significantly impacted total, medical and surgical hospitalization costs, whereas the location phenotype affected only surgical costs. Younger age at diagnosis predicted greater surgical expenses. Behavior is the dominant phenotype driving health care cost. Use of the Montreal classification permits detection of cost differences caused by perianal fistula.

  3. Developing and Testing the Effectiveness of a Novel Health Qigong for Frail Elders in Hong Kong: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Hector W. H. Tsang

    2013-01-01

    Full Text Available Eight-Section Brocades and Yijin Jing consist of some routine movements that are too difficult for frail elders. A novel health qigong protocol was developed and its effectiveness for frail elders was examined using a randomized clinical trial (RCT. An expert panel performed functional anatomy analysis and safety field test prior to the RCT. The experimental group (n=61, 83±6 yr was given a 12-week qigong exercise program, while the comparison group (n=55, 84±6 yr participated in a newspaper reading program with the same duration and frequency. Pre-, mid-, post-, and follow-up assessments were conducted. At 12 weeks, the qigong group had significant improvements in thinking operations (F=4.05, P=.02 and significant reduction of resting heart rate (F=3.14, P=.045 as compared to the newspaper reading group. A trend of improvements in grip strength and a decreasing trend of depression levels were observed among the qigong group. Significant perceived improvements in physical health (F=13.01, P=.001, activities of daily living (F=5.32, P=.03, and overall health status (F=15.26, P=.0001 were found. There are improvements in some aspects of psychosocial, cognitive, physical, and physiological domains. Clinical applications and possibilities for further research are discussed.

  4. Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10 year-old children.

    Science.gov (United States)

    Angelopoulou, Matina V; Kavvadia, Katerina; Taoufik, Konstantina; Oulis, Constantine J

    2015-04-28

    School based oral health education through traditional lecturing has been found successful only in improving oral health knowledge, while has low effectiveness in oral hygiene and gingival health. The aim of this study was to evaluate the effectiveness of experiential learning (EL) oral health education to traditional lecturing (TL), on enhancing oral health knowledge, attitude and behavior as well as oral hygiene, gingival health and caries of 10-year-old children. Eighty-four children were recruited for the EL and 100 for the TL group from 3 locations in Greece. Data regarding oral health knowledge, attitude and behavior were collected via questionnaires. Data regarding dental plaque, gingivitis and caries were collected by clinical examination. The evaluation using questionnaires and clinical examination was assessed at baseline and 6 and 18 months afterwards. Two calibrated pediatric dentists examined the students using a periodontal probe and artificial light. Modified hygiene index (HI) was used for dental plaque recording, the simplified gingival index (GI-S) was used for gingivitis and DMFT, based on BASCD criteria, for dental caries. Based on a dedicated manual, the teacher applied in the classroom the oral health educational program using EL. EL group had statistically significant better hygiene than the TL at 6 months (p 0.05) and attitude (p > 0.05) at 6 months in comparison to baseline. EL program was found more successful than TL in oral hygiene improvement. Both oral health education programs improved the oral health knowledge, attitude and behavior of children. ClinicalTrials.gov (NCT02320162).

  5. The effect of ill health and socioeconomic status on labor force exit and re-employment: a prospective study with ten years follow-up in the Netherlands.

    Science.gov (United States)

    Schuring, Merel; Robroek, Suzan J W; Otten, Ferdy W J; Arts, Coos H; Burdorf, Alex

    2013-03-01

    The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming economically inactive. A secondary objective was to investigate the effect of ill health and socioeconomic status on return to work. A representative sample of the Dutch working population (N=15 152) was selected for a prospective study with ten years follow-up (93 917 person-years). Perceived health and individual and household characteristics were measured at baseline with the Permanent Quality of Life Survey (POLS) during 1999-2002. Statistics Netherlands ascertained employment status monthly from January 1999 to December 2008. Cox proportional hazards analyses were used to determine the factors that predicted labor force exit and return to work. Ill health increased the likelihood of labor force exit into unemployment [hazard ratio (HR) 1.89], disability pension (HR 6.39), and early retirement (HR 1.20), but was not a determinant of becoming economically inactive (HR 1.07). Workers with low socioeconomic status were, even after adjusting for ill health, more likely to leave the labor force due to unemployment, disability pension, and economic inactivity. Workers with ill health at baseline were less likely to return to work after unemployment (HR 0.75) or disability pension (HR 0.62). Socioeconomic status did not influence re-employment. Ill health is an important determinant for entering and maintaining paid employment. Workers with lower education were at increased risk for health-based selection out of paid employment. Policies to improve labor force participation, especially among low socioeconomic level workers, should protect workers with health problems against exclusion from the labor force.

  6. Klokwerk + study protocol: An observational study to the effects of night-shift work on body weight and infection susceptibility and the mechanisms underlying these health effects.

    Science.gov (United States)

    Loef, Bette; van Baarle, Debbie; van der Beek, Allard J; van Kerkhof, Linda W; van de Langenberg, Daniëlla; Proper, Karin I

    2016-08-02

    Night-shift work may cause severe disturbances in the worker's circadian rhythm, which has been associated with the onset of health problems and diseases. As a substantial part of the workforce is exposed to night-shift work, harmful aspects of night-shift work should not be overlooked. The aim of the Klokwerk + study is to study the effects of night-shift work on body weight and infection susceptibility and the mechanisms underlying these health effects. First, we will study the relation between night-shift work exposure and body weight and between night-shift work exposure and infection susceptibility. Second, we will examine the mechanisms linking night-shift work exposure to body weight and infection susceptibility, with a specific focus on sleep, physical activity, diet, light exposure, vitamin D level, and immunological factors. Lastly, we will focus on the identification of biomarkers for chronic circadian disturbance associated with night-shift work. The design of this study is a prospective observational cohort study consisting of 1,960 health care workers aged 18-65 years. The study population will consist of a group of night-shift workers and an equally sized group of non-night-shift workers. During the study, there will be two measurement periods. As one of the main outcomes of this study is infection susceptibility, the measurement periods will take place at approximately the first (September/October) (T0) and the last month (April/May) (T1, after 6 months) of the flu season. The measurements will consist of questionnaires, anthropometric measurements, a smartphone application to determine infection susceptibility, food diaries, actigraphy, light sensors, and blood sample analyses. The Klokwerk + study will contribute to the current need for high-quality data on the health effects of night-shift work and its underlying behavioral and physiological mechanisms. The findings can be the starting point for the development of interventions that

  7. Klokwerk + study protocol: An observational study to the effects of night–shift work on body weight and infection susceptibility and the mechanisms underlying these health effects

    Directory of Open Access Journals (Sweden)

    Bette Loef

    2016-08-01

    Full Text Available Abstract Background Night–shift work may cause severe disturbances in the worker’s circadian rhythm, which has been associated with the onset of health problems and diseases. As a substantial part of the workforce is exposed to night–shift work, harmful aspects of night–shift work should not be overlooked. The aim of the Klokwerk + study is to study the effects of night–shift work on body weight and infection susceptibility and the mechanisms underlying these health effects. First, we will study the relation between night–shift work exposure and body weight and between night–shift work exposure and infection susceptibility. Second, we will examine the mechanisms linking night–shift work exposure to body weight and infection susceptibility, with a specific focus on sleep, physical activity, diet, light exposure, vitamin D level, and immunological factors. Lastly, we will focus on the identification of biomarkers for chronic circadian disturbance associated with night–shift work. Methods/design The design of this study is a prospective observational cohort study consisting of 1,960 health care workers aged 18–65 years. The study population will consist of a group of night–shift workers and an equally sized group of non–night–shift workers. During the study, there will be two measurement periods. As one of the main outcomes of this study is infection susceptibility, the measurement periods will take place at approximately the first (September/October (T0 and the last month (April/May (T1, after 6 months of the flu season. The measurements will consist of questionnaires, anthropometric measurements, a smartphone application to determine infection susceptibility, food diaries, actigraphy, light sensors, and blood sample analyses. Discussion The Klokwerk + study will contribute to the current need for high–quality data on the health effects of night–shift work and its underlying behavioral and physiological

  8. Developing a new perspective to study the health of survivors of Sichuan earthquakes in China: a study on the effect of post-earthquake rescue policies on survivors' health-related quality of life.

    Science.gov (United States)

    Liang, Ying; Wang, Xiukun

    2013-10-29

    Sichuan is a province in China with an extensive history of earthquakes. Recent earthquakes, including the Lushan earthquake in 2013, have resulted in thousands of people losing their homes and their families. However, there is a research gap on the efficiency of government support policies. Therefore, this study develops a new perspective to study the health of earthquake survivors, based on the effect of post-earthquake rescue policies on health-related quality of life (HRQOL) of survivors of the Sichuan earthquake. This study uses data from a survey conducted in five hard-hit counties (Wenchuan, Qingchuan, Mianzhu, Lushan, and Dujiangyan) in Sichuan in 2013. A total of 2,000 questionnaires were distributed, and 1,672 were returned; the response rate was 83.6%. Results of the rescue policies scale and Medical Outcomes Study Short Form 36 (SF-36) scale passed the reliability test. The confirmatory factor analysis model showed that the physical component summary (PCS) directly affected the mental component summary (MCS). The results of structural equation model regarding the effects of rescue policies on HRQOL showed that the path coefficients of six policies (education, orphans, employment, poverty, legal, and social rescue policies) to the PCS of survivors were all positive and passed the test of significance. Finally, although only the path coefficient of the educational rescue policy to the MCS of survivors was positive and passed the test of significance, the other five policies affected the MCS indirectly through the PCS. The general HRQOL of survivors is not ideal; the survivors showed a low satisfaction with the post-earthquake rescue policies. Further, the six post-earthquake rescue policies significantly improved the HRQOL of survivors and directly affected the promotion of the PCS of survivors. Aside from the educational rescue policy, all other policies affected the MCS indirectly through the PCS. This finding indicates relatively large differences in

  9. 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…

  10. 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

  11. Embedding health literacy into health systems: a case study of a regional health service.

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2017-12-01

    Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them

  12. Process Evaluation for Improving K12 Program Effectiveness: Case Study of a National Institutes of Health Building Interdisciplinary Research Careers in Women's Health Research Career Development Program.

    Science.gov (United States)

    Raymond, Nancy C; Wyman, Jean F; Dighe, Satlaj; Harwood, Eileen M; Hang, Mikow

    2018-06-01

    Process evaluation is an important tool in quality improvement efforts. This article illustrates how a systematic and continuous evaluation process can be used to improve the quality of faculty career development programs by using the University of Minnesota's Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 program as an exemplar. Data from a rigorous process evaluation incorporating quantitative and qualitative measurements were analyzed and reviewed by the BIRCWH program leadership on a regular basis. Examples are provided of how this evaluation model and processes were used to improve many aspects of the program, thereby improving scholar, mentor, and advisory committee members' satisfaction and scholar outcomes. A rigorous evaluation plan can increase the effectiveness and impact of a research career development plan.

  13. The Effect of Armed Conflict on the Utilization of Maternal Health Services in Uganda: A Population-based Study.

    Science.gov (United States)

    Namasivayam, Amrita; Arcos González, Pedro; Castro Delgado, Rafael; Chi, Primus Che

    2017-10-03

    Maternal mortality rates can be adversely affected by armed conflict, implying a greater level of vulnerability among women, and is often linked to the lack of or limited access to maternal healthcare during conflict. Previous research in Uganda has shown that armed conflict negatively impacts women's utilization of maternal healthcare services for a multitude of reasons at the individual, health-system and political levels. This study compared aggregated Demographic and Health Surveys data from 13 districts in Northern Uganda, a conflict-affected region, with data from the rest of the country, for the use of maternal healthcare services for the years 1988, 1995, 2000, 2006 and 2011, using statistical analyses and logistic regression. Specific indicators for maternal healthcare utilization included contraceptive use, antenatal care, skilled assistance at birth and institutional delivery. Use of contraception and institutional deliveries among women in Northern Uganda was significantly lower compared to the rest of the country. However, skilled assistance at birth among women in Northern Uganda was significantly higher. The findings in this study show that armed conflict can have a negative impact on aspects of maternal healthcare such as contraceptive use and institutional deliveries; however, other indicators such as skilled assistance at birth were seen to be better among conflict-affected populations. This reiterates the complex nature of armed conflict and the interplay of different factors such as conflict intensity, existing health systems and services, and humanitarian interventions that could influence maternal healthcare utilization. Armed conflict, maternal health utilization, Northern Uganda, contraception, skilled assistance at birth, antenatal care, institutional delivery.

  14. Internet-based cognitive behaviour therapy and physical exercise - Effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial.

    Science.gov (United States)

    Strid, Catharina; Andersson, Claes; Forsell, Yvonne; Öjehagen, Agneta; Lundh, Lars-Gunnar

    2016-11-01

    Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different

  15. Public Health and Air Pollution in Asia (PAPA): A Multicity Study of Short-Term Effects of Air Pollution on Mortality

    OpenAIRE

    Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Kan, Haidong; Qian, Zhengmin

    2008-01-01

    Background and Objectives: Although the deleterious effects of air pollution from fossil fuel combustion have been demonstrated in many Western nations, fewer studies have been conducted in Asia. The Public Health and Air Pollution in Asia (PAPA) project assessed the effects of short-term exposure to air pollution on daily mortality in Bangkok, Thailand, and in three cities in China: Hong Kong, Shanghai, and Wuhan. Methods: Poisson regression models incorporating natural spline smoothing func...

  16. Pilot Study of A Novel Biobehavioral Intervention’s Effect on Physiologic State, Perceived Stress and Affect: An Investigation of the Health Benefits of Laughter Yoga Participational

    Science.gov (United States)

    2017-03-25

    Intervention’s Effect on Physiologic State, Perceived Stress and Affect: An Investigation of the Health Benefits of Laughter Yoga Participation presented at...Pilot Study of a Novel Biobehavioral lntervention’s Effect on Physiologic State, Perceived Stress and Affect: An Investigation of Laughter Yoga MHSRS...was to explore the practice of the evidence-based biobehavioral interv~ntion, laughter yoga, as a means to lessen the physiologic and psychological

  17. A comparison of the effects of hatha yoga and resistance exercise on mental health and well-being in sedentary adults: a pilot study.

    Science.gov (United States)

    Taspinar, Betul; Aslan, Ummuhan Bas; Agbuga, Bulent; Taspinar, Ferruh

    2014-06-01

    Physical activity has a positive effect on people's mental health and well-being. The aim of this study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults. Randomized controlled study. Fifty-one participants aged mean (SD) 25.6 (5.7) years were randomly divided into three groups: Hatha Yoga Group, Resistance Exercise Group and Control Group. The Hatha Yoga Group and Resistance Exercise Group participated in sessions three days per week for 7 weeks and the Control Group did not participate in any sessions. All the subjects were evaluated through the Rosenberg Self-Esteem Scale, Beck Depression Inventory, Body Cathexis Scale, Nottingham Health Profile and Visual Analog Scale for fatigue pre-and post-session. Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group. No improvements were found in the Control Group. Hatha yoga more improved the dimensions fatigue, self-esteem, and quality of life, whilst resistance exercise training more improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level. The results indicated that hatha yoga and resistance exercise had positive effects on mental health and well-being in sedentary adults. Hatha yoga and resistance exercise may affect different aspects of mental health and well-being. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  20. 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

  1. The effect of attending steiner schools during childhood on health in adulthood: a multicentre cross-sectional study.

    Science.gov (United States)

    Fischer, H Felix; Binting, Sylvia; Bockelbrink, Angelina; Heusser, Peter; Hueck, Christoph; Keil, Thomas; Roll, Stephanie; Witt, Claudia

    2013-01-01

    It is speculated that attending Steiner schools, whose pedagogical principles include an account for healthy psycho-physical development, may have long-term beneficial health effects. We examined whether the current health status differed between former attendees of German Steiner schools and adults from the general population. Furthermore, we examined factors that might explain those differences. We included former Steiner school attendees from 4 schools in Berlin, Hanover, Nuremberg and Stuttgart and randomly selected population controls. Using a self-report questionnaire we assessed sociodemographics, current and childhood lifestyle and health status. Outcomes were self-reports on 16 diseases: atopic dermatitis, allergic rhinitis, bronchial asthma, chronic obstructive pulmonary disease (COPD), cardiac arrhythmia, cardiac insufficiency, angina pectoris, arteriosclerosis, hypertension, hypercholesterolemia, osteoarthritis, rheumatism, cancer, diabetes, depression and multiple sclerosis. Furthermore, participants rated the symptom burden resulting from back pain, cold symptoms, headache, insomnia, joint pain, gastrointestinal symptoms and imbalance. Unadjusted and adjusted odds ratios were calculated for each outcome. 1136 Steiner school attendees and 1746 controls were eligible for analysis. Both groups were comparable regarding sex, age and region, but differed in nationality and educational status. After adjusting for possible confounders, we found statistically significant effects of Steiner school attendance for osteoarthritis (OR 0.69 [0.49-0.97]) and allergic rhinitis (OR 0.77, [0.59-1.00]) as well as for symptom burden from back pain (OR 0.80, [0.64-1.00]), insomnia (OR 0.65, [0.50-0.84]), joint pain (OR 0.62, [0.48-0.82]), gastrointestinal symptoms (OR 0.76, [0.58-1.00]) and imbalance (OR 0.60, [0.38-0.93]). The risk of most examined diseases did not differ between former Steiner school attendees and the general population after adjustment for

  2. Adverse mental health effects of cannabis use in two indigenous communities in Arnhem Land, Northern Territory, Australia: exploratory study.

    Science.gov (United States)

    Clough, Alan R; d'Abbs, Peter; Cairney, Sheree; Gray, Dennis; Maruff, Paul; Parker, Robert; O'Reilly, Bridie

    2005-07-01

    We investigated adverse mental health effects and their associations with levels of cannabis use among indigenous Australian cannabis users in remote communities in the Northern Territory. Local indigenous health workers and key informants assisted in developing 28 criteria describing mental health symptoms. Five symptom clusters were identified using cluster analysis of data compiled from interviews with 103 cannabis users. Agreement was assessed (method comparison approach, kappa-statistic) with a clinician's classification of the 28 criteria into five groups labelled: 'anxiety', 'dependency', 'mood', 'vegetative' and 'psychosis'. Participants were described as showing 'anxiety', 'dependency' etc., if they reported half or more of the symptoms comprising the cluster. Associations between participants' self-reported cannabis use and each symptom cluster were assessed (logistic regression adjusting for age, sex, other substance use). Agreement between two classifications of 28 criteria into five groups was 'moderate' (64%, kappa = 0.55, p < 0.001). When five clusters were combined into three, 'anxiety-dependency', 'mood-vegetative' and 'psychosis', agreement rose to 71% (kappa = 0.56, p < 0.001). 'Anxiety-dependency' was positively associated with number of 'cones' usually smoked per week and this remained significant when adjusted for confounders (p = 0.020) and tended to remain significant in those who had never sniffed petrol (p = 0.052). Users of more than five cones per week were more likely to display 'anxiety-dependency' symptoms than those who used one cone per week (OR = 15.8, 1.8-141.2, p = 0.013). A crude association between the 'mood-vegetative' symptom cluster and number of cones usually smoked per week (p = 0.014) also remained statistically significant when adjusted for confounders (p = 0.012) but was modified by interactions with petrol sniffing (p = 0.116) and alcohol use (p = 0.276). There were no associations between cannabis use and 'psychosis

  3. Evaluation of the effectiveness and cost-effectiveness of Families for Health V2 for the treatment of childhood obesity: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Robertson, Wendy; Stewart-Brown, Sarah; Stallard, Nigel; Petrou, Stavros; Griffiths, Frances; Thorogood, Margaret; Simkiss, Douglas; Lang, Rebecca; Reddington, Kate; Poole, Fran; Rye, Gloria; Khan, Kamran A; Hamborg, Thomas; Kirby, Joanna

    2013-03-20

    Effective programs to help children manage their weight are required. Families for Health focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health V1 showed sustained reductions in overweight after 2 years in a pilot evaluation, but lacks a randomized controlled trial (RCT) evidence base. This is a multi-center, investigator-blind RCT, with parallel economic evaluation, with a 12-month follow-up. The trial will recruit 120 families with at least one child aged 6 to 11 years who is overweight (≥91st centile BMI) or obese (≥98th centile BMI) from three localities and assigned randomly to Families for Health V2 (60 families) or the usual care control (60 families) groups. Randomization will be stratified by locality (Coventry, Warwickshire, Wolverhampton).Families for Health V2 is a family-based intervention run in a community venue. Parents/carers and children attend parallel groups for 2.5 hours weekly for 10 weeks. The usual care arm will be the usual support provided within each NHS locality.A mixed-methods evaluation will be carried out. Child and parent participants will be assessed at home visits at baseline, 3-month (post-treatment) and 12-month follow-up. The primary outcome measure is the change in the children's BMI z-scores at 12 months from the baseline. Secondary outcome measures include changes in the children's waist circumference, percentage body fat, physical activity, fruit/vegetable consumption and quality of life. The parents' BMI and mental well-being, family eating/activity, parent-child relationships and parenting style will also be assessed.Economic components will encompass the measurement and valuation of service utilization, including the costs of running Families for Health and usual care, and the EuroQol EQ-5D health outcomes. Cost-effectiveness will be expressed in terms of incremental cost per quality-adjusted life year gained. A de

  4. Long-term effects of 1-year maintenance training on physical functioning and health status in patients with COPD: A randomized controlled study

    DEFF Research Database (Denmark)

    Ringbaek, Thomas; Brondum, Eva; Martinez, Gerd

    2010-01-01

    PURPOSE: To examine whether maintenance training (MT) for 1 year improved the long-term effects of a 7-week chronic obstructive pulmonary disease (COPD) rehabilitation program. METHODS: After a 7-week outpatient rehabilitation program, 96 patients with COPD were randomized to either an MT group (n...... study period. Primary effect parameters were Endurance Shuttle Walk Test (ESWT) time and health status (St. George's Respiratory Questionnaire, SGRQ). Secondary effect parameters were adherence to supervised training, dropout rates, and hospitalization. RESULTS: Compared with the control group, the MT...... or hospital admissions, compared with unsupervised daily training at home. The effect of the MT was closely related to adherence to the program....

  5. The NLstart2run study : Health effects of a running promotion program in novice runners, design of a prospective cohort study

    NARCIS (Netherlands)

    Kluitenberg, Bas; van Middelkoop, Marienke; Diercks, Ronald; Hartgens, Fred; Verhagen, Evert; Smits, Dirk-Wouter; Buist, Ida; van der Worp, Henk

    2013-01-01

    Background: Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout

  6. The NLstart2run study: health effects of a running promotion program in novice runners, design of a prospective cohort study

    NARCIS (Netherlands)

    Kluitenberg, B.; van Middelkoop, M.; Diercks, R.L.; Hartgens, F.; Verhagen, E.A.L.M.; Smits, D.W.; Buist, I.; van der Worp, H.

    2013-01-01

    Background: Running is associated with desirable lifestyle changes. Therefore several initiatives have been undertaken to promote running. Exact data on the health effects as a result of participating in a short-term running promotion program, however, is scarce. One important reason for dropout

  7. The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study.

    Science.gov (United States)

    Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

    2013-07-01

    This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

  8. Effectiveness and Appropriateness of mHealth Interventions for Maternal and Child Health: Systematic Review

    OpenAIRE

    Chen, Huan; Chai, Yanling; Dong, Le; Niu, Wenyi; Zhang, Puhong

    2018-01-01

    Background The application of mobile health (mHealth) technology in reproductive, maternal, newborn, and child health (RMNCH) is increasing worldwide. However, best practice and the most effective mHealth interventions have not been reviewed systematically. Objective A systematic review and meta-analysis of studies of mHealth interventions for RMNCH around the world were conducted to investigate their characteristics as well as the features and effectiveness of mHealth interventions. Methods ...

  9. Effects of requested, forced and denied shift schedule change on work ability and health of nurses in Europe -results from the European NEXT-Study.

    Science.gov (United States)

    Galatsch, Michael; Li, Jian; Derycke, Hanne; Müller, Bernd Hans; Hasselhorn, Hans Martin

    2013-12-05

    Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.

  10. Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

    Science.gov (United States)

    Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

    2015-10-01

    To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300. © 2015 John Wiley & Sons Ltd.

  11. The Effect of Working Conditions to the Health Status in Taxi and Bus Drivers in Canakkale, Turkey; Community Based Study

    Directory of Open Access Journals (Sweden)

    Aysegul Uludag

    2016-04-01

    Full Text Available Aim: The growing taxi and bus driver workforce is at risk for poor health status, obesity, hypertension, metabolic syndrome and with increased risk for cardiovascular disease. We aimed to determine the relationship between working conditions and health status in taxi and bus drivers. Material and Method: This study is a descriptive study. The population of the study was taxi and bus drivers in central of Canakkale. There were total 250 taxi and bus drivers who registered in The Chamber of Canakkale Drivers and Vehicle. We reached the 70 taxi drivers and 93 bus drivers. The participants were visited at their workplace. We performed the questionnaire that include the socio-demografic features, habits, the working conditions. We evaluated the blood pressure, waist-hip measurements and capillary blood glucose at any time. Results: Total of the 163 men drivers were enrolled the study. Nine (12.9% taxi drivers and 6 (6.5% bus drivers were hipertensive, and 1 taxi driver and 2 bus drivers with random capillary blood glucose levels higher than 200 mg. The prevalence of hypertension was 9.2%, diabetes mellitus was 1.8, obesity was 49.4%. Discussion: Drivers have many risk factors for CVD like stress and immobility. In our study, the socio-demografic and working conditions are limited for explaining the risk for hipertension, diabetes mellitus and obesity in drivers in Canakkale. These study have to be done in metropolitan cities. In this aspect, the drivers can be evaluated in their own living spaces and working conditions.

  12. Awareness of health effects of exposure to secondhand smoke from cigarettes: A cross-sectional study of never-smoked adult primary care patients in Eastern Nigeria

    Science.gov (United States)

    Pascal Iloh, Gabriel Uche; Collins, Peace Ifeoma

    2017-01-01

    Background: Cigarette smoking whether actively or passively is a growing public health problem. Despite the wealth of information on the hazards of active cigarette smoking, awareness of the health effects of passive smoking on human population is often neglected in Nigeria. Aim: The study was aimed at describing the awareness of health effects of exposure to secondhand smoke from cigarettes among never-smoked adult primary care patients in Eastern Nigeria. Materials and Methods: A hospital-based study carried out on a cross-section of 500 adult patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never-smoked adult patient in the previous 1 year. Data were analyzed using Statistical Package for Social Sciences version 21 for the calculation of percentages for categorical variables. Bivariate analysis involving Chi-square test was used to test for significance of association between categorical variables at P < 0.05. Results: The age of the respondents ranged from 18 to 74 years, with a mean age of 36 ± 12.4 years. There were 180 (36.0%) males with 320 (64%) females, with a sex ratio of 1.8. Awareness of general health effects of secondhand smoke on adults, children, and pregnant women was 95.6%, 92.8%, and 65.2%, respectively. The most common specific health effects the respondents were aware for adults, children, and obstetric population were lung cancer (95.6%), precipitation of asthmatic condition (92.8%), and delivery of small babies (65.2%), respectively. The predominant source of awareness of information was radio (93.6%). Awareness of general health effects of exposure to secondhand smoke on adults (P = 0.041), children (P = 0.031), and obstetrics population (P = 0.02) was significantly associated with exposure status. Conclusion: The most common health effects of secondhand smoke the respondents

  13. Effect of health development assistance on health status in sub-Saharan Africa

    OpenAIRE

    Negeri, Gutema; Haile Mariam,Damen

    2016-01-01

    Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this stud...

  14. Effect of health education on trainee teachers' knowledge, attitudes, and first aid management of epilepsy: An interventional study.

    Science.gov (United States)

    Eze, Christian N; Ebuehi, Olufunke M; Brigo, Francesco; Otte, Willem M; Igwe, Stanley C

    2015-12-01

    High rates of poor knowledge of, and negative attitudes towards people with epilepsy (PWE) are generally found among school teachers. Their first aid epilepsy management skills are poor. It remains unknown if this is different among trainee teachers and whether educational intervention might reduce these rates. We examined the effect of health education on the knowledge, attitudes, and first aid management of epilepsy on trainee teachers in Nigeria. Baseline data and socio-demographic determinants were collected from 226 randomly selected trainee teachers, at the Federal College of Education, Lagos, Nigeria, with self-administered questionnaires. They received a health intervention comprising an hour and half epilepsy lecture followed by a discussion. Baseline knowledge of, and attitudes towards PWE and their first aid epilepsy management skills were compared to post-interventional follow-up data collected twelve weeks later with similar questionnaires. At baseline the majority (61.9%) and largest proportion (44.2%) of respondents had negative attitudes and poor knowledge of epilepsy, respectively. The knowledge of, and attitudes towards epilepsy, and the first aid management skill increased in most respondents, post-intervention. The proportion of respondents with poor knowledge and negative attitudes dropped by 15.5% (pfirst aid management skills increased by 25.0% (pfirst aid management. This emphasizes the potential benefit of incorporating an epilepsy tailored intervention programme into teachers' training curricula. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  15. Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda-A matched cohort study.

    Science.gov (United States)

    Kirby, Miles A; Nagel, Corey L; Rosa, Ghislaine; Umupfasoni, Marie Mediatrice; Iyakaremye, Laurien; Thomas, Evan A; Clasen, Thomas F

    2017-08-01

    Unsafe drinking water is a substantial health risk contributing to child diarrhoea. We investigated impacts of a program that provided a water filter to households in rural Rwandan villages. We assessed drinking water quality and reported diarrhoea 12-24 months after intervention delivery among 269 households in the poorest tertile with a child under 5 from 9 intervention villages and 9 matched control villages. We also documented filter coverage and use. In Round 1 (12-18 months after delivery), 97.4% of intervention households reported receiving the filter, 84.5% were working, and 86.0% of working filters contained water. Sensors confirmed half of households with working filters filled them at least once every other day on average. Coverage and usage was similar in Round 2 (19-24 months after delivery). The odds of detecting faecal indicator bacteria in drinking water were 78% lower in the intervention arm than the control arm (odds ratio (OR) 0.22, 95% credible interval (CrI) 0.10-0.39, p<0.001). The intervention arm also had 50% lower odds of reported diarrhoea among children <5 than the control arm (OR=0.50, 95% CrI 0.23-0.90, p=0.03). The protective effect of the filter is also suggested by reduced odds of reported diarrhoea-related visits to community health workers or clinics, although these did not reach statistical significance. Copyright © 2017 Elsevier GmbH. All rights reserved.

  16. How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya.

    Science.gov (United States)

    Tsofa, Benjamin; Molyneux, Sassy; Gilson, Lucy; Goodman, Catherine

    2017-09-15

    A common challenge for health sector planning and budgeting has been the misalignment between policies, technical planning and budgetary allocation; and inadequate community involvement in priority setting. Health system decentralisation has often been promoted to address health sector planning and budgeting challenges through promoting community participation, accountability, and technical efficiency in resource management. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous devolved county governments, and a substantial transfer of responsibility for healthcare from the central government to these counties. This study analysed the effects of this major political decentralization on health sector planning, budgeting and overall financial management at county level. We used a qualitative, case study design focusing on Kilifi County, and were guided by a conceptual framework which drew on decentralisation and policy analysis theories. Qualitative data were collected through document reviews, key informant interviews, and participant and non-participant observations conducted over an eighteen months' period. We found that the implementation of devolution created an opportunity for local level prioritisation and community involvement in health sector planning and budgeting hence increasing opportunities for equity in local level resource allocation. However, this opportunity was not harnessed due to accelerated transfer of functions to counties before county level capacity had been established to undertake the decentralised functions. We also observed some indication of re-centralisation of financial management from health facility to county level. We conclude by arguing that, to enhance the benefits of decentralised health systems, resource allocation, priority setting and financial management functions between central and decentralised units are guided by considerations around decision space, organisational structure and capacity, and

  17. 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...

  18. Effects of health empowerment intervention on resilience of adolescents in a tribal area: A study using the Solomon four-groups design.

    Science.gov (United States)

    Sarkar, Kaushik; Dasgupta, Aparajita; Sinha, Multipada; Shahbabu, Bhaskar

    2017-10-01

    Resilience prevents the emergence of stress-related mental health problems among adolescents. Adolescents in tribal areas of India are more prone to develop such problems. The primary objective was to determine the effect of combined life skills-based health empowerment intervention on the resilience of school-going adolescents in a tribal area. The secondary objectives were to determine the effect of the intervention on internal health locus of control and self-determination and to compare the effect of intervention on resilience between non-tribal and tribal adolescents. We conducted this quasi-experimental study using a Solomon four-group design among 742 adolescents in two schools of Purulia, West Bengal, India. Students of the pretested group were examined for resilience using the Child Youth Resilience Measurement scale. A life skills education-based health empowerment intervention was administered among students of the experimental group. Post-test data on resilience, self-determination, internal health locus of control and pathological behaviour was obtained 3 months after the completion of intervention. A multi-level general linear mixed model was constructed to determine the effect of intervention on resilience. Resilience was less among tribal adolescents at baseline. The intervention significantly improved resilience [β Adjusted  = 11.19 (95% CI = 10.55, 11.83], with a greater increase for tribal adolescents [β tribal-nontribal  = 1.53 (95% CI = 0.03, 3.03)]. The intervention also significantly improved internal health locus of control (marginal mean increment 1.38 ± 0.05), self-determination (marginal