WorldWideScience

Sample records for health impact evaluation

  1. Impact evaluation on health: three case studies for Colombia

    OpenAIRE

    Gaviria Garces, Carlos Felipe

    2017-01-01

    The present work uses impact evaluation tools in health economics to analyze three different issues in Colombia. The first issue is how losing health insurance for young adults affects medical service usage and health outcomes. Results show that losing health insurance when turning 18 years old increases visits to the ED, reduces preventive care visits with a physician, and increases the usage of private medical services (out-of-pocket) for young adults. For the second issue, we measure how e...

  2. Allied health research positions: a qualitative evaluation of their impact.

    Science.gov (United States)

    Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

    2017-02-06

    Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health

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

    Science.gov (United States)

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

    2017-12-01

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

  4. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    ; what benefits have been realised and for whom; the level of community satisfaction with the service; and the impact of a health service on community viability. While the need to reduce the rural-urban health service disparity in Australia is pressing, the evidence regarding how to move forward is inadequate. This comprehensive evaluation will add significant new knowledge regarding the characteristics associated with a sustainable rural primary health care service.

  5. Distributed Impact Detector System (DIDS) Health Monitoring System Evaluation

    Science.gov (United States)

    Prosser, William H.; Madaras, Eric I.

    2010-01-01

    Damage due to impacts from micrometeoroids and orbital debris is one of the most significant on-orbit hazards for spacecraft. Impacts to thermal protection systems must be detected and the damage evaluated to determine if repairs are needed to allow safe re-entry. To address this issue for the International Space Station Program, Langley Research Center and Johnson Space Center technologists have been working to develop and implement advanced methods for detecting impacts and resultant leaks. LaRC funded a Small Business Innovative Research contract to Invocon, Inc. to develop special wireless sensor systems that are compact, light weight, and have long battery lifetimes to enable applications to long duration space structures. These sensor systems are known as distributed impact detection systems (DIDS). In an assessment, the NASA Engineering and Safety Center procured two prototype DIDS sensor units to evaluate their capabilities in laboratory testing and field testing in an ISS Node 1 structural test article. This document contains the findings of the assessment.

  6. Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students.

    Science.gov (United States)

    Braun, Hannan M; Garcia-Grossman, Ilana R; Quiñones-Rivera, Andrea; Deutsch, Madeline B

    2017-02-01

    Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge. Students participated in a 10-session, lunch-hour elective course during the spring of 2015. To evaluate impact, course participants completed pre-, immediately post-, and 3-month postcourse questionnaires, including a previously validated nine-item transphobia scale, to determine the course's effect on knowledge, attitudes, and beliefs about transgender health. Forty-six students completed the pre- and immediately postelective questionnaire (74% response rate). Compared with pre-elective surveys, immediately postelective scores demonstrated increased knowledge in most domains and reduced transphobia. Specific knowledge domains with improvements included terminology, best practices for collecting gender identity, awareness of the DSM-V gender dysphoria diagnosis, medications used for gender affirmation, and relevant federal policies. A previously validated transphobia scale was found to have good reliability in the current sample. This elective course led to positive short-term changes in measures of multiple knowledge domains and reduced measures of transphobia among health profession students. Further study is needed to assess the long-term impact. Our methods and findings, including the demonstration of reliability of a previously validated nine-item transphobia scale, serve as formative data for the future development of theory-based transgender medicine curricula and measures.

  7. Evaluating the Impacts of School Nutrition and Physical Activity Policies on Child Health. PRGS Dissertation

    Science.gov (United States)

    Fernandes, Meenakshi Maria

    2010-01-01

    This dissertation evaluates the impact of elementary school policies on child health behaviors and obesity in the United States. Two chapters address nutrition policies, two chapters address physical activity policies, and a final chapter estimates the health care cost savings associated with a decline in childhood obesity prevalence. The use of…

  8. Evaluation of health and safety impacts of defense high-level waste in geologic repositories

    International Nuclear Information System (INIS)

    Smith, E.D.; Kocher, D.C.; Witherspoon, J.P.

    1985-02-01

    Pursuant to the requirement of the Nuclear Waste Policy Act of 1982 that the President evaluate the use of commercial high-level waste repositories for the disposal of defense high-level wastes, a comparative assessment has been performed of the potential health and safety impacts of disposal of defense wastes in commercial or defense-only repositories. Simplified models were used to make quantitative estimates of both long- and short-term health and safety impacts of several options for defense high-level waste disposal. The results indicate that potential health and safety impacts are not likely to vary significantly among the different disposal options for defense wastes. Estimated long-term health and safety impacts from all defense-waste disposal options are somewhat less than those from commercial waste disposal, while short-term health and safety impacts appear to be insensitive to the differences between defense and commercial wastes. In all cases, potential health and safety impacts are small because of the need to meet stringent standards promulgated by the US Environmental Protection Agency and the US Nuclear Regulatory Commission. We conclude that health and safety impacts should not be a significant factor in the choice of a disposal option for defense high-level wastes. 20 references, 14 tables

  9. Advanced combustion, emission control, health impacts, and fuels merit review and peer evaluation

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2006-10-01

    This report is a summary and analysis of comments from the Advisory Panel at the FY 2006 DOE National Laboratory Advanced Combustion, Emission Control, Health Impacts, and Fuels Merit Review and Peer Evaluation, held May 15-18, 2006 at Argonne National Laboratory. The work evaluated in this document supports the FreedomCAR and Vehicle Technologies Program. The results of this merit review and peer evaluation are major inputs used by DOE in making its funding decisions for the upcoming fiscal year.

  10. Systematic Review of Health Economic Impact Evaluations of Risk Prediction Models : Stop Developing, Start Evaluating

    NARCIS (Netherlands)

    van Giessen, Anoukh; Peters, Jaime; Wilcher, Britni; Hyde, Chris; Moons, Carl; de Wit, Ardine; Koffijberg, Erik

    2017-01-01

    Background: Although health economic evaluations (HEEs) are increasingly common for therapeutic interventions, they appear to be rare for the use of risk prediction models (PMs). Objectives: To evaluate the current state of HEEs of PMs by performing a comprehensive systematic review. Methods: Four

  11. Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue.

    Science.gov (United States)

    Coates, Anna R; Del Pino Marchito, Sandra; Vitoy, Bernardino

    2016-06-01

    Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children's health in Brazil, ranging from those explicitly targeting indigenous children's health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses.

  12. Evaluating external costs of human health and environmental impacts using IAEA model SIMPACTS

    International Nuclear Information System (INIS)

    Bobric, Elena; Jelev, Adrian

    2005-01-01

    SIMPACTS (Simplified Approach for Estimating Impacts and External Costs of Electricity Generation) model developed at the International Atomic Energy Agency is a powerful and convenient tool for evaluating external costs induced by different energy sources. The model was developed for industrial countries and for developing countries as well where studies of alternatives of sustainable energy policies are conducted. The SIMPACTS allow the decision making factors involved in energy policy to have reasonable estimates of environment impacts and relating costs appealing to a rather low number of input parameters. The paper aims at analyzing by means of SIMPACTS the environmental impact produced by Cernavoda NPP operation in two cases: a) the impact of the Cernavoda NPP itself; b) the impact of an hypothetical coal based power plant of the same power level and located on the Cernavoda NPP site. The SIMPACTS modules AIRPACTS and NUCPACTS were applied to assess the impacts on human health, agricultural crops and building materials from exposure to routine atmospheric emissions and as well to quantify and value the adverse effects on human health due to routine atmospheric release of radionuclides from the NPP, via radioactive waste ground disposal or resulting from accidents in nuclear facility, respectively. The conclusion of this study based on SIMPACTS model application to assess the health effects and damage cost per year is that the Cernavoda NPP presents the lower health effects and damage cost comparing with power plants of other types

  13. Evaluation of the Early Childhood Oral Health Impact Scale in an Australian preschool child population.

    Science.gov (United States)

    Arrow, P; Klobas, E

    2015-09-01

    Early childhood caries has significant impacts on children and their families. The Early Childhood Oral Health Impact Scale (ECOHIS) is an instrument for capturing the complex dimensions of preschool children's oral health. This study aimed to evaluate the reliability and validity of the instrument among Australian preschool children. Parents/children dyads (n = 286) participating in a treatment trial on early childhood caries completed the scale at baseline, and 33 parents repeated the questionnaire 2-3 weeks later. The validity and reliability of the ECOHIS was determined using tests for convergent and discriminant validity, internal reliability of the instrument and test-retest reliability. Scale impacts were strongly correlated with global oral health ratings (Spearman's correlations; r = 0.51, total score; r = 0.43, child impact; and r = 0.49, family impact; p child and the family domains, respectively. Test-retest reliability was 0.92, 0.89 and 0.78 for the total, child and family domains, respectively. The scale demonstrated acceptable validity and reliability for assessing the impact of early childhood caries among Australian preschool children. © 2015 Australian Dental Association.

  14. User evaluations of design complexity: the impact of visual perceptions for effective online health communication.

    Science.gov (United States)

    Lazard, Allison; Mackert, Michael

    2014-10-01

    This paper highlights the influential role of design complexity for users' first impressions of health websites. An experimental design was utilized to investigate whether a website's level of design complexity impacts user evaluations. An online questionnaire measured the hypothesized impact of design complexity on predictors of message effectiveness. Findings reveal that increased design complexity was positively associated with higher levels of perceived design esthetics, attitude toward the website, perceived message comprehensibility, perceived ease of use, perceived usefulness, perceived message quality, perceived informativeness, and perceived visual informativeness. This research gives further evidence that design complexity should be considered an influential variable for health communicators to effectively reach their audiences, as it embodies the critical first step for message evaluation via electronic platforms. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Evaluating the balanced scorecard at the University Health Network: an impact assessment.

    Science.gov (United States)

    Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert

    2008-01-01

    The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.

  16. The impact of rural mutual health care on health status: evaluation of a social experiment in rural China.

    Science.gov (United States)

    Wang, Hong; Yip, Winnie; Zhang, Licheng; Hsiao, William C

    2009-07-01

    Despite widespread efforts to expand health insurance in developing countries, there is scant evidence as to whether doing so actually improves people's health. This paper aims to fill this gap by evaluating the impact of Rural Mutual Health Care (RMHC), a community-based health insurance scheme, on enrollees' health outcomes. RMHC is a social experiment that was conducted in one of China's western provinces from 2003 to 2006. The RMHC experiment adopted a pre-post treatment-control study design. This study used panel data collected in 2002, 1 year prior to the intervention, and followed up in 2005, 2 years after the intervention, both in the intervention and control sites. We measured health status using both a 5-point Categorical Rating Scale and the EQ-5D instruments. The estimation method used here is difference-in-difference combined propensity score matching. The results show that RMHC has a positive effect on the health status of participants. Among the five dimensions of EQ-5D, RMHC significantly reduces pain/discomfort and anxiety/depression for the general population, and has a positive impact on mobility and usual activity for those over 55-years old. Our study provides useful policy information on the development of health insurance in developing countries, and also identifies areas where further research is needed.

  17. Evaluation of Health Equity Impact of Structural Policies: Overview of Research Methods Used in the SOPHIE Project

    NARCIS (Netherlands)

    Kunst, Anton E.

    2017-01-01

    This article briefly assesses the research methods that were applied in the SOPHIE project to evaluate the impact of structural policies on population health and health inequalities. The evaluation of structural policies is one of the key methodological challenges in today's public health. The

  18. A system for evaluating the impact of noise pollution on the population's health.

    Science.gov (United States)

    Bressane, Adriano; Mochizuki, Patricia Satie; Caram, Rosana Maria; Roveda, José Arnaldo Frutuoso

    2016-05-01

    The aim of this study was to develop a support system for the evaluation of noise pollution, applied to the central urban area of Rio Claro, São Paulo State, Brazil. Data were obtained from noise measurements and interviews with the population, generating the following indicators: equivalent sound level (Leq ), traffic noise index (LTNI ), and a participatory diagnosis (Dp ), integrated through a fuzzy inference system (FIS). The proposed system allowed classifying the measurement points according to the degree of impact of noise pollution on the population's health (IPS ) in the study area. Impact was considered significant in 31.4% of the measurement points and very significant in 62.9%. The FIS can be adjusted to local conditions, allowing generalization and thus also supporting noise pollution evaluation and respective environmental noise management in other geographic areas.

  19. Can volunteer community health workers decrease child morbidity and mortality in southwestern Uganda? An impact evaluation.

    Directory of Open Access Journals (Sweden)

    Jennifer L Brenner

    Full Text Available BACKGROUND: The potential for community health workers to improve child health in sub-Saharan Africa is not well understood. Healthy Child Uganda implemented a volunteer community health worker child health promotion model in rural Uganda. An impact evaluation was conducted to assess volunteer community health workers' effect on child morbidity, mortality and to calculate volunteer retention. METHODOLOGY/PRINCIPAL FINDINGS: Two volunteer community health workers were selected, trained and promoted child health in each of 116 villages (population ∼61,000 during 2006-2009. Evaluation included a household survey of mothers at baseline and post-intervention in intervention/control areas, retrospective reviews of community health worker birth/child death reports and post-intervention focus group discussions. Retention was calculated from administrative records. Main outcomes were prevalence of recent child illness/underweight status, community health worker reports of child deaths, focus group perception of effect, and community health worker retention. After 18-36 months, 86% of trained volunteers remained active. Post-intervention surveys in intervention households revealed absolute reductions of 10.2% [95%CI (-17.7%, -2.6%] in diarrhea prevalence and 5.8% [95%CI (-11.5%, -0.003%] in fever/malaria; comparative decreases in control households were not statistically significant. Underweight prevalence was reduced by 5.1% [95%CI (-10.7%, 0.4%] in intervention households. Community health worker monthly reports revealed a relative decline of 53% in child deaths (<5 years old, during the first 18 months of intervention. Focus groups credited community health workers with decreasing child deaths, improved care-seeking practices, and new income-generating opportunities. CONCLUSIONS/SIGNIFICANCE: A low-cost child health promotion model using volunteer community health workers demonstrated decreased child morbidity, dramatic mortality trend declines and

  20. Development and psychometric evaluation of the Impact of Health Information Technology (I-HIT) scale.

    Science.gov (United States)

    Dykes, Patricia C; Hurley, Ann; Cashen, Margaret; Bakken, Suzanne; Duffy, Mary E

    2007-01-01

    The use of health information technology (HIT) for the support of communication processes and data and information access in acute care settings is a relatively new phenomenon. A means of evaluating the impact of HIT in hospital settings is needed. The purpose of this research was to design and psychometrically evaluate the Impact of Health Information Technology scale (I-HIT). I-HIT was designed to measure the perception of nurses regarding the ways in which HIT influences interdisciplinary communication and workflow patterns and nurses' satisfaction with HIT applications and tools. Content for a 43-item tool was derived from the literature, and supported theoretically by the Coiera model and by nurse informaticists. Internal consistency reliability analysis using Cronbach's alpha was conducted on the 43-item scale to initiate the item reduction process. Items with an item total correlation of less than 0.35 were removed, leaving a total of 29 items. Item analysis, exploratory principal component analysis and internal consistency reliability using Cronbach's alpha were used to confirm the 29-item scale. Principal components analysis with Varimax rotation produced a four-factor solution that explained 58.5% of total variance (general advantages, information tools to support information needs, information tools to support communication needs, and workflow implications). Internal consistency of the total scale was 0.95 and ranged from 0.80-0.89 for four subscales. I-HIT demonstrated psychometric adequacy and is recommended to measure the impact of HIT on nursing practice in acute care settings.

  1. Evaluation of Health Equity Impact of Structural Policies: Overview of Research Methods Used in the SOPHIE Project.

    Science.gov (United States)

    Kunst, Anton E

    2017-07-01

    This article briefly assesses the research methods that were applied in the SOPHIE project to evaluate the impact of structural policies on population health and health inequalities. The evaluation of structural policies is one of the key methodological challenges in today's public health. The experience in the SOPHIE project was that mixed methods are essential to identify, understand, and predict the health impact of structural policies. On the one hand, quantitative studies that included spatial comparisons or time trend analyses, preferably in a quasi-experimental design, showed that some structural policies were associated with improved population health and smaller health inequalities. On the other hand, qualitative studies, often inspired by realist approaches, were important to understand how these policies could have achieved the observed impact and why they would succeed in some settings but fail in others. This review ends with five recommendations for future studies that aim to evaluate, understand, and predict how health inequalities can be reduced through structural policies.

  2. Evaluating Modeled Impact Metrics for Human Health, Agriculture Growth, and Near-Term Climate

    Science.gov (United States)

    Seltzer, K. M.; Shindell, D. T.; Faluvegi, G.; Murray, L. T.

    2017-12-01

    Simulated metrics that assess impacts on human health, agriculture growth, and near-term climate were evaluated using ground-based and satellite observations. The NASA GISS ModelE2 and GEOS-Chem models were used to simulate the near-present chemistry of the atmosphere. A suite of simulations that varied by model, meteorology, horizontal resolution, emissions inventory, and emissions year were performed, enabling an analysis of metric sensitivities to various model components. All simulations utilized consistent anthropogenic global emissions inventories (ECLIPSE V5a or CEDS), and an evaluation of simulated results were carried out for 2004-2006 and 2009-2011 over the United States and 2014-2015 over China. Results for O3- and PM2.5-based metrics featured minor differences due to the model resolutions considered here (2.0° × 2.5° and 0.5° × 0.666°) and model, meteorology, and emissions inventory each played larger roles in variances. Surface metrics related to O3 were consistently high biased, though to varying degrees, demonstrating the need to evaluate particular modeling frameworks before O3 impacts are quantified. Surface metrics related to PM2.5 were diverse, indicating that a multimodel mean with robust results are valuable tools in predicting PM2.5-related impacts. Oftentimes, the configuration that captured the change of a metric best over time differed from the configuration that captured the magnitude of the same metric best, demonstrating the challenge in skillfully simulating impacts. These results highlight the strengths and weaknesses of these models in simulating impact metrics related to air quality and near-term climate. With such information, the reliability of historical and future simulations can be better understood.

  3. Toxicological Evaluations of Rare Earths and Their Health Impacts to Workers: A Literature Review

    Directory of Open Access Journals (Sweden)

    Kyung Taek Rim

    2013-03-01

    Full Text Available In concert with the development of new materials in the last decade, the need for toxicological studies of these materials has been increasing. These new materials include a group of rare earths (RE. The use of RE nanotechnology is being considered in some green applications, to increase their efficiency by using nano-sized RE compounds, and therefore hazard evaluation and risk assessment are highly recommended. This review was conducted through an extensive contemplation of the literatures in toxicology with in vitro and in vivo studies. Major aspects reviewed were the toxicological evaluations of these elements and metallic compounds at the molecular and cellular level, animal and human epidemiological studies and environmental and occupational health impacts on workers. We also discuss the future prospect of industries with appliances using RE together with the significance of preventive efforts for workers’ health. To establish a safe and healthy working environment for RE industries, the use of biomarkers is increasing to provide sustainable measure, due to demand for information about the health risks from unfavorable exposures. Given the recent toxicological results on the exposure of cells, animals and workers to RE compounds, it is important to review the toxicological studies to improve the current understanding of the RE compounds in the field of occupational health. This will help to establish a sustainable, safe and healthy working environment for RE industries.

  4. Impact of Enhanced Health Interventions for United States-Bound Refugees: Evaluating Best Practices in Migration Health.

    Science.gov (United States)

    Mitchell, Tarissa; Lee, Deborah; Weinberg, Michelle; Phares, Christina; James, Nicola; Amornpaisarnloet, Kittisak; Aumpipat, Lalita; Cooley, Gretchen; Davies, Anita; Tin Shwe, Valerie Daw; Gajdadziev, Vasil; Gorbacheva, Olga; Khwan-Niam, Chutharat; Klosovsky, Alexander; Madilokkowit, Waritorn; Martin, Diana; Htun Myint, Naing Zaw; Yen Nguyen, Thi Ngoc; Nutman, Thomas B; O'Connell, Elise M; Ortega, Luis; Prayadsab, Sugunya; Srimanee, Chetdanai; Supakunatom, Wasant; Vesessmith, Vattanachai; Stauffer, William M

    2018-03-01

    With an unprecedented number of displaced persons worldwide, strategies for improving the health of migrating populations are critical. United States-bound refugees undergo a required overseas medical examination to identify inadmissible conditions (e.g., tuberculosis) 2-6 months before resettlement, but it is limited in scope and may miss important, preventable infectious, chronic, or nutritional causes of morbidity. We sought to evaluate the feasibility and health impact of diagnosis and management of such conditions before travel. We offered voluntary testing for intestinal parasites, anemia, and hepatitis B virus infection, to U.S.-bound refugees from three Thailand-Burma border camps. Treatment and preventive measures (e.g., anemia and parasite treatment, vaccination) were initiated before resettlement. United States refugee health partners received overseas results and provided post-arrival medical examination findings. During July 9, 2012 to November 29, 2013, 2,004 refugees aged 0.5-89 years enrolled. Among 463 participants screened for seven intestinal parasites overseas and after arrival, helminthic infections decreased from 67% to 12%. Among 118 with positive Strongyloides -specific antibody responses, the median fluorescent intensity decreased by an average of 81% after treatment. The prevalence of moderate-to-severe anemia (hemoglobin migration process to improve the health of refugees before resettlement. With more than 250 million migrants globally, this model may offer insights into healthier migration strategies.

  5. Evaluation of the Personal Impact Health Assessment Questionnaire (PI HAQ) to capture the impact of disability in osteoarthritis.

    Science.gov (United States)

    Wylde, Vikki; Livesey, Christine; Learmonth, Ian D; Blom, Ashley W; Hewlett, Sarah

    2010-06-01

    Measuring facts about disability may not reflect their personal impact. An individualized values instrument has been used to weight difficulty in performing activities of daily living in rheumatoid arthritis, and calculate personal impact (Personal Impact Health Assessment Questionnaire; PI HAQ). This study aimed to evaluate the PI HAQ in osteoarthritis (OA). Study 1: 51 people with OA completed short and long versions of the value instrument at 0 and 1 week. Study 2: 116 people with OA completed the short value instrument, disability and psychological measures at 0 and 4 weeks. Study 1: The eight-category and 20-item value instruments correlated well (r = 0.85) and scores differed by just 2.7%. The eight-category instrument showed good internal consistency reliability (Cronbach's alpha = 0.85) and moderate one-week test-retest reliability (r = 0.68, Wilcoxon signed-rank test p = 0.16, intra-class correlation coefficient [ICC] 0.62). Study 2: Values for disability were not associated with disability severity or clinical status. After weighting disability by value, the resulting PI HAQ scores were significantly associated with dissatisfaction with disability, perceived increase in disability, poor clinical status and life dissatisfaction, and differed significantly between people with high and low clinical status (convergent and discriminant construct validity). There was moderate association with the disease repercussion profile disability subscale (r = 0.511; p personal impact of disability in people with OA, setting disability within a personal context. Further studies, including sensitivity to change, are required.

  6. Mental health first aid guidelines: an evaluation of impact following download from the World Wide Web.

    Science.gov (United States)

    Hart, Laura M; Jorm, Anthony F; Paxton, Susan J; Cvetkovski, Stefan

    2012-11-01

    Mental health first aid guidelines provide the public with consensus-based information about how to assist someone who is developing a mental illness or experiencing a mental health crisis. The aim of the current study was to evaluate the usefulness and impact of the guidelines on web users who download them. Web users who downloaded the documents were invited to respond to an initial demographic questionnaire, then a follow up about how the documents had been used, their perceived usefulness, whether first-aid situations had been encountered and if these were influenced by the documents. Over 9.8 months, 706 web users responded to the initial questionnaire and 154 responded to the second. A majority reported downloading the document because their job involved contact with people with mental illness. Sixty-three web users reported providing first aid, 44 of whom reported that the person they were assisting had sought professional care as a result of their suggestion. Twenty-three web users reported seeking care themselves. A majority of those who provided first aid reported feeling that they had been successful in helping the person, that they had been able to assist in a way that was more knowledgeable, skilful and supportive, and that the guidelines had contributed to these outcomes. Information made freely available on the Internet, about how to provide mental health first aid to someone who is developing a mental health problem or experiencing a mental health crisis, is associated with more positive, empathic and successful helping behaviours. © 2012 Wiley Publishing Asia Pty Ltd.

  7. Selecting new health technologies for evaluation:Can clinical experts predict which new anticancer drugswill impact Danish health care?

    DEFF Research Database (Denmark)

    Douw, Karla; Vondeling, Hindrik

    2007-01-01

    Several countries have systems in place to support the managed entry of new health technologies. The big challenge for these so-called horizon-scanning systems is to select those technologies that require decision support by means of an early evaluation. Clinical experts are considered a valuable...... source of information on new health technologies, but research on the relevance of their input is scarce. In 2000, we asked six Danish expert oncologists to predict whether a sample of 19 new anticancer drugs would impact Danish health care over the next 5 years. In 2005, we assessed the accuracy...... of these predictions in a delayed type cross-sectional study. The specificity of the Danish experts' prediction was 1 (95% confidence interval 0.74-1.00) and the sensitivity was 0.63 (0.31-0.86). The negative predictive value was 0.79 (0.52-0.92) and the positive predictive value was 1 (0.57-1.00). This indicates...

  8. The impact of recommendations and warnings on the quality evaluation of health websites: An online experiment

    NARCIS (Netherlands)

    Diviani, N.; Meppelink, C.S.

    With the increase in availability of online health information (OHI), consumers need to be able to properly evaluate the quality of health websites. Although several established evaluation criteria for OHI are available, these are rarely used by consumers. To improve people's ability and motivation

  9. Evaluating the impact of direct and indirect contact on the mental health stigma of pharmacy students.

    Science.gov (United States)

    Nguyen, Elizabeth; Chen, Timothy F; O'Reilly, Claire L

    2012-07-01

    Contact with mental health consumers has shown to be a promising strategy to address mental health stigma, particularly in the context of pharmacy education. This research aimed to compare the effectiveness of a direct (face-to-face) contact intervention with an indirect (film based) contact intervention in reducing the mental health stigma of pharmacy students. A two-group, non-randomized, comparative study was conducted with third year pharmacy students (n = 198) allocated to the direct contact arm and fourth year pharmacy students (n = 278) allocated to the indirect contact arm. Baseline and immediate post-intervention data were collected using a validated 39 item survey instrument to assess the impact of the interventions on mental health stigma as well as attitudes towards providing mental health pharmaceutical services. Participants in the direct contact group showed a significant improvement in 37 out of 39 survey items and participants in the indirect contact group showed a significant improvement in 27 out of 39 items (P direct contact had a stronger impact than indirect contact for 22 items (P interventions was equivalent. Both indirect and direct contact may positively impact mental health stigma. While the strength of the stigma-change process may be heightened by face-to-face interactions, the largely positive impact of indirect contact suggests that stigma reduction may depend less on the medium of contact but more on the transcendent messages contributed by the consumers facilitating the contact experience.

  10. The Impact of Channel Context and Task on Consumers' Evaluations of Personalized Health Recommendation Systems

    NARCIS (Netherlands)

    Wendel, S.; Ronteltap, A.; Dellaert, B.G.C.; Trijp, van J.C.M.

    2008-01-01

    We investigate consumer perspectives on complex, multistage systems designed to provide personalized health recommendations. We conceptualize the underlying benefit trade-offs that consumers make in evaluating such systems as the manifestation of a psychological contract in which consumers

  11. Evaluating the public health impacts of legalizing recreational cannabis use in the United States.

    Science.gov (United States)

    Hall, Wayne; Lynskey, Michael

    2016-10-01

    Since 2012 four US states have legalized the retail sale of cannabis for recreational use by adults, and more are likely to follow. This report aimed to (1) briefly describe the regulatory regimes so far implemented; (2) outline their plausible effects on cannabis use and cannabis-related harm; and (3) suggest what research is needed to evaluate the public health impact of these policy changes. We reviewed the drug policy literature to identify: (1) plausible effects of legalizing adult recreational use on cannabis price and availability; (2) factors that may increase or limit these effects; (3) pointers from studies of the effects of legalizing medical cannabis use; and (4) indicators of cannabis use and cannabis-related harm that can be monitored to assess the effects of these policy changes. Legalization of recreational use will probably increase use in the long term, but the magnitude and timing of any increase is uncertain. It will be critical to monitor: cannabis use in household and high school surveys; cannabis sales; the number of cannabis plants legally produced; and the tetrahydrocannabinol (THC) content of cannabis. Indicators of cannabis-related harms that should be monitored include: car crash fatalities and injuries; emergency department presentations; presentations to addiction treatment services; and the prevalence of regular cannabis use among young people in mental health services and the criminal justice system. Plausible effects of legalizing recreational cannabis use in the United States include substantially reducing the price of cannabis and increasing heavy use and some types of cannabis-related harm among existing users. In the longer term it may also increase the number of new users. © 2016 Society for the Study of Addiction.

  12. Accountability: Evaluating the impact of emission control policies on air pollutant levels and health outcomes

    Science.gov (United States)

    Presentation on examining the impacts of an actual regulatory action (NOx SIP Call) on human health. We examined respiratory-related hospital admissions before and after the implementation of the NOx SIP Call. In addition, we found that enriched exposure information (incorporat...

  13. Feasibility and impact of providing feedback to vaccinating medical clinics: evaluating a public health intervention

    Directory of Open Access Journals (Sweden)

    Kiely Marilou

    2010-12-01

    Full Text Available Abstract Background Vaccine coverage (VC at a given age is a widely-used indicator for measuring the performance of vaccination programs. However, there is increasing data suggesting that measuring delays in administering vaccines complements the measure of VC. Providing feedback to vaccinators is recognized as an effective strategy for improving vaccine coverage, but its implementation has not been widely documented in Canada. The objective of this study was to evaluate the feasibility of providing personalized feedback to vaccinators and its impact on vaccination delays (VD. Methods In April and May 2008, a one-hour personalized feedback session was provided to health professionals in vaccinating medical clinics in the Quebec City region. VD for vaccines administered at two and twelve months of age were presented. Data from the regional vaccination registry were analysed for participating clinics. Two 12-month periods before and after the intervention were compared, namely from April 1st, 2007 to March 31st, 2008 and from June 1st, 2008 to May 31st, 2009. Results Ten medical clinics out of the twelve approached (83%, representing more than 2500 vaccinated children, participated in the project. Preparing and conducting the feedback involved 20 hours of work and expenses of $1000 per clinic. Based on a delay of one month, 94% of first doses of DTaP-Polio-Hib and 77% of meningococcal vaccine doses respected the vaccination schedule both before and after the intervention. Following the feedback, respect of the vaccination schedule increased for vaccines planned at 12 months for the four clinics that had modified their vaccination practices related to multiple injections (depending on the clinic, VD decreased by 24.4%, 32.0%, 40.2% and 44.6% respectively, p Conclusions The present study shows that it is feasible to provide personalized feedback to vaccinating clinics. While it may have encouraged positive changes in practice concerning multiple

  14. Evaluating digital libraries in the health sector. Part 2: measuring impacts and outcomes.

    Science.gov (United States)

    Cullen, Rowena

    2004-03-01

    This is the second part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. Part 1 focuses on approaches to evaluation that have been proposed for mainstream digital information services. This paper investigates evaluative models developed for some innovative digital library projects, and some major national and international electronic health information projects. The value of ethnographic methods to provide qualitative data to explore outcomes, adding to quantitative approaches based on inputs and outputs is discussed. The paper concludes that new 'post-positivist' models of evaluation are needed to cover all the dimensions of the digital library in the health sector, and some ways of doing this are outlined.

  15. Air quality mapping using GIS and economic evaluation of health impact for Mumbai City, India.

    Science.gov (United States)

    Kumar, Awkash; Gupta, Indrani; Brandt, Jørgen; Kumar, Rakesh; Dikshit, Anil Kumar; Patil, Rashmi S

    2016-05-01

    Mumbai, a highly populated city in India, has been selected for air quality mapping and assessment of health impact using monitored air quality data. Air quality monitoring networks in Mumbai are operated by National Environment Engineering Research Institute (NEERI), Maharashtra Pollution Control Board (MPCB), and Brihanmumbai Municipal Corporation (BMC). A monitoring station represents air quality at a particular location, while we need spatial variation for air quality management. Here, air quality monitored data of NEERI and BMC were spatially interpolated using various inbuilt interpolation techniques of ArcGIS. Inverse distance weighting (IDW), Kriging (spherical and Gaussian), and spline techniques have been applied for spatial interpolation for this study. The interpolated results of air pollutants sulfur dioxide (SO2), nitrogen dioxide (NO2) and suspended particulate matter (SPM) were compared with air quality data of MPCB in the same region. Comparison of results showed good agreement for predicted values using IDW and Kriging with observed data. Subsequently, health impact assessment of a ward was carried out based on total population of the ward and air quality monitored data within the ward. Finally, health cost within a ward was estimated on the basis of exposed population. This study helps to estimate the valuation of health damage due to air pollution. Operating more air quality monitoring stations for measurement of air quality is highly resource intensive in terms of time and cost. The appropriate spatial interpolation techniques can be used to estimate concentration where air quality monitoring stations are not available. Further, health impact assessment for the population of the city and estimation of economic cost of health damage due to ambient air quality can help to make rational control strategies for environmental management. The total health cost for Mumbai city for the year 2012, with a population of 12.4 million, was estimated as USD

  16. Health risk and impact evaluation for recycling of radioactive scrap metal

    International Nuclear Information System (INIS)

    Nieves, L.A.; Chen, S.Y.; Murphie, W.E.; Lilly, M.J. III

    1994-01-01

    The DoE, Office of Environmental Restoration and Waste Management, is participating with the Organization for Economic Cooperation and Development in providing analytical support for developing international standards for recycling of radioactive scrap metals. For this purpose, Argonne National Laboratory is assessing health, environmental and societal implications of recycling and/or disposal process alternatives. This effort includes development of international inventory estimates for contaminated metals; investigation of international scrap metal markets; assessment of radiological and non-radiological human health risks; impacts on environmental quality and resources; and investigation of social and political factors. The RSM disposal option is being assessed with regard to the environmental and health impacts of replacing the metals if they are withdrawn from use. Impact estimates are developed for steel as an illustrative example because steel comprises a major portion of the scrap metal inventory. Current and potential sources of RSM include nuclear power plants, fuel cycle and weapons production facilities, industrial and medical facilities and equipment, and petroleum and phosphate rock extraction equipment. Millions of metric tons (t) of scrap iron and steel, stainless steel, and copper, as well as lesser quantities of aluminum, nickel, lead, and zirconium, are likely to become available in the future as these facilities are withdrawn from service

  17. Reference amounts utilised in front of package nutrition labelling; impact on product healthfulness evaluations.

    Science.gov (United States)

    Raats, M M; Hieke, S; Jola, C; Hodgkins, C; Kennedy, J; Wills, J

    2015-05-01

    The research question addressed in this paper is how different reference amounts utilised in front of package nutrition labelling influence evaluation of product healthfulness. A total of 13,117 participants from six European countries (Germany, UK, Spain, France, Poland and Sweden) were recruited via online panels. A mixed between/within-subject factorial design was employed with food (biscuits, sandwiches, yogurts), healthfulness and presence of Guideline Daily Amounts as within-subjects factors and reference amount ('per 100 g', 'typical portion', 'half portion') and country as between-subjects factors. Overall, people correctly ranked foods according to their objective healthfulness as defined by risk nutrients alone, and could distinguish between more and less healthful variants of foods. General healthfulness associations with the three product categories do not appear to have had a strong influence on product ratings. This study shows that where the reference amount of 'per 100 g' is very different from the 'typical' portion size, as was the case for biscuits, products with a 'per 100 g' label are rated significantly less healthful than the 'typical' or 'half typical' portions. The results indicate that across the three food categories, consumers do factor the reference amount, that is, the quantity of food for which the nutritional information is being presented, into their judgements of healthfulness. Therefore, appropriate reference amounts are also of importance for the effective presentation of nutritional information.

  18. Application of an evidence-based tool to evaluate health impacts of changes to the built environment.

    Science.gov (United States)

    Ulmer, Jared M; Chapman, James E; Kershaw, Suzanne E; Campbell, Monica; Frank, Lawrence D

    2014-07-11

    To create and apply an empirically based health and greenhouse gas (GHG) impact assessment tool linking detailed measures of walkability and regional accessibility with travel, physical activity, health indicators and GHG emissions. Parcel land use and transportation system characteristics were calculated within a kilometre network buffer around each Toronto postal code. Built environment measures were linked with health and demographic characteristics from the Canadian Community Health Survey and travel behaviour from the Transportation Tomorrow Survey. Results were incorporated into an existing software tool and used to predict health-related indicators and GHG emissions for the Toronto West Don Lands Redevelopment. Walkability, regional accessibility, sidewalks, bike facilities and recreation facility access were positively associated with physical activity and negatively related to body weight, high blood pressure and transportation impacts. When applied to the West Don Lands, the software tool predicted a substantial shift from automobile use to walking, biking and transit. Walking and biking trips more than doubled, and transit trips increased by one third. Per capita automobile trips decreased by half, and vehicle kilometres travelled and GHG emissions decreased by 15% and 29%, respectively. The results presented are novel and among the first to link health outcomes with detailed built environment features in Canada. The resulting tool is the first of its kind in Canada. This tool can help policy-makers, land use and transportation planners, and health practitioners to evaluate built environment influences on health-related indicators and GHG emissions resulting from contrasting land use and transportation policies and actions.

  19. The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

    Directory of Open Access Journals (Sweden)

    Annemarie Ruijsbroek

    Full Text Available Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run.With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008 and intervention period (mid 2008-2013-14 in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme.Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes.We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

  20. Evaluating the impact of wind turbine noise on health-related quality of life.

    Science.gov (United States)

    Shepherd, Daniel; McBride, David; Welch, David; Dirks, Kim N; Hill, Erin M

    2011-01-01

    We report a cross-sectional study comparing the health-related quality of life (HRQOL) of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. The study employed a nonequivalent comparison group posttest-only design. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful. Our data suggest that wind farm noise can negatively impact facets of HRQOL.

  1. Evaluation of methamphetamine-associated socioeconomic status and addictive behaviors, and their impact on oral health.

    Science.gov (United States)

    Rommel, Niklas; Rohleder, Nils H; Wagenpfeil, Stefan; Haertel-Petri, Roland; Kesting, Marco R

    2015-11-01

    Chronic methamphetamine abuse can lead to multiple health hazards. In particular, the substance is associated with devastating effects on oral health including symptoms such as rampant caries, gingiva inflammation, and xerostomia, whereby the term "Meth Mouth" occurs in the current literature. However, "Meth Mouth" pathology is primarily described on the basis of individual cases or has been evaluated without consideration of the mass of potential influencing factors. Therefore, we have conducted a systematic study to investigate the effects of accompanying factors and circumstances on oral health in cases of chronic methamphetamine abuse. In cooperation with two centers for addiction medicine, we assessed the data of 100 chronic methamphetamine users and 100 matched-pair controls between March 2012 and November 2013. We investigated their socioeconomic status, details of methamphetamine consumption behavior, collateral consumption of sugar beverages, nicotine alcohol, and other addictive substances including cannabis, opioids, other stimulants, and hallucinogens, and dental care. We found considerably greater unstable social circumstances, a high collateral consumption of substances with pathogenic potential for the stomatognathic system, and significantly poorer dental care in the methamphetamine-user group. Various factors have to be considered with regard to methamphetamine use and its influence on oral health. These factors can trigger potential damage by the drug methamphetamine possibly leading to the symptoms of "Meth Mouth", and should be considered in prevention and therapy strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations

    Directory of Open Access Journals (Sweden)

    Jenine R. Leal

    2017-06-01

    Full Text Available Abstract Background The rates of antimicrobial-resistant organisms (ARO continue to increase for both hospitalized and community patients. Few resources have been allocated to reduce the spread of resistance on global, national and local levels, in part because the broader economic impact of antimicrobial resistance (i.e. the externality is not fully considered when determining how much to invest to prevent AROs, including strategies to contain antimicrobial resistance, such as antimicrobial stewardship programs. To determine how best to measure and incorporate the impact of externalities associated with the antimicrobial resistance when making resource allocation decisions aimed to reduce antimicrobial resistance within healthcare facilities, we reviewed the literature to identify publications which 1 described the externalities of antimicrobial resistance, 2 described approaches to quantifying the externalities associated with antimicrobial resistance or 3 described macro-level policy options to consider the impact of externalities. Medline was reviewed to identify published studies up to September 2016. Main body An externality is a cost or a benefit associated with one person’s activity that impacts others who did not choose to incur that cost or benefit. We did not identify a well-accepted method of accurately quantifying the externality associated with antimicrobial resistance. We did identify three main methods that have gained popularity to try to take into account the externalities of antimicrobial resistance, including regulation, charges or taxes on the use of antimicrobials, and the right to trade permits or licenses for antimicrobial use. To our knowledge, regulating use of antimicrobials is the only strategy currently being used by health care systems to reduce antimicrobial use, and thereby reduce AROs. To justify expenditures on programs that reduce AROs (i.e. to formally incorporate the impact of the negative externality of

  3. Impacting Binational Health through Leadership Development: A Program Evaluation of the Leaders across Borders Program, 2010–2014

    Directory of Open Access Journals (Sweden)

    Omar A. Contreras

    2017-08-01

    Full Text Available BackgroundWorkforce and leadership development is imperative for the advancement of public health along the U.S./Mexico border. The Leaders across borders (LaB program aims to train the public health and health-care workforce of the border region. The LaB is a 6-month intensive leadership development program, which offers training in various areas of public health. Program curriculum topics include: leadership, border health epidemiology, health diplomacy, border public policies, and conflict resolution.MethodsThis article describes the LaB program evaluation outcomes across four LaB cohort graduates between 2010 and 2014. LaB graduates received an invitation to participate via email in an online questionnaire. Eighty-five percent (n = 34 of evaluation participants indicated an improvement in the level of binationality since participating in the LaB program. Identified themes in the evaluation results included increased binational collaborations and partnerships across multidisciplinary organizations that work towards improving the health status of border communities. Approximately 93% (n = 37 of the LaB samples were interested in participating in future binational projects while 80% (n = 32 indicated interest in the proposal of other binational initiatives. Participants expressed feelings of gratitude from employers who supported their participation and successful completion of LaB.DiscussionPrograms such as LaB are important in providing professional development and education to a health-care workforce along the U.S./Mexico border that is dedicated to positively impacting the health outcomes of vulnerable populations residing in this region.

  4. Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University's Tikur Anbessa Specialized Hospital (Ethiopia).

    Science.gov (United States)

    Busse, Heidi; Aboneh, Ephrem A; Tefera, Girma

    2014-09-05

    The positive impact of global health activities by volunteers from the United States in low-and middle-income countries has been recognized. Most existing global health partnerships evaluate what knowledge, ideas, and activities the US institution transferred to the low- or middle-income country. However, what this fails to capture are what kinds of change happen to US-based partners due to engagement in global health partnerships, both at the individual and institutional levels. "Reverse innovation" is the term that is used in global health literature to describe this type of impact. The objectives of this study were to identify what kinds of impact global partnerships have on health volunteers from developed countries, advance this emerging body of knowledge, and improve understanding of methods and indicators for assessing reverse innovation. The study population consisted of 80 US, Canada, and South Africa-based health care professionals who volunteered at Tikur Anbessa Specialized Hospital in Ethiopia. Surveys were web-based and included multiple choice and open-ended questions to assess global health competencies. The data were analyzed using IBRM SPSS® version 21 for quantitative analysis; the open-ended responses were coded using constant comparative analysis to identify themes. Of the 80 volunteers, 63 responded (79 percent response rate). Fifty-two percent of the respondents were male, and over 60 percent were 40 years of age and older. Eighty-three percent reported they accomplished their trip objectives, 95 percent would participate in future activities and 96 percent would recommend participation to other colleagues. Eighty-nine percent reported personal impact and 73 percent reported change on their professional development. Previous global health experience, multiple prior trips, and the desire for career advancement were associated with positive impact on professional development. Professionally and personally meaningful learning happens often

  5. Gender equity and health: evaluating the impact of Millennium Development Goal Three on women's health in South Asia.

    Science.gov (United States)

    Shannon, Geordan D; Im, Dana D; Katzelnick, Leah; Franco, Oscar H

    2013-01-01

    Researchers evaluated the progress of Millennium Development Goal Three, which promotes gender equity and empowering women, by assessing the targets for education, employment, and government, and their relation to women's health in South Asia. Researchers obtained data from the United Nations, Inter-Parliamentary Union, International Labor Organization, World Bank, and World Health Organization. First, they performed a literature review including manuscripts that quantified a Millenium Development Goal Three outcome in South Asia and were published after 1991. They derived women's health outcomes from World Health Organization databases. Spearman's rank test was used to evaluate the relationship between change in gender parity and change in women's health outcomes. South Asia's average primary education Gender Parity Index (defined as the ratio of girls to boys enrolled in primary, secondary, and tertiary education and expressed as a value between 0 and 1.0) improved from 0.73 (SD 0.34) to 0.92 (SD 0.13) between 2000 and 2008. Secondary and tertiary education had a lower Gender Parity Index (average 2008 Gender Parity Index 0.87 (SD 0.21) and 0.59 (SD 0.23), respectively), but had also improved from 2000 (average Gender Parity Index = 0.77, SD 0.38) to 2008 (average Gender Parity Index = 0.52, SD 0.11). An average proportion of 22.1% (SD 12.58) of women participated in waged, non-agricultural employment and 16.6% (SD 10.3) in national parliaments. No clear association was found between change in gender equity and women's health in South Asia between 2000 and 2008. Some progress has been made toward gender equity in South Asia, although the results have been mixed and inequities persist, especially in employment and government. While gender equity does not appear to have been related to female health outcomes, both must be addressed simultaneously as priority development targets and remain prerequisites to achieving the overall Millennium Development Goals

  6. Quasi-Experimental Approaches to Evaluating the Impact of Air Pollution on Children’s Health

    Science.gov (United States)

    Heep, Samantha; Neidell, Matthew

    2016-01-01

    Many studies have shown a correlation between air pollution and poor children’s health. This paper focuses on recent studies that employ quasi-experimental designs in an effort to minimize the effect of confounding factors. These studies are complementary to studies using other designs and confirm that reducing air pollution reduces infant mortality, low birth weight, prematurity, congenital anomalies, asthma hospitalizations, and school absences. These results suggest that lowering the thresholds for acceptable air pollution levels may be prudent, as research has consistently found that some pollutants have negative impacts even at levels below current regulatory thresholds. Policy makers should also consider providing more information to pregnant women and families about when and where the risk of pollution exposure is highest so that they can employ avoidance behavior. PMID:22147868

  7. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review

    Science.gov (United States)

    Schmitt, Laetitia H. M.; Graham, Hilary M.; White, Piran C. L.

    2016-01-01

    The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies) or Asia (seven studies), whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies), closely followed by flooding (six studies). No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events. PMID:27834843

  8. Economic Evaluations of the Health Impacts of Weather-Related Extreme Events: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Laetitia H. M. Schmitt

    2016-11-01

    Full Text Available The frequency and severity of extreme events is expected to increase under climate change. There is a need to understand the economic consequences of human exposure to these extreme events, to underpin decisions on risk reduction. We undertook a scoping review of economic evaluations of the adverse health effects from exposure to weather-related extreme events. We searched PubMed, Embase and Web of Science databases with no restrictions to the type of evaluations. Twenty studies were included, most of which were recently published. Most studies have been undertaken in the U.S. (nine studies or Asia (seven studies, whereas we found no studies in Africa, Central and Latin America nor the Middle East. Extreme temperatures accounted for more than a third of the pool of studies (seven studies, closely followed by flooding (six studies. No economic study was found on drought. Whilst studies were heterogeneous in terms of objectives and methodology, they clearly indicate that extreme events will become a pressing public health issue with strong welfare and distributional implications. The current body of evidence, however, provides little information to support decisions on the allocation of scarce resources between risk reduction options. In particular, the review highlights a significant lack of research attention to the potential cost-effectiveness of interventions that exploit the capacity of natural ecosystems to reduce our exposure to, or ameliorate the consequences of, extreme events.

  9. Evaluating the impact of wind turbine noise on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Daniel Shepherd

    2011-01-01

    Full Text Available We report a cross-sectional study comparing the health-related quality of life (HRQOL of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. The study employed a nonequivalent comparison group posttest-only design. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful. Our data suggest that wind farm noise can negatively impact facets of HRQOL.

  10. The Italian national archive of radio and TV broadcasters: Preliminary evaluations of health and environmental impact

    International Nuclear Information System (INIS)

    Lepori, V.; Polichetti, A.; Vecchia, P.

    1996-01-01

    Several health effects of exposures to radiofrequency and microwave electromagnetic fields are well known and documented by a wide scientific literature. Although doubts still exist about the possibility of long-term effects of chronic exposure to low intensity fields, a vast agreement has been reached in the scientific community about the pathologies associated to exposures to relatively intense fields. On the basis of this consensus, protection norms and guidelines have been issued, either by international organizations or by health Authorities of individual Countries. In Italy, a regulation in this area has been urged for years by health operators, by scientists, and even by the industry. At the moment, two national Commissions, set up by the Ministry for the Environment and the Ministry of Health, are developing standards for the protection of the general population and workers, respectively. In the meantime, some Regions (Pedmont, Latium, Abruzzo and Venetia) have enforced own regional laws, to face in particular the problems posed by the exposure of the public to electromagnetic fields radiated by radio and TV broadcasters. A number of surveys carried out by various agencies have shown in fact that these plants give rise, in several circumstances, to fields exceeding the limits recommended by international organizations. That is due either to the proximity of individual antennas to houses or residential areas, or to the concentration of several broadcasters at the same site. Since the space distribution of the power radiated by an antenna can be calculated theoretically, detailed information on the siting and the technical characteristics of each plant would allow an a priori evaluation of possible exposures and help to identify critical situations

  11. A new framework for evaluating the health impacts of treatment for Gaucher disease type 1

    Directory of Open Access Journals (Sweden)

    Michael L. Ganz

    2017-02-01

    Full Text Available Abstract Background The Disease Severity Scoring System (DS3 is a validated measure for evaluating Gaucher disease type 1 (GD1 severity. We developed a new framework, consisting of health states, transition probabilities between those states, and preferences for those states (utilities based on the DS3 to predict long-term outcomes of patients starting treatment. We defined nine mutually exclusive (alive health states based on three DS3 categories: mild (0 ≤ DS3 ≤ 3.5 without symptoms of bone disease; mild with bone pain, mild with severe skeletal complications (SSC defined as lytic lesions, avascular necrosis, or fracture; moderate (3.5 < DS3 ≤ 6.5 without SSC; moderate with SSC; marked (6.5 < DS3 ≤ 9.5 without SSC; marked with SSC; severe (9.5 < DS3 ≤ 19 without SSC; and severe with SSC. Health-state transition probabilities and utilities were estimated from a longitudinal sample of patients with GD1 who started enzyme replacement therapy (the DS3 Score Study. Age dependent GD1-specific mortality was derived from published data. We used a Markov state-transition model to illustrate how to estimate time spent in each health state. Results The average predicted utilities for each health state ranged from 0.76 for mild disease with no clinical symptoms of bone disease to 0.52 with severe disease with SSC. Transition probabilities depended on disease severity (DS3 score at treatment initiation and whether patients had undergone a total splenectomy or had an intact spleen/partial splenectomy prior to starting treatment. Patients who started treatment with intact or residual spleens spent more time in better health states than those who started treatment with total splenectomy. Conclusions This new framework, which is based on the DS3, can be used to project the long-term outcomes of GD1 patients starting treatment. The framework could also be used to compare the long-term outcomes of different GD1 treatment options. Trial

  12. Evaluating the Impact of Contaminant Dilution and Biodegradation in Uncertainty Quantification of Human Health Risk

    Science.gov (United States)

    Zarlenga, Antonio; de Barros, Felipe; Fiori, Aldo

    2016-04-01

    We present a probabilistic framework for assessing human health risk due to groundwater contamination. Our goal is to quantify how physical hydrogeological and biochemical parameters control the magnitude and uncertainty of human health risk. Our methodology captures the whole risk chain from the aquifer contamination to the tap water assumption by human population. The contaminant concentration, the key parameter for the risk estimation, is governed by the interplay between the large-scale advection, caused by heterogeneity and the degradation processes strictly related to the local scale dispersion processes. The core of the hazard identification and of the methodology is the reactive transport model: erratic displacement of contaminant in groundwater, due to the spatial variability of hydraulic conductivity (K), is characterized by a first-order Lagrangian stochastic model; different dynamics are considered as possible ways of biodegradation in aerobic and anaerobic conditions. With the goal of quantifying uncertainty, the Beta distribution is assumed for the concentration probability density function (pdf) model, while different levels of approximation are explored for the estimation of the one-point concentration moments. The information pertaining the flow and transport is connected with a proper dose response assessment which generally involves the estimation of physiological parameters of the exposed population. Human health response depends on the exposed individual metabolism (e.g. variability) and is subject to uncertainty. Therefore, the health parameters are intrinsically a stochastic. As a consequence, we provide an integrated in a global probabilistic human health risk framework which allows the propagation of the uncertainty from multiple sources. The final result, the health risk pdf, is expressed as function of a few relevant, physically-based parameters such as the size of the injection area, the Péclet number, the K structure metrics and

  13. Health impacts of floods.

    Science.gov (United States)

    Du, Weiwei; FitzGerald, Gerard Joseph; Clark, Michele; Hou, Xiang-Yu

    2010-01-01

    Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. This study involved an extensive literature review that located >500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.

  14. Evaluating inter-continental transport of fine aerosols:(2) Global health impact

    Science.gov (United States)

    Liu, Junfeng; Mauzerall, Denise L.; Horowitz, Larry W.

    In this second of two companion papers, we quantify for the first time the global impact on premature mortality of the inter-continental transport of fine aerosols (including sulfate, black carbon, organic carbon, and mineral dust) using the global modeling results of (Liu et al., 2009). Our objective is to estimate the number of premature mortalities in each of ten selected continental regions resulting from fine aerosols transported from foreign regions in approximately year 2000. Our simulated annual mean population-weighted (P-W) concentrations of total PM2.5 (aerosols with diameter less than 2.5 μm) are highest in East Asia (EA, 30 μg m -3) and lowest in Australia (3.6 μg m -3). Dust is the dominant component of PM2.5 transported between continents. We estimate global annual premature mortalities (for adults age 30 and up) due to inter-continental transport of PM2.5 to be nearly 380 thousand (K) in 2000. Approximately half of these deaths occur in the Indian subcontinent (IN), mostly due to aerosols transported from Africa and the Middle East (ME). Approximately 90K deaths globally are associated with exposure to foreign (i.e., originating outside a receptor region) non-dust PM2.5. More than half of the premature mortalities associated with foreign non-dust aerosols are due to aerosols originating from Europe (20K), ME (18K) and EA (15K); and nearly 60% of the 90K deaths occur in EA (21K), IN (19K) and Southeast Asia (16K). The lower and higher bounds of our estimated 95% confidence interval (considering uncertainties from the concentration-response relationship and simulated aerosol concentrations) are 18% and 240% of the estimated deaths, respectively, and could be larger if additional uncertainties were quantified. We find that in 2000 nearly 6.6K premature deaths in North America (NA) were associated with foreign PM2.5 exposure (5.5K from dust PM2.5). NA is least impacted by foreign PM2.5 compared to receptors on the Eurasian continent. However, the

  15. Evaluating for impact: what type of data can assist a health promoting school approach?

    Science.gov (United States)

    Joyce, Andrew; Dabrowski, Anna; Aston, Ruth; Carey, Gemma

    2017-04-01

    There is debate within the health promoting school (HPS) movement on whether schools should monitor health behaviour outcomes as part of an evaluation or rely more on process type measures, such as changes to school policies and the physical and social environment which yield information about (in)effective implementation. The debate is often framed around ideological considerations of the role of schools and there is little empirical work on how these indicators of effective implementation can influence change at a policy and practice level in real world settings. Information has potentially powerful effects in motivating a change process, but this will vary according to the type of information and the type of organizational culture into which it is presented. The current predominant model relies on process data, policy and environmental audit monitoring and benchmarking approaches, and there is little evidence of whether this engages school communities. Theoretical assertions on the importance of monitoring data to motivate change need to be empirically tested and, in doing so, we can learn which types of data influence adoption of HPS in which types of school and policy contexts. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

    Directory of Open Access Journals (Sweden)

    Rajaraman Divya

    2012-05-01

    Full Text Available Abstract Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility, the uptake of services (acceptability, and the number of students who received corrective health treatment (evidence of impact. Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility, evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the

  17. The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation.

    Science.gov (United States)

    Rajaraman, Divya; Travasso, Sandra; Chatterjee, Achira; Bhat, Bhargav; Andrew, Gracy; Parab, Suraj; Patel, Vikram

    2012-05-25

    Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. The intervention was based on the WHO's Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students' anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals

  18. Evaluation of the Impact of Ruminant Trans Fatty Acids on Human Health: Important Aspects to Consider.

    Science.gov (United States)

    Kuhnt, Katrin; Degen, Christian; Jahreis, Gerhard

    2016-09-09

    The definition and evaluation of trans fatty acids (TFA) with regard to foodstuffs and health hazard are not consistent. Based on the current situation, the term should be restricted only to TFA with isolated double bonds in trans-configuration. Conjugated linoleic acids (CLA) should be separately assessed. Ideally, the origin of the consumed fat should be declared, i.e., ruminant TFA (R-TFA) and industrial TFA (non-ruminant; I-TFA). In ruminant fat, more than 50% of R-TFA consists of vaccenic acid (C18:1 t11). In addition, natural CLA, i.e., c9,t11 CLA is also present. Both are elevated in products from organic farming. In contrast to elaidic acid (t9) and t10, which occur mainly in partially hydrogenated industrial fat, t11 is partially metabolized into c9,t11 CLA via Δ9-desaturation. This is the major metabolic criterion used to differentiate between t11 and other trans C18:1. t11 indicates health beneficial effects in several studies. Moreover, CLA in milk fat is associated with the prevention of allergy and asthma. An analysis of the few studies relating to R-TFA alone makes clear that no convincing adverse physiological effect can be attributed to R-TFA. Only extremely high R-TFA intakes cause negative change in blood lipids. In conclusion, in most European countries, the intake of R-TFA is assessed as being low to moderate. Restriction of R-TFA would unjustifiably represent a disadvantage for organic farming of milk.

  19. A review of family health's latest evaluation of the demographic impact of the Louisiana Family Planning Program.

    Science.gov (United States)

    Gettys, J O; Atkins, E H; Mary, C C

    1974-03-01

    The report, "Recent Trends in Louisiana Fertility," released in January 1973 is reviewed. This report was distinguished from other Louisiana Family Planning Program evaluations of demographic impact by several features: 1) Louisiana crude birth rates are compared with those of the United States and Mississippi; 2) differences in age-specific nonwhite fertility rates in Louisiana between 1965 and 1971 are compared with corresponding differences in Mississippi; and 3) the concepts of "parity components of age-specific rates" and "excess births" are introduced into the discussion of Louisiana fertility trends. According to the reviewers, no scientific or even psudoscientific analysis of the Louisiana Family Planning Program has ever been published or made available by the Family Health Foundation to any state agency. They contend that the so-called evaluations of the demographic impact of the Louisiana Family Planning Program are textbook examples of customized statistics. It is suggested that the family planning program services may contribute to increased natality and that the family planning program workers are more highly motivated to retain their jobs than to bring down the brith rate. The reviewers are not convinced that the statisticians on the Family Health Foundation are responsible for all of the narrative that accompanies their charts and tables.

  20. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Science.gov (United States)

    Mayhew, Susannah H; Ploubidis, George B; Sloggett, Andy; Church, Kathryn; Obure, Carol D; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E; Watts, Charlotte; Vassall, Anna

    2016-01-01

    The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration". These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  1. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    Directory of Open Access Journals (Sweden)

    Susannah H Mayhew

    Full Text Available The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs.Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure and a Functional Integration Index (integrated delivery of services to clients. The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration".These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  2. Evaluating the Impact of Health Insurance Industry Consolidation: Learning from Experience.

    Science.gov (United States)

    Dafny, Leemore S

    2015-11-01

    Research shows consolidation in the private health insurance industry leads to premium increases, even though insurers with larger local market shares generally obtain lower prices from health care providers. Additional research is needed to understand how to protect against harms and unlock benefits from scale. Data on enrollment, premiums, and costs of commercial health insurance--by insurer, plan, customer segment, and local market--would help us understand whether, when, and for whom consolidation is harmful or beneficial. Such transparency is common where there is a strong public interest and substantial public regulation, both of which characterize this vital sector.

  3. Accountability: Evaluating the Impact of Regulatory Policies on Air Quality, Human Health, and the Environment

    Science.gov (United States)

    This presentation discusses "accountability"; e.g., do emission-control regulations really reduce exposure to pollutants and improve human health? In this presentation, we provide examples of how to examine this and related questions.

  4. Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren.

    Science.gov (United States)

    de Paula, Janice S; Sarracini, Karin L M; Meneghim, Marcelo C; Pereira, Antônio C; Ortega, Edwin M M; Martins, Natália S; Mialhe, Fábio L

    2015-06-01

    This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL. © 2015 Eur J Oral Sci.

  5. Evaluating the transport, health and economic impacts of new urban cycling infrastructure in Sydney, Australia - protocol paper.

    Science.gov (United States)

    Rissel, Chris; Greaves, Stephen; Wen, Li Ming; Capon, Anthony; Crane, Melanie; Standen, Chris

    2013-10-17

    There are repeated calls to build better cycling paths in Australian cities if the proportion of people cycling is to increase. Yet the full range of transport, health, environmental and economic impacts of new cycling infrastructure and the extent to which observed changes are sustained is not well understood. The City of Sydney is currently building a new bicycle network, which includes a new bicycle path separated from road traffic in the south Sydney area. This protocol paper describes a comprehensive method to evaluate this new cycling infrastructure. A cohort of residents within two kilometres of the new bicycle path will be surveyed at baseline before a new section of bicycle path is built, and again 12 and 24 months later to assess changes in travel behaviour, sense of community, quality of life and health behaviours. Residents in a comparable area of Sydney that will not get a new separated bike path will act as a comparison group. At baseline a sub-set of residents who volunteer will also take a small GPS device with them for one week to assess travel behaviour. This research should contribute to the advancement in evaluation and appraisal methods for cycling projects.

  6. Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system

    Directory of Open Access Journals (Sweden)

    Malaz A Boustani

    2010-05-01

    Full Text Available Malaz A Boustani1,2,3,4, Stephanie Munger1,2, Rajesh Gulati3,4, Mickey Vogel4, Robin A Beck3,4, Christopher M Callahan1,2,3,41Indiana University Center for Aging Research, 2Regenstrief Institute Inc., 3Indiana University School of Medicine, Department of Medicine, Division of General Internal Medicine and Geriatrics, 4Indiana University Medical Group-Primary Care; Indianapolis, IN USAAbstract: Complexity science suggests that our current health care delivery system acts as a complex adaptive system (CAS. Such systems represent a dynamic and flexible network of individuals who can coevolve with their ever changing environment. The CAS performance fluctuates and its members’ interactions continuously change over time in response to the stress generated by its surrounding environment. This paper will review the challenges of intervening and introducing a planned change into a complex adaptive health care delivery system. We explore the role of the “reflective adaptive process” in developing delivery interventions and suggest different evaluation methodologies to study the impact of such interventions on the performance of the entire system. We finally describe the implementation of a new program, the Aging Brain Care Medical Home as a case study of our proposed evaluation process.Keywords: complexity, aging brain, implementation, complex adaptive system, sustained change, care delivery

  7. Evaluation of health impact of cans and cladding from fuel processing

    International Nuclear Information System (INIS)

    Pages, P.; Lombard, J.

    1989-10-01

    Radiological impact related to exposure of workers during processing of tubes and cladding was based on data related to processing of 600 tons of uranium per year. Two reprocessing options were taken into account: processing by fusion and by cementation. Data are given for different posts. Apart from professional exposure data are given for public exposure. Two possible site were treated: reprocessing plant at the river bank (Rhone) or on the sea coast. (Manche)

  8. Evaluating the impact of investments in information technology on structural inertia in health organizations.

    Science.gov (United States)

    Bewley, Lee W

    2010-01-01

    Structural inertia is the overall capacity of an organization to adapt within a market environment. This paper reviews the impact of healthcare investments in information management/information technology (IM/IT) on the strategic management concept of structural inertia. Research indicates that healthcare executives should consider the relative state of structural inertia for their firms and match them with potential IM/IT solutions. Additionally, organizations should favorably consider IM/IT solutions that are comparatively less complex.

  9. Energy systems evaluation of potential for incidents having health or safety impact

    International Nuclear Information System (INIS)

    Speas, I.G.

    1986-01-01

    The paper discusses the results of safety surveys of Martin Marietta Energy Systems - operated nuclear facilities. The purpose was to identify potential incidents that could cause large numbers of casualties, evaluate existing prevention/response actions, and identify possible improvements. The survey findings indicate the potential for an accident with consequences similar to those at Bhopal, India, is essentially non-existent

  10. Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France

    OpenAIRE

    Hiligsmann, M.; Burlet, N.; Fardellone, P.; Al-Daghri, N.; Reginster, J.-Y.

    2016-01-01

    Summary The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60?years. Introduction This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60?years. Methods We estimated the lifetime health impacts expressed in number of fractures prevented, life...

  11. Functional foods: health claim-food product compatibility and the impact of health claim framing on consumer evaluation

    NARCIS (Netherlands)

    Kleef, van E.; Trijp, van H.C.M.; Luning, P.A.

    2005-01-01

    Two studies are reported, which aim to strengthen the scientific underpinning of strategic decisions regarding functional food development, as to (1) which health benefits to claim, (2) with which product (category), and (3) in which communication format. The first exploratory study is a secondary

  12. Evaluating the Impact of Air Pollution on Human Health in China: the Price of Clean Air

    Science.gov (United States)

    Wang, X.; Mauzerall, D. L.; Hu, Y.; Russell, A. G.; Woo, J.; Streets, D. G.

    2003-12-01

    Population growth, rapid urbanization and economic development are contributing to increased energy consumption in China. One of the unintended consequences is poor air quality due to a lack of environmental controls. The coal dependent energy structure in China only worsens the situation. Quantification of the environmental costs resulting from air pollution is needed in order to provide a mechanism for making strategic energy policy that accounts for the life-cycle cost of energy use. However, few such studies have been conducted for China that examine the entire energy system. Here we examine the extent to which public health has been compromised due to elevated air pollution and how China could incorporate environmental costs into future energy and environmental policies. Taking the Shandong region in eastern China as a case study, we develop a high-resolution regional inventory for anthropogenic emissions of NOx, CO, PM2.5, PM10, VOCs, NH3 and SO2. SMOKE (Sparse Matrix Operator Kernel Emissions Modeling System) is used to process spatial and temporal distributions and chemical speciation of the regional emissions, MM5 (the Fifth-Generation NCAR/Penn State Meso-scale Model, Version 3) is used to generate meteorology and Models3/CMAQ (Community Multi-scale Air Quality Modeling System) is used to simulate ambient concentrations of particulates and other gaseous species in this region. We then estimate the mortality and morbidity in this region resulting from exposure to these air pollutants. We also estimate the monetary values associated with the resulting mortality and morbidity and quantify the contributions from various economic sectors (i.e. power generation, transportation, industry, residential and others). Finally, we examine the potential health benefits that adoption of best available or advanced energy (coal-based, in particular) and environmental technologies in different sectors could bring about. The results of these analyses are intended to provide

  13. A Multicriteria Risk Analysis to Evaluate Impacts of Forest Management Alternatives on Forest Health in Europe

    Directory of Open Access Journals (Sweden)

    Hervé Jactel

    2012-12-01

    Full Text Available Due to climate change, forests are likely to face new hazards, which may require adaptation of our existing silvicultural practices. However, it is difficult to imagine a forest management approach that can simultaneously minimize all risks of damage. Multicriteria decision analysis (MCDA has been developed to help decision makers choose between actions that require reaching a compromise among criteria of different weights. We adapted this method and produced a multicriteria risk analysis (MCRA to compare the risk of damage associated with various forest management systems with a range of management intensity. The objective was to evaluate the effect of four forest management alternatives (FMAs (i.e., close to nature, extensive management with combined objectives, intensive even-aged plantations, and short-rotation forestry for biomass production on biotic and abiotic risks of damage in eight regional case studies combining three forest biomes (Boreal, Continental, Atlantic and five tree species (Eucalyptus globulus, Pinus pinaster, Pinus sylvestris, Picea sitchensis, and Picea abies relevant to wood production in Europe. Specific forest susceptibility to a series of abiotic (wind, fire, and snow and biotic (insect pests, pathogenic fungi, and mammal herbivores hazards were defined by expert panels and subsequently weighted by corresponding likelihood. The PROMETHEE ranking method was applied to rank the FMAs from the most to the least at risk. Overall, risk was lower in short-rotation forests designed to produce wood biomass, because of the reduced stand susceptibility to the most damaging hazards. At the opposite end of the management intensity gradient, close-to-nature systems also had low overall risk, due to lower stand value exposed to damage. Intensive even-aged forestry appeared to be subject to the greatest risk, irrespective of tree species and bioclimatic zone. These results seem to be robust as no significant differences in relative

  14. "Love me, parents!": impact evaluation of a national social and behavioral change communication campaign on maternal health outcomes in Tanzania.

    Science.gov (United States)

    Kaufman, Michelle R; Harman, Jennifer J; Smelyanskaya, Marina; Orkis, Jennifer; Ainslie, Robert

    2017-09-15

    Despite marked improvements over the last few decades, maternal mortality in Tanzania remains among the world's highest at 454 maternal deaths per 100,000 live births. Many factors contribute to this disparity, such as a lack of attendance at antenatal care (ANC) services and low rates of delivery at a health facility with a skilled provider. The Wazazi Nipendeni (Love me, parents) social and behavioral change communication campaign was launched in Tanzania in 2012 to improve a range of maternal health outcomes, including individual birth planning, timely ANC attendance, and giving birth in a healthcare facility. An evaluation to determine the impact of the national Wazazi Nipendeni campaign was conducted in five purposively selected regions of Tanzania using exit interviews with pregnant and post-natal women attending ANC clinics. A total of 1708 women were interviewed regarding campaign exposure, ANC attendance, and individual birth planning. Over one third of interviewed women (35.1%) reported exposure to the campaign in the last month. The more sources from which women reported hearing the Wazazi Nipendeni message, the more they planned for the birth of their child (β = 0.08, p = .001). Greater numbers of types of exposure to the Wazazi Nipendeni message was associated with an increase in ANC visits (β = 0.05, p = .004). Intervention exposure did not significantly predict the timing of the first ANC visit or HIV testing in the adjusted model, however, findings showed that exposure did predict whether women delivered at a health care facility (or not) and whether they tested for HIV with a partner in the unadjusted models. The Wazazi Nipendeni campaign shows promise that such a behavior change communication intervention could lead to better pregnancy and childbirth outcomes for women in low resource settings. For outcomes such as HIV testing, message exposure showed some promising effects, but demographic variables such as age and socioeconomic status

  15. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  16. Developing a system of multi-evaluation of the impact of global climate change on human health in Russia

    Science.gov (United States)

    Granberg, I.; Golitsyn, G.; Istoshin, N.; Efimenko, N.; Alekhin, A.; Rogoza, A.; Povolotskaya, N.; Artamonova, M.; Pogarski, F.

    2009-04-01

    High people sensitivity to weather and space factors, particularly encumbered by various illnesses, was from time immemorial. Now, in terms of global climate change, accompanied by frequent and severe restructuring of atmospheric processes, thermal anomalies, droughts, environmental change through meteorological and heliogeophysical factors affect the human body particularly intense, causing adverse effects to health. There are currently beginning to develop methods for evaluating multifactor of the external environment and prevention of their negative influence on people. For those sensitive to such influences, with adverse weather in response to sudden changes in weather factors pathological of meteopathic reactions may arise. In doing so, even among healthy individuals it is up to 35-45% of meteosensitive. Meteopathic reactions lead to the appearance and progression of pathological disorders, and the associated increase in chronic diseases. In this connection the tasks solution related to assessing the impact of meteorological and climatic variations of different space-time scale on the health of the population of Russia becomes extremely important, especially for the people with cardiovascular disease. This is confirmed by as clinical observations, and the state of vital systems of meteosensitive people. Based on the results of comprehensive research of Pyatigorsk State Research Institute of Curortology (PSRIC), the A. M. Obukhov Institute of Atmospheric Physics of the Russian Academy of Sciences (IAP), and Hydrometeocenter of Russia in the region of Caucasian Mineral Waters (CMW) by scientists of IAP and PSRIC there was established a system of Operational Medical Weather Forecast (OMWF), which aims to have possibility on time to host events for the prevention of meteopathic reactions of people with high meteodependence. Also, we have introduced improved definition of Weather Pathogenicity Index (WPI) for medical weather forecast. As a basis of medical weather

  17. Impact evaluation of "Have Fun - Be Healthy" program: A community based health promotion intervention to prevent childhood obesity.

    Science.gov (United States)

    Pathirana, Thanya; Stoneman, Rebecca; Lamont, Amanda; Harris, Neil; Lee, Patricia

    2018-04-01

    Childhood obesity is rising in prevalence in Australia. This study aimed to evaluate the impact of the "Have Fun-Be Healthy" (HFBH) intervention, delivered in the Playgroup setting, to generate short term changes in dietary, physical activity and sedentary behaviours of children under 5 years and self-efficacy of parents and primary carers. This intervention consisted of eight structured cooking and physical play sessions delivered over a period of 8 weeks by trained facilitators. Pre- and post-intervention data collection was performed using survey questionnaires administered to parents and carers of children under 5 years from low socioeconomic backgrounds recruited through convenience sampling. A total of 640 pre-intervention surveys and 312 post-intervention surveys were returned. The matched response rate was 45.5%. There was an improvement in mean intake of healthy foods and mean physical activity with a decrease in mean intake of unhealthy food and mean screen time in children (P > .05). Following the intervention, parental/carer self-efficacy in promoting healthy eating and limiting screen time of children improved significantly (P < .05). Children's physical activity levels and consumption of healthy foods were positively correlated with parental/carer self-efficacy (P < .01) while screen time and consumption of unhealthy foods were negatively correlated (P < .01). HFBH intervention was successful in improving the dietary, physical activity and screen time in children and parental self-efficacy. SO WHAT?: Being amongst the first of its' kind in Australia, the findings of this study can have implications for developing and implementing similar future health promotion interventions in comparable settings. © 2017 Australian Health Promotion Association.

  18. Modeling of Global BEAM Structure for Evaluation of MMOD Impacts to Support Development of a Health Monitoring System

    Science.gov (United States)

    Lyle, Karen H.; Vassilakos, Gregory J.

    2015-01-01

    This report summarizes the initial modeling of the global response of the Bigelow Expandable Activity Module (BEAM) to micrometeorite and orbital debris(MMOD) impacts using a structural, nonlinear, transient dynamic, finite element code. These models complement the on-orbit deployment of the Distributed Impact Detection System (DIDS) to support structural health monitoring studies. Two global models were developed. The first focused exclusively on impacts on the soft-goods (fabric-envelop) portion of BEAM. The second incorporates the bulkhead to support understanding of bulkhead impacts. These models were exercised for random impact locations and responses monitored at the on-orbit sensor locations. The report concludes with areas for future study.

  19. Introduction to the "Evaluating the Impact of Structural Policies on Health Inequalities and Their Social Determinants and Fostering Change" (SOPHIE) Project.

    Science.gov (United States)

    Borrell, Carme; Malmusi, Davide; Muntaner, Carles

    2017-01-01

    The SOPHIE Project (acronym for Structural Policies for Health Inequalities Evaluation) has focused on evaluating the impact of structural policies on health equity, considering as such all those policies that exert a powerful influence on the structural determinants of health (e.g., patterns of social stratification, living and working conditions) and thus on health-related exposures through intermediary determinants. In these sections of the International Journal of Health Services, we present some of the main findings of the SOPHIE Project. We include both articles that summarize all the evidence already published in the project on a thematic area (such as labor market, gender, or housing) and articles that present new, unpublished evidence on a specific health inequality or policy. © The Author(s) 2016.

  20. Computer-based monitoring and evaluation of epilepsy-related health variables and their impact on treatment decision.

    Science.gov (United States)

    Bergmann, Melanie; Prieschl, Manuela; Walser, Gerald; Luef, Gerhard; Rumpold, Gerhard; Unterberger, Iris

    2018-04-30

    This study aimed to determine the effectiveness of electronic patient-reported outcomes (ePROs) with focus on epilepsy-specific quality of life, psychiatric and psychosocial burden, drug side effects, and patient satisfaction via the Computer-based Health Evaluation System (CHES) and to evaluate their impact on treatment regimen. Forty consecutive patients with drug-resistant focal epilepsy undergoing prolonged video-electroencephalography (EEG) monitoring at the Department of Neurology, Innsbruck Medical University were included and randomized to an intervention group (questionnaire results accessible to the physicians) and a control group (questionnaire results inaccessible to the physicians). Patients had to complete questionnaires on the day of admission (T0) and the day of discharge (T1). Overall, twenty-five patients (25/40, 62.5%) showed abnormal assessment results, twelve of them exclusively due to pathological scores on the Liverpool Adverse Events Profile (LAEP). Mean LAEP score was within the pathological range of 48.8 points (48.8 ± 7.2). The psychosocial burden with respect to the Performance, Socio-Demographic Aspects, Subjective Evaluation (PESOS) scale "fear" (48.7 ± 21.4) was also moderately affected. Moreover, mean anxiety (9.1 ± 4.4) and depression (7.6 ± 4.5) scores were both slightly abnormal. Quality of life (as measured using the Quality of Life Inventory in Epilepsy (QOLIE-31)) was moderately impaired (seizure worry: 46.5 ± 21.3, overall quality of life: 52.6 ± 18.6, well-being: 54.1 ± 16.3, energy-fatigue: 39.4 ± 14.7, cognitive functioning: 41.4 ± 19.5, medication effects: 46.2 ± 23.4, social functioning: 51.1 ± 20.8, and total score: 47.2 ± 12.3). Careful medical history-taking and patient-physician consultations alone failed to detect needs for psychological/psychiatric help in three out of 7 patients in the control group (42.8%). Changes over time in Hospital Anxiety and

  1. Advancing Social Work Education for Health Impact

    Science.gov (United States)

    Keefe, Robert H.; Ruth, Betty J.; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie

    2017-01-01

    Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy. PMID:29236540

  2. River modeling and multi-level fish health assessment to evaluate impacts from oil sands water releases (Part 2)

    International Nuclear Information System (INIS)

    Shaw, R.; Swanson, S.M.; Lagimodiere, M.; Gulley, J.

    1995-01-01

    A multi-level, multi-scale approach was used to assess potential impacts to fish health from oil sands water releases. The method used to arrive at predicted impacts involved assembling experimental data on the effects of chronic exposure to oil sands wastewaters on biochemical, physiological and whole-organism endpoint. This information was used to determine no effect levels (NOELs) and lowest effect levels (LOELs) for the suite of fish health parameters used in laboratory experiments (primarily biochemical and physiological measurement endpoints). LOELs and NOELs were compared to modeled concentrations of wastewater in the Athabasca River for five time snapshots. For each time period, concentrations were predicted based on mean annual flows and 7Q10 flows (low flows). This comparison was used to predict impacts on biochemical/physiological endpoints. Impacts on at the whole-organism and population-level were determined by comparing what the laboratory data would predict with what was observed in the field. This process was used to draw a conclusion regarding the health and sustainability of fish populations

  3. Evaluating impacts of air pollution in China on public health: Implications for future air pollution and energy policies

    Science.gov (United States)

    Wang, Xiaoping; Mauzerall, Denise L.

    Our objective is to establish the link between energy consumption and technologies, air pollution concentrations, and resulting impacts on public health in eastern China. We use Zaozhuang, a city in eastern China heavily dependent on coal, as a case study to quantify the impacts that air pollution in eastern China had on public health in 2000 and the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual (BAU), through the implementation of best available emission control technology (BACT) and advanced coal gasification technologies (ACGT). We use an integrated assessment approach, utilizing state-of-the-science air quality and meteorological models, engineering, epidemiology, and economics, to achieve this objective. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang, using the "willingness-to-pay" metric, was equivalent to 10% of Zaozhuang's GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have more than tripled. With no new air pollution controls implemented between 2000 and 2020 but with projected increases in energy use, we estimate health damages from air pollution exposure to be equivalent to 16% of Zaozhuang's projected 2020 GDP. BACT and ACGT (with only 24% penetration in Zaozhuang and providing 2% of energy needs in three surrounding municipalities) could reduce the potential health damage of air pollution in 2020 to 13% and 8% of projected GDP, respectively. Benefits to public health, of substantial monetary value, can be achieved through the use of BACT; health benefits from the use of ACGT could be even larger. Despite significant uncertainty associated with each element of the integrated assessment approach, we demonstrate that substantial benefits to public health could be achieved in this region of eastern China through the use of additional pollution controls and particularly from the

  4. Health Hazard Evaluations

    Science.gov (United States)

    ... May 1, 2018 Content source: National Institute for Occupational Safety and Health Division of Surveillance, Hazard Evaluation, and Field Studies ... Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 ...

  5. Systematically evaluating the impact of diagnosis-related groups (DRGs) on health care delivery: a matrix of ethical implications.

    Science.gov (United States)

    Fourie, Carina; Biller-Andorno, Nikola; Wild, Verina

    2014-04-01

    Swiss hospitals were required to implement a prospective payment system for reimbursement using a diagnosis-related groups (DRGs) classification system by the beginning of 2012. Reforms to a health care system should be assessed for their impact, including their impact on ethically relevant factors. Over a number of years and in a number of countries, questions have been raised in the literature about the ethical implications of the implementation of DRGs. However, despite this, researchers have not attempted to identify the major ethical issues associated with DRGs systematically. To address this gap in the literature, we have developed a matrix for identifying the ethical implications of the implementation of DRGs. It was developed using a literature review, and empirical studies on DRGs, as well as a review and analysis of existing ethics frameworks. The matrix consists of the ethically relevant parameters of health care systems on which DRGs are likely to have an impact; the ethical values underlying these parameters; and examples of specific research questions associated with DRGs to illustrate how the matrix can be applied. While the matrix has been developed in light of the Swiss health care reform, it could be used as a basis for identifying the ethical implications of DRG-based systems worldwide and for highlighting the ethical implications of other kinds of provider payment systems (PPS). Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Understanding the performance and impact of public knowledge translation funding interventions: protocol for an evaluation of Canadian Institutes of Health Research knowledge translation funding programs.

    Science.gov (United States)

    McLean, Robert K D; Graham, Ian D; Bosompra, Kwadwo; Choudhry, Yumna; Coen, Stephanie E; Macleod, Martha; Manuel, Christopher; McCarthy, Ryan; Mota, Adrian; Peckham, David; Tetroe, Jacqueline M; Tucker, Joanne

    2012-06-22

    The Canadian Institutes of Health Research (CIHR) has defined knowledge translation (KT) as a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products, and strengthen the healthcare system. CIHR, the national health research funding agency in Canada, has undertaken to advance this concept through direct research funding opportunities in KT. Because CIHR is recognized within Canada and internationally for leading and funding the advancement of KT science and practice, it is essential and timely to evaluate this intervention, and specifically, these funding opportunities. The study will employ a novel method of participatory, utilization-focused evaluation inspired by the principles of integrated KT. It will use a mixed methods approach, drawing on both quantitative and qualitative data, and will elicit participation from CIHR funded researchers, knowledge users, KT experts, as well as other health research funding agencies. Lines of inquiry will include an international environmental scan, document/data reviews, in-depth interviews, targeted surveys, case studies, and an expert review panel. The study will investigate how efficiently and effectively the CIHR model of KT funding programs operates, what immediate outcomes these funding mechanisms have produced, and what impact these programs have had on the broader state of health research, health research uptake, and health improvement. The protocol and results of this evaluation will be of interest to those engaged in the theory, practice, and evaluation of KT. The dissemination of the study protocol and results to both practitioners and theorists will help to fill a gap in knowledge in three areas: the role of a public research funding agency in facilitating KT, the outcomes and impacts KT funding interventions, and how KT can best be evaluated.

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

    Science.gov (United States)

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

  8. Exploring perceived barriers, drivers, impacts and the need for evaluation of public involvement in health and social care research: a modified Delphi study

    Science.gov (United States)

    Snape, D; Kirkham, J; Britten, N; Froggatt, K; Gradinger, F; Lobban, F; Popay, Jennie; Wyatt, K; Jacoby, Ann

    2014-01-01

    Objective To explore areas of consensus and conflict in relation to perceived public involvement (PI) barriers and drivers, perceived impacts of PI and ways of evaluating PI approaches in health and social care research. Background Internationally and within the UK the recognition of potential benefits of PI in health and social care research is gathering momentum and PI is increasingly identified by organisations as a prerequisite for funding. However, there is relatively little examination of the impacts of PI and how those impacts might be measured. Design Mixed method, three-phase, modified Delphi technique, conducted as part of a larger MRC multiphase project. Sample Clinical and non-clinical academics, members of the public, research managers, commissioners and funders. Findings This study found high levels of consensus about the most important barriers and drivers to PI. There was acknowledgement that tokenism was common in relation to PI; and strong support for the view that demonstrating the impacts and value of PI was made more difficult by tokenistic practice. PI was seen as having intrinsic value; nonetheless, there was clear support for the importance of evaluating its impact. Research team cohesion and appropriate resources were considered essential to effective PI implementation. Panellists agreed that PI can be challenging, but can be facilitated by clear guidance, together with models of good practice and measurable standards. Conclusions This study is the first to present empirical evidence of the opinions voiced by key stakeholders on areas of consensus and conflict in relation to perceived PI barriers and drivers, perceived impacts of PI and the need to evaluate PI. As such it further contributes to debate around best practice in PI, the potential for tokenism and how best to evaluate the impacts of PI. These findings have been used in the development of the Public Involvement Impact Assessment Framework (PiiAF), an online resource which offers

  9. Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation.

    Science.gov (United States)

    Basinga, Paulin; Gertler, Paul J; Binagwaho, Agnes; Soucat, Agnes L B; Sturdy, Jennifer; Vermeersch, Christel M J

    2011-04-23

    the greatest effect on those services that had the highest payment rates and needed the least effort from the service provider. P4P financial performance incentives can improve both the use and quality of maternal and child health services, and could be a useful intervention to accelerate progress towards Millennium Development Goals for maternal and child health. World Bank's Bank-Netherlands Partnership Program and Spanish Impact Evaluation Fund, the British Economic and Social Research Council, Government of Rwanda, and Global Development Network. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Evaluation of the impact of the 2012 Rhode Island health care worker influenza vaccination regulations: implementation process and vaccination coverage.

    Science.gov (United States)

    Kim, Hanna; Lindley, Megan C; Dube, Donna; Kalayil, Elizabeth J; Paiva, Kristi A; Raymond, Patricia

    2015-01-01

    In October 2012, the Rhode Island Department of Health (HEALTH) amended its health care worker (HCW) vaccination regulations to require all HCWs to receive annual influenza vaccination or wear a surgical mask during direct patient contact when influenza is widespread. Unvaccinated HCWs failing to wear a mask are subject to a fine and disciplinary action. To describe the implementation of the 2012 Rhode Island HCW influenza vaccination regulations and examine their impact on vaccination coverage. Two data sources were used: (1) a survey of all health care facilities subject to the HCW regulations and (2) HCW influenza vaccination coverage data reported to HEALTH by health care facilities. Descriptive statistics and paired t tests were performed using SAS Release 9.2. For the 2012-2013 influenza season, 271 inpatient and outpatient health care facilities in Rhode Island were subject to the HCW regulations. Increase in HCW influenza vaccination coverage. Of the 271 facilities, 117 facilities completed the survey (43.2%) and 160 facilities reported vaccination data to HEALTH (59.0%). Between the 2011-2012 and 2012-2013 influenza seasons, the proportion of facilities having a masking policy, as required by the revised regulations, increased from 9.4% to 94.0% (P employee HCWs in Rhode Island increased from 69.7% in the 2011-2012 influenza season to 87.2% in the 2012-2013 season. Rhode Island's experience demonstrates that statewide HCW influenza vaccination requirements incorporating mask wearing and moderate penalties for noncompliance can be effective in improving influenza vaccination coverage among HCWs.

  11. Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya.

    Science.gov (United States)

    Warren, Charlotte; Abuya, Timothy; Obare, Francis; Sunday, Joseph; Njue, Rebecca; Askew, Ian; Bellows, Ben

    2011-03-23

    Alternatives to the traditional 'supply-side' approach to financing service delivery are being explored. These strategies are termed results-based finance, demand-side health financing or output-based aid which includes a range of interventions that channel government or donor subsidies to the user rather than the provider. Initial pilot assessments of reproductive health voucher programs suggest that, they can increase access and use, reducing inequities and enhancing program efficiency and service quality. However, there is a paucity of evidence describing how the programs function in different settings, for various reproductive health services. Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the 'voucher and accreditation' approaches to improving the reproductive health of low income women in Kenya. A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level; and assessing the effect of vouchers on increasing access to, and quality of, and reducing inequities in the use of selected reproductive health services. The study comprises of four populations: facilities, providers, women of reproductive health age using facilities and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in samples of health facilities - public, private and faith-based in: three districts; Kisumu, Kiambu, Kitui and two informal settlements in Nairobi which are accredited to provide maternal and newborn health and family planning services to women holding vouchers for the services; and compared with a matched sample of non-accredited facilities. Health facility assessments (HFA) will be conducted at two stages to track temporal changes in quality of care and utilization. Facility inventories, structured observations, and

  12. The Teachers of Quality Academy: Evaluation of the Effectiveness and Impact of a Health Systems Science Training Program.

    Science.gov (United States)

    Walsh, Danielle S; Lazorick, Suzanne; Lawson, Luan; Lake, Donna; Garrison, Herbert G; Higginson, Jason; Vos, Paul; Baxley, Elizabeth

    2018-05-01

    This project aimed to evaluate the effectiveness of a faculty development program in health systems science (HSS)-the Teachers of Quality Academy (TQA). Participants in TQA and a comparison group were evaluated before, during, and 1 year after the program using self-perception questionnaires, tests of HSS knowledge, and tracking of academic productivity and career advancement. Among program completers (n = 27), the mean self-assessed ratings of knowledge and skills of HSS topics immediately after the program, as compared to baseline, increased significantly compared to controls (n = 30). Participants demonstrated progressive improvement of self-perceived skills and attitudes, and retention of HSS knowledge, from baseline to completion of the program. Participants also demonstrated substantially higher HSS scholarly productivity, leadership, and career advancement compared to the comparison group. The TQA effectively created a faculty cadre able to role model, teach, and create a curriculum in HSS competencies for medical students, resident physicians, and other health professionals.

  13. Evaluating the Intersections of Socioeconomic Status and Health Impacts from Exposure to Air Pollution in Bogotá, Colombia

    Science.gov (United States)

    Baublitz, C. B.; Henderson, B. H.; Pachon, J. E.; Galvis, B. R.

    2014-12-01

    Colombia has strict economic divisions, which may be represented by six strata assigned by the National Planning Department. These are assigned by housing conditions and are arranged such that the divisions with subpar living conditions (strata levels one through three) may receive support from those with better than acceptable living conditions (strata levels five and six). Notably, division three no longer receives aid, and division four neither contributes to this system nor receives support. About ten percent of the population is in the upper three strata, while the remaining populace experiences subpar living conditions. Bogotá, DC has poor air quality that sometimes puts sensitive populations at risk due to particulate matter (PM). The local environmental agency has developed seven strategies to reduce air pollution, predominantly by regulating fixed and mobile sources, for the promotion of public health. Preliminary mapping of results indicates there may be higher concentrations of pollutants in areas whose residents are of a lower socioeconomic status (SES). Because it's more difficult for impoverished people to miss work or afford healthcare, higher exposure could have more significance for the city's overall health burden. The aim of this project is to determine the effective impactful regulatory strategy for the benefit of public health as a result of emission reductions. This will be done by using CMAQ results and BenMAP with information for long-term relative risk estimates for PM to find premature mortality rates per source type and location, segregated by strata division. A statistical regression will define the correspondence between health impact and SES. The benefit per reduction will be given in premature mortalities avoided per ton of PM emissions reduced per source type. For each of seven proposed regulatory strategies, this project provides results in mortalities avoided per ton of emissions of PM reduced per source type. It also compares

  14. Can wastewater-based epidemiology be used to evaluate the health impact of temperature? - An exploratory study in an Australian population.

    Science.gov (United States)

    Phung, Dung; Mueller, Jochen; Lai, Foon Yin; O'Brien, Jake; Dang, Nhung; Morawska, Lidia; Thai, Phong K

    2017-07-01

    Ambient temperature is known to have impact on population health but assessing its impact by the traditional cohort approach is resource intensive. Wastewater-based epidemiology (WBE) could be an alternative for the traditional approach. This study was to provide the first evaluation to see if WBE can be used to assess the impact of temperature exposure to a population in South East Queensland, Australia using selected pharmaceuticals and personal care products (PPCPs) as biomarkers. Daily loads of eight PPCPs in wastewater collected from a wastewater treatment plant were measured from February 2011 to June 2012. Corresponding daily weather data were obtained from the closest weather station. Missing data of PPCPs were handled using the multiple imputation (MI) method, then we used a one-way between-groups analysis of variance to examine the seasonal effect on daily variation of PPCPs by seasons. Finally, an MI estimate was performed to evaluate the continuous relationship between daily average temperature and each multiply-imputed PPCP using time-series regression analysis. The results indicated that an increase of 1°C in average temperature associated with decrease at 1.3g/d (95% CI: -2.2 to (-0.4), pmethod to traditional cohort studies in epidemiological evaluation of the association between environmental factors and health outcomes provided that specific biomarkers of such health outcomes can be identified. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

    Science.gov (United States)

    Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

    2014-10-11

    Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

  16. A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products.

    Science.gov (United States)

    Levy, David T; Cummings, K Michael; Villanti, Andrea C; Niaura, Ray; Abrams, David B; Fong, Geoffrey T; Borland, Ron

    2017-01-01

    The use of vaporized nicotine products (VNPs), especially e-cigarettes and, to a lesser extent, pressurized aerosol nicotine products and heat-not-burn tobacco products, are being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Considerable controversy has accompanied their marketing and use. We propose a framework that describes and incorporates patterns of VNP and combustible cigarette use in determining the total amount of toxic exposure effects on population health. We begin by considering toxicity and the outcomes relevant to population health. We then present the framework and define different measures of VNP use; namely, trial and long-term use for exclusive cigarette smokers, exclusive VNP and dual (cigarette and VNP) use. Using a systems thinking framework and decision theory we considered potential pathways for current, former and never users of VNPs. We then consider the evidence to date and the probable impacts of VNP use on public health, the potential effects of different policy approaches and the possible influence of the tobacco industry on VNP and cigarette use. © 2016 Society for the Study of Addiction.

  17. The impact of NHS based primary care complementary therapy services on health outcomes and NHS costs: a review of service audits and evaluations

    Directory of Open Access Journals (Sweden)

    Wye Lesley

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.

  18. Columbia River impact evaluation plan

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    As a result of past practices, four areas of the Hanford Site (the 100, 200, 300, and 1100 Areas) have been included on the US Environmental Protection Agency`s (EPA`s) National Priorities List (NPL) under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980. To accomplish the timely cleanup of the past-practice units, the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement), was signed by the Washington State Department of Ecology (Ecology), EPA, and the US Department of Energy (DOE). To support the Tri-Party Agreement, milestones were adopted. These milestones represent the actions needed to ensure acceptable progress toward Hanford Site compliance with CERCLA, RCRA, and the Washington State Hazardous Waste Management Act of 1976. This report was prepared to fulfill the requirement of Tri-Party Agreement Milestone M-30-02, which requires a plan to determine cumulative health and environmental impacts to the Columbia River. This plan supplements the CERCLA remedial investigations/feasibility studies (RI/FS) and RCRA facility investigations/corrective measures studies (RFI/CMSs) that will be undertaken in the 100 Area. To support the plan development process, existing information was reviewed and a preliminary impact evaluation based on this information was performed. The purpose of the preliminary impact evaluation was to assess the adequacy of existing data and proposed data collection activities. Based on the results of the evaluation, a plan is proposed to collect additional data or make changes to existing or proposed data collection activities.

  19. Modeling PM10 in Ho Chi Minh City, Vietnam and evaluation of its impact on human health

    Directory of Open Access Journals (Sweden)

    Bang Quoc Ho

    2017-03-01

    Full Text Available According to World Health Organization (WHO and Global Burden of Disease, ambient air pollution is estimated to be responsible for 3.7 million premature deaths in 2012 [1]. Therefore, it is urgent to estimate the impact of air pollution on public health and economic damage. The objectives of this research are: study the distribution of PM10 concentration over Ho Chi Minh city (HCMC and relationship to public health and for proposing solutions of diseases prevention in HCM, Vietnam. EMIssion SENSitivity model was applied to conduct air emission inventory for transportation sector. Then, Finite Volume Model and Transport and Photochemistry Mesoscale Model were used to simulate the meteorology and the spatial distribution of PM10 in HCMC. Together with disease data obtained, the US Environmental Benefits Mapping and Analysis Model was applied for calculating the number of deaths and estimating economic losses due to PM10 pollution. Finally, solutions to reduce PM10 pollution and protect public health are proposed. The results showed that the highest 1-h average concentration of PM10 is 240 μg m−3 in North Eastern of HCMC. The concentration of PM10 for annual average in District 5 ranged from 17 to 49 μg m−3. There are 12 wards of District 5 with PM10 concentration exceeding the WHO guidelines (20 μg m−3 for annual average of PM10 and 50 μg m−3 for 24-h average. The high concentration of PM10 causes 5 deaths yr−1 in District 5 and 204 deaths yr−1 in HCMC, and it causes economic losses of 1.84 billion of USD.

  20. Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France.

    Science.gov (United States)

    Hiligsmann, M; Burlet, N; Fardellone, P; Al-Daghri, N; Reginster, J-Y

    2017-03-01

    The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years. This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years. We estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60-69, 70-79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case. The total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years. Vitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years.

  1. Creating supportive nutrition environments for population health impact and health equity: an overview of the Nutrition and Obesity Policy Research and Evaluation Network's efforts.

    Science.gov (United States)

    Blanck, Heidi M; Kim, Sonia A

    2012-09-01

    Childhood obesity is a major threat to individual health and society overall. Policies that support healthier food and beverage choices have been endorsed by many decision makers. These policies may reach a large proportion of the population or in some circumstances aim to reduce nutrition disparities to ensure health equity. The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) evaluates policy as a tool to improve food and beverage environments where Americans live, work, play, and learn. The network aspires to address research and evaluation gaps related to relevant policies, create standardized research tools, and help build the evidence base of effective policy solutions for childhood obesity prevention with a focus on reach, equity, cost effectiveness, and sustainability. Published by Elsevier Inc.

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

    Science.gov (United States)

    Alzarea, Bader K

    2016-04-01

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

  3. The impact of Cochrane Reviews: a mixed-methods evaluation of outputs from Cochrane Review Groups supported by the National Institute for Health Research.

    Science.gov (United States)

    Bunn, Frances; Trivedi, Daksha; Alderson, Phil; Hamilton, Laura; Martin, Alice; Pinkney, Emma; Iliffe, Steve

    2015-04-01

    The last few decades have seen a growing emphasis on evidence-informed decision-making in health care. Systematic reviews, such as those produced by Cochrane, have been a key component of this movement. The National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs) in the UK and it is important that this funding represents value for money. The overall aim was to identify the impacts and likely impacts on health care, patient outcomes and value for money of Cochrane Reviews published by 20 NIHR-funded CRGs during the years 2007-11. We sent questionnaires to CRGs and review authors, undertook interviews with guideline developers (GDs) and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane Reviews. The evaluation was guided by a framework with four categories (knowledge production, research targeting, informing policy development and impact on practice/services). A total of 3187 new and updated reviews were published on the Cochrane Database of Systematic Reviews between 2007 and 2011, 1502 (47%) of which were produced by the 20 CRGs funded by the NIHR. We found 40 examples where reviews appeared to have influenced primary research and reviews had contributed to the creation of new knowledge and stimulated debate. Twenty-seven of the 60 reviews had 100 or more citations in Google Scholar™ (Google, CA, USA). Overall, 483 systematic reviews had been cited in 247 sets of guidance. This included 62 sets of international guidance, 175 sets of national guidance (87 from the UK) and 10 examples of local guidance. Evidence from the interviews suggested that Cochrane Reviews often play an instrumental role in informing guidance, although reviews being a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and GDs were barriers to their use. Cochrane Reviews appeared to have led

  4. Study protocol for a longitudinal study evaluating the impact of rape on women's health and their use of health services in South Africa.

    Science.gov (United States)

    Abrahams, Naeemah; Seedat, Soraya; Lombard, Carl; Kengne, Andre P; Myers, Bronwyn; Sewnath, Alesha; Mhlongo, Shibe; Ramjee, Gita; Peer, Nasheeta; Garcia-Moreno, Claudia; Jewkes, Rachel

    2017-09-29

    South Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care. This longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied. The South African Medical Research Council's Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  5. Revisiting policy on chronic HCV treatment under the Thai Universal Health Coverage: An economic evaluation and budget impact analysis.

    Science.gov (United States)

    Rattanavipapong, Waranya; Anothaisintawee, Thunyarat; Teerawattananon, Yot

    2018-01-01

    Thailand is encountering challenges to introduce the high-cost sofosbuvir for chronic hepatitis C treatment as part of the Universal Health Care's benefit package. This study was conducted in respond to policy demand from the Thai government to assess the value for money and budget impact of introducing sofosbuvir-based regimens in the tax-based health insurance scheme. The Markov model was constructed to assess costs and benefits of the four treatment options that include: (i) current practice-peginterferon alfa (PEG) and ribavirin (RBV) for 24 weeks in genotype 3 and 48 weeks for other genotypes; (ii) Sofosbuvir plus peginterferon alfa and ribavirin (SOF+PEG-RBV) for 12 weeks; (iii) Sofosbuvir and daclatasvir (SOF+DCV) for 12 weeks; (iv) Sofosbuvir and ledipasvir (SOF+LDV) for 12 weeks for non-3 genotypes and SOF+PEG-RBV for 12 weeks for genotype 3 infection. Given that policy options (ii) and (iii) are for pan-genotypic infection, the cost of genotype testing was applied only for policy options (i) and (iv). Results reveal that all sofosbuvir-based regimens had greater quality adjusted life years (QALY) gains compared with the current treatment, therefore associated with lower lifetime costs and more favourable health outcomes. Additionally, among the three regimens of sofosbuvir, SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype are the most cost-effective treatment option with the threshold of 160,000 THB per QALY gained. The results of this study had been used in policy discussion which resulted in the recent inclusion of SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype in the Thailand's benefit package.

  6. Assessment of the health impact of an environmental pollution and quantitative assessment of health risks; Estimation de l'impact sanitaire d'une pollution environnementale et evaluation quantitative des risques sanitaires

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-09-15

    The report made by a working group is written for experts in health risk assessment or for professionals involved in risk management. It proposes a methodological and conceptual framework which could build a unified approach to a quantitative assessment of health risks. In the first part, under the form of questions and answers, it defines the health impact, describes how to assess the excess of individual risk and the related hypothesis, how to pass from the excess of individual risk to the health impact, how to express the results of an health impact calculation, how to take the lack of knowledge into account at the different steps of this calculation, what is the significance of the result of such a calculation, and how useful an health impact assessment can be. The second part proposes a more detailed presentation of the scientific background for the health impact calculation with its indicators, its uncertainties, its practice in other countries, its relevance, and its fields of application. Then, after a comment of the dose-response relationship, it reports the scientific validity of the assessment of a number of cases.

  7. Exogenous factors matter when interpreting the results of an impact evaluation: a case study of rainfall and child health programme intervention in Rwanda.

    Science.gov (United States)

    Mukabutera, Assumpta; Thomson, Dana R; Hedt-Gauthier, Bethany L; Atwood, Sidney; Basinga, Paulin; Nyirazinyoye, Laetitia; Savage, Kevin P; Habimana, Marcellin; Murray, Megan

    2017-12-01

    Public health interventions are often implemented at large scale, and their evaluation seems to be difficult because they are usually multiple and their pathways to effect are complex and subject to modification by contextual factors. We assessed whether controlling for rainfall-related variables altered estimates of the efficacy of a health programme in rural Rwanda and have a quantifiable effect on an intervention evaluation outcomes. We conducted a retrospective quasi-experimental study using previously collected cross-sectional data from the 2005 and 2010 Rwanda Demographic and Health Surveys (DHS), 2010 DHS oversampled data, monthly rainfall data collected from meteorological stations over the same period, and modelled output of long-term rainfall averages, soil moisture, and rain water run-off. Difference-in-difference models were used. Rainfall factors confounded the PIH intervention impact evaluation. When we adjusted our estimates of programme effect by controlling for a variety of rainfall variables, several effectiveness estimates changed by 10% or more. The analyses that did not adjust for rainfall-related variables underestimated the intervention effect on the prevalence of ARI by 14.3%, fever by 52.4% and stunting by 10.2%. Conversely, the unadjusted analysis overestimated the intervention's effect on diarrhoea by 56.5% and wasting by 80%. Rainfall-related patterns have a quantifiable effect on programme evaluation results and highlighted the importance and complexity of controlling for contextual factors in quasi-experimental design evaluations. © 2017 John Wiley & Sons Ltd.

  8. Methodological and Design Considerations in Evaluating the Impact of Prevention Programs on Violence and Related Health Outcomes.

    Science.gov (United States)

    Massetti, Greta M; Simon, Thomas R; Smith, Deborah Gorman

    2016-10-01

    Drawing on research that has identified specific predictors and trajectories of risk for violence and related negative outcomes, a multitude of small- and large-scale preventive interventions for specific risk behaviors have been developed, implemented, and evaluated. One of the principal challenges of these approaches is that a number of separate problem-specific programs targeting different risk areas have emerged. However, as many negative health behaviors such as substance abuse and violence share a multitude of risk factors, many programs target identical risk factors. There are opportunities to understand whether evidence-based programs can be leveraged for potential effects across a spectrum of outcomes and over time. Some recent work has documented longitudinal effects of evidence-based interventions on generalized outcomes. This work has potential for advancing our understanding of the effectiveness of promising and evidence-based prevention strategies. However, conducting longitudinal follow-up of established interventions presents a number of methodological and design challenges. To answer some of these questions, the Centers for Disease Control and Prevention convened a panel of multidisciplinary experts to discuss opportunities to take advantage of evaluations of early prevention programs and evaluating multiple long-term outcomes. This special section of the journal Prevention Science includes a series of papers that begin to address the relevant considerations for conducting longitudinal follow-up evaluation research. This collection of papers is intended to inform our understanding of the challenges and strategies for conducting longitudinal follow-up evaluation research that could be used to drive future research endeavors.

  9. Health impact assessment in Korea

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  10. Gender equality in couples and self-rated health - A survey study evaluating measurements of gender equality and its impact on health.

    Science.gov (United States)

    Sörlin, Ann; Lindholm, Lars; Ng, Nawi; Ohman, Ann

    2011-08-26

    Men and women have different patterns of health. These differences between the sexes present a challenge to the field of public health. The question why women experience more health problems than men despite their longevity has been discussed extensively, with both social and biological theories being offered as plausible explanations. In this article, we focus on how gender equality in a partnership might be associated with the respondents' perceptions of health. This study was a cross-sectional survey with 1400 respondents. We measured gender equality using two different measures: 1) a self-reported gender equality index, and 2) a self-perceived gender equality question. The aim of comparison of the self-reported gender equality index with the self-perceived gender equality question was to reveal possible disagreements between the normative discourse on gender equality and daily practice in couple relationships. We then evaluated the association with health, measured as self-rated health (SRH). With SRH dichotomized into 'good' and 'poor', logistic regression was used to assess factors associated with the outcome. For the comparison between the self-reported gender equality index and self-perceived gender equality, kappa statistics were used. Associations between gender equality and health found in this study vary with the type of gender equality measurement. Overall, we found little agreement between the self-reported gender equality index and self-perceived gender equality. Further, the patterns of agreement between self-perceived and self-reported gender equality were quite different for men and women: men perceived greater gender equality than they reported in the index, while women perceived less gender equality than they reported. The associations to health were depending on gender equality measurement used. Men and women perceive and report gender equality differently. This means that it is necessary not only to be conscious of the methods and measurements

  11. Framework for Evaluating the Health Impact of the Scale-Up of Malaria Control Interventions on All-Cause Child Mortality in Sub-Saharan Africa

    Science.gov (United States)

    Yé, Yazoume; Eisele, Thomas P.; Eckert, Erin; Korenromp, Eline; Shah, Jui A.; Hershey, Christine L.; Ivanovich, Elizabeth; Newby, Holly; Carvajal-Velez, Liliana; Lynch, Michael; Komatsu, Ryuichi; Cibulskis, Richard E.; Moore, Zhuzhi; Bhattarai, Achuyt

    2017-01-01

    Abstract. Concerted efforts from national and international partners have scaled up malaria control interventions, including insecticide-treated nets, indoor residual spraying, diagnostics, prompt and effective treatment of malaria cases, and intermittent preventive treatment during pregnancy in sub-Saharan Africa (SSA). This scale-up warrants an assessment of its health impact to guide future efforts and investments; however, measuring malaria-specific mortality and the overall impact of malaria control interventions remains challenging. In 2007, Roll Back Malaria's Monitoring and Evaluation Reference Group proposed a theoretical framework for evaluating the impact of full-coverage malaria control interventions on morbidity and mortality in high-burden SSA countries. Recently, several evaluations have contributed new ideas and lessons to strengthen this plausibility design. This paper harnesses that new evaluation experience to expand the framework, with additional features, such as stratification, to examine subgroups most likely to experience improvement if control programs are working; the use of a national platform framework; and analysis of complete birth histories from national household surveys. The refined framework has shown that, despite persisting data challenges, combining multiple sources of data, considering potential contributions from both fundamental and proximate contextual factors, and conducting subnational analyses allows identification of the plausible contributions of malaria control interventions on malaria morbidity and mortality. PMID:28990923

  12. Mice housed on coal dust-contaminated sand: A model to evaluate the impacts of coal mining on health.

    Science.gov (United States)

    Caballero-Gallardo, Karina; Olivero-Verbel, Jesus

    2016-03-01

    Coal dust is the most important air pollutant in coal mining in regards to producing deleterious health effects. It permeates the surrounding environment threatening public health. The aim of this study was to evaluate the toxic effects associated with exposure to sand contaminated with coal dust particles below 38 μm in diameter, obtained from a mineral sample collected in the largest coal mine in South America, La Loma, Cesar, Colombia. Sterilized sand was spiked with coal dust to obtain concentrations ranging from zero to 4% coal dust. To model natural exposure, mice were housed for eight weeks in boxes containing this mixture as bedding after which, they were euthanized and blood and tissue samples were collected. Real time PCR analysis revealed an increase in Cyp1A1 mRNA for living on sand with coal dust concentrations greater than 2% compared to mice living on sand without coal dust. Unexpectedly, for mice on coal dust-polluted sand, Sod1, Scd1 and Nqo1 hepatic mRNA were downregulated. The Comet assay in peripheral blood cells and the micronucleus test in blood smears, showed a significant potential genotoxic effect only at the highest coal dust concentration. Histopathological analysis revealed vascular congestion and peribronchial inflammation in the lungs. A dose-response relationship for the presence of hepatic steatosis, vacuolization and nuclei enlargements was observed in the exposed animals. The data suggest living on a soil polluted with coal dust induces molecular, cellular and histopathological changes in mice. Accordingly, the proposed model can be used to identify deleterious effects of exposure to coal dust deposited in soils that may pose health risks for surrounding wildlife populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The positive impact of interprofessional education: a controlled trial to evaluate a programme for health professional students.

    Science.gov (United States)

    Darlow, Ben; Coleman, Karen; McKinlay, Eileen; Donovan, Sarah; Beckingsale, Louise; Gray, Ben; Neser, Hazel; Perry, Meredith; Stanley, James; Pullon, Sue

    2015-06-04

    Collaborative interprofessional practice is an important means of providing effective care to people with complex health problems. Interprofessional education (IPE) is assumed to enhance interprofessional practice despite challenges to demonstrate its efficacy. This study evaluated whether an IPE programme changed students' attitudes to interprofessional teams and interprofessional learning, students' self-reported effectiveness as a team member, and students' perceived ability to manage long-term conditions. A prospective controlled trial evaluated an eleven-hour IPE programme focused on long-term conditions' management. Pre-registration students from the disciplines of dietetics (n = 9), medicine (n = 36), physiotherapy (n = 12), and radiation therapy (n = 26) were allocated to either an intervention group (n = 41) who received the IPE program or a control group (n = 42) who continued with their usual discipline specific curriculum. Outcome measures were the Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning Scale (RIPLS), the Team Skills Scale (TSS), and the Long-Term Condition Management Scale (LTCMS). Analysis of covariance compared mean post-intervention scale scores adjusted for baseline scores. Mean post-intervention attitude scores (all on a five-point scale) were significantly higher in the intervention group than the control group for all scales. The mean difference for the ATHCTS was 0.17 (95 %CI 0.05 to 0.30; p = 0.006), for the RIPLS was 0.30 (95 %CI 0.16 to 0.43; p < 0.001), for the TSS was 0.71 (95 %CI 0.49 to 0.92; p < 0.001), and for the LTCMS was 0.75 (95 %CI 0.56 to 0.94; p < 0.001). The mean effect of the intervention was similar for students from the two larger disciplinary sub-groups of medicine and radiation therapy. An eleven-hour IPE programme resulted in improved attitudes towards interprofessional teams and interprofessional learning, as well as self

  14. Health impacts of large dams

    International Nuclear Information System (INIS)

    Lerer, L.B.

    1999-01-01

    Large dams have been criticized because of their negative environmental and social impacts. Public health interest largely has focused on vector-borne diseases, such as schistosomiasis, associated with reservoirs and irrigation projects. Large dams also influence health through changes in water and food security, increases in communicable diseases, and the social disruption caused by construction and involuntary resettlement. Communities living in close proximity to large dams often do not benefit from water transfer and electricity generation revenues. A comprehensive health component is required in environmental and social impact assessments for large dam projects

  15. Evaluating the Impact of an Accountable Care Organization on Population Health: The Quasi-Experimental Design of the German Gesundes Kinzigtal.

    Science.gov (United States)

    Pimperl, Alexander; Schulte, Timo; Mühlbacher, Axel; Rosenmöller, Magdalena; Busse, Reinhard; Groene, Oliver; Rodriguez, Hector P; Hildebrandt, Helmut

    2017-06-01

    A central goal of accountable care organizations (ACOs) is to improve the health of their accountable population. No evidence currently links ACO development to improved population health. A major challenge to establishing the evidence base for the impact of ACOs on population health is the absence of a theoretically grounded, robust, operationally feasible, and meaningful research design. The authors present an evaluation study design, provide an empirical example, and discuss considerations for generating the evidence base for ACO implementation. A quasi-experimental study design using propensity score matching in combination with small-scale exact matching is implemented. Outcome indicators based on claims data were constructed and analyzed. Population health is measured by using a range of mortality indicators: mortality ratio, age at time of death, years of potential life lost/gained, and survival time. The application is assessed using longitudinal data from Gesundes Kinzigtal, one of the leading population-based ACOs in Germany. The proposed matching approach resulted in a balanced control of observable differences between the intervention (ACO) and control groups. The mortality indicators used indicate positive results. For example, 635.6 fewer years of potential life lost (2005.8 vs. 2641.4; t-test: sig. P < 0.05*) in the ACO intervention group (n = 5411) attributable to the ACO, also after controlling for a potential (indirect) immortal time bias by excluding the first half year after enrollment from the outcome measurement. This empirical example of the impact of a German ACO on population health can be extended to the evaluation of ACOs and other integrated delivery models of care.

  16. Impacts on human health

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2016-11-01

    Full Text Available .12 Noise pathway exposures 12-33 12.12.1 Worker 12-33 12.12.2 Community 12-34 12.13 Direct physical contact (traffic or machine injury) 12-34 12.13.1 Worker 12-34 12.13.2 Community 12-34 12.14 Dermal exposure to chemicals 12-34 12.14.1 Worker 12..., with air, water, noise, direct contact resulting from traffic or machine injuries, and dermal contact were considered. These were considered separately for workers and community members. The four scenarios were found to yield health risks as ranging from...

  17. Mice housed on coal dust-contaminated sand: A model to evaluate the impacts of coal mining on health

    Energy Technology Data Exchange (ETDEWEB)

    Caballero-Gallardo, Karina, E-mail: kcaballerog@unicartagena.edu.co; Olivero-Verbel, Jesus, E-mail: joliverov@unicartagena.edu.co

    2016-03-01

    Coal dust is the most important air pollutant in coal mining in regards to producing deleterious health effects. It permeates the surrounding environment threatening public health. The aim of this study was to evaluate the toxic effects associated with exposure to sand contaminated with coal dust particles below 38 μm in diameter, obtained from a mineral sample collected in the largest coal mine in South America, La Loma, Cesar, Colombia. Sterilized sand was spiked with coal dust to obtain concentrations ranging from zero to 4% coal dust. To model natural exposure, mice were housed for eight weeks in boxes containing this mixture as bedding after which, they were euthanized and blood and tissue samples were collected. Real time PCR analysis revealed an increase in Cyp1A1 mRNA for living on sand with coal dust concentrations greater than 2% compared to mice living on sand without coal dust. Unexpectedly, for mice on coal dust-polluted sand, Sod1, Scd1 and Nqo1 hepatic mRNA were downregulated. The Comet assay in peripheral blood cells and the micronucleus test in blood smears, showed a significant potential genotoxic effect only at the highest coal dust concentration. Histopathological analysis revealed vascular congestion and peribronchial inflammation in the lungs. A dose–response relationship for the presence of hepatic steatosis, vacuolization and nuclei enlargements was observed in the exposed animals. The data suggest living on a soil polluted with coal dust induces molecular, cellular and histopathological changes in mice. Accordingly, the proposed model can be used to identify deleterious effects of exposure to coal dust deposited in soils that may pose health risks for surrounding wildlife populations. - Highlights: • Mice were exposed to coal dust-contaminated sand. • mRNA Markers for PAH exposure, lipid metabolism and oxidative stress increased. • ALT activity in plasma increased at the highest exposure to coal dust. • Liver tissues of exposed

  18. Public health interventions: evaluating the economic evaluations

    Directory of Open Access Journals (Sweden)

    Martin Forster

    2013-10-01

    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  19. Does Implementation Follow Design? A Case Study of a Workplace Health Promotion Program Using the 4-S Program Design and the PIPE Impact Metric Evaluation Models.

    Science.gov (United States)

    Äikäs, Antti Hermanni; Pronk, Nicolaas P; Hirvensalo, Mirja Hannele; Absetz, Pilvikki

    2017-08-01

    The aim of this study was to describe the content of a multiyear market-based workplace health promotion (WHP) program and to evaluate design and implementation processes in a real-world setting. Data was collected from the databases of the employer and the service provider. It was classified using the 4-S (Size, Scope, Scalability, and Sustainability) and PIPE Impact Metric (Penetration, Implementation) models. Data analysis utilized both qualitative and quantitative methods. Program design covered well the evidence-informed best practices except for clear path toward sustainability, cooperation with occupational health care, and support from middle-management supervisors. The penetration rate among participants was high (99%) and majority (81%) of services were implemented as designed. Study findings indicate that WHP market would benefit the use of evidence-based design principles and tendentious decisions to anticipate a long-term implementation process already during the planning phase.

  20. Quality of Life of Patients Treated With Implant-Supported Mandibular Overdentures Evaluated With the Oral Health Impact Profile (OHIP-14: a Survey of 58 Patients

    Directory of Open Access Journals (Sweden)

    Ritva Kuoppala

    2013-06-01

    Full Text Available Objectives: The purpose of this study was to evaluate the oral health-related quality of life of patients treated with implant-supported mandibular overdentures and to compare the attachment systems used.Material and Methods: Altogether 112 patients treated with implant-supported mandibular overdentures in 1985 - 2004 were invited to the follow-up; 58 of them attended and replied to the Oral Health Impact Profile (OHIP-14 -questionnaire. There were 48 overdentures with a bar connection and 10 with a ball connection, the total number of implants installed and still in use was 197. The mean follow-up time was 13.7 years. The associations between the OHIP-14 variables and the patient’s age, gender as well as the number of implants supporting the overdenture and the type of attachment used were assessed.Results: The results showed that patients with implant-supported mandibular overdentures were satisfied with their oral health-related quality of life (OHRQoL. Older patients were more satisfied than younger ones in both genders. Neither the implant connection type nor the number of supporting implants seemed to have a significant influence on the OHRQoL.Conclusions: Especially older patients with mandibular implant-supported overdentures were satisfied with their oral health-related quality of life. Attachment type or the number of supporting implants did not have a significant influence on the oral health-related quality of life.

  1. An Evaluation of the Implementation and Impact of England's Mandated School-Based Mental Health Initiative in Elementary Schools

    Science.gov (United States)

    Wolpert, Miranda; Humphrey, Neil; Deighton, Jessica; Patalay, Praveetha; Fugard, Andrew J. B.; Fonagy, Peter; Belsky, Jay; Vostanis, Panos

    2015-01-01

    We report on a randomized controlled trial of Targeted Mental Health in Schools (TaMHS), which is a nationally mandated school-based mental health program in England. TaMHS aimed to improve mental health for students with, or at risk of, behavioral and emotional difficulties by providing evidence-informed interventions relating to closer working…

  2. [Evaluation of continuous education: from the satisfaction to the impact. With regard to a formative programme in minor surgery in a health area].

    Science.gov (United States)

    Martín Fernández, J; Martínez Marcos, M; Ferrándiz Santos, J

    2001-04-30

    To compare the evaluation of reaction of an activity of continuous education (CE) in minor surgery (MS), with the impact in the realization of MS in a health area. Observational cross-sectional study. Setting. 27 centers in a health area that offer MS between their services. The valuation was studied in a scale from 1 to 10, of 9 theoretical-practical activities of CE in MS and the consideration of its utility. The number of activities of MS (NMS) carried out in all the units, was picked up during one year, and a model of lineal regression was built. The independent variable was the NMS, and the explanatory ones the assistance pressure (AP), the postgraduate formation (PF), the staff of the unit, the equipment (E), and the carried out CE. The valuation of the CE had a median of 8 (with interquartile range 1), 85.1% of the people who realized CE in MS said that this would be of utility. However in the explanatory regression model the PF was the only significant variable (beta = 6.7; 95% CI, 0.12-12.22). Neither the CE, nor the AP, nor the E, explained the variability among the NMS. The CE in MS with conventional methodology has a very positive reaction evaluation, but its impact in the later realization of MS is not significant.

  3. Computerized evaluation of flood impact

    International Nuclear Information System (INIS)

    Gagnon, J.; Quach, T.T.; Marche, C.; Lessard, G.

    1998-01-01

    A computerized evaluation process for assessing the economic impacts of a potential dam failure is described. The DOMINO software, which was developed by Hydro-Quebec, takes into account flow data from dam break simulations of floods, the territory involved, plus the economic evaluations of the real estate and infrastructures affected. Some examples of software applications and impact evaluations are presented. The principal elements involved in estimating economic or other types of impacts induced by natural flooding or dam failure, are: (1) flow forecasting, (2) defining the contour of the involved territory, and (3) accounting for the various impacts identified in the affected zone. Owing to its wide range of functions and utilities, DOMINO has proven to be a very useful, user-friendly and portable decision-making tool. 5 refs., 6 tabs

  4. Impacts of globalization in health.

    Science.gov (United States)

    Ioannou, Andriani; Mechili, Aggelos; Kolokathi, Aikaterini; Diomidous, Marianna

    2013-01-01

    Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Globalization describes the interplay of macro-social forces across cultures. The purpose of this study is a systematic review of the bibliography on the impacts of globalization in health. The consequences of globalization on health present a twofold dimension, on the one hand affects the health of the population and on the other hand organization and functioning of health systems. As a result of globalization, there has been an undeniable economic development and technological progress to support the level of health around the world, improving the health status of certain populations with a beneficial increase in life expectancy. In many aspects globalization is good but there are many problems too.

  5. Explaining the impact of a women's group led community mobilisation intervention on maternal and newborn health outcomes: the Ekjut trial process evaluation

    Directory of Open Access Journals (Sweden)

    Sinha Rajesh

    2010-10-01

    Full Text Available Abstract Background Few large and rigorous evaluations of participatory interventions systematically describe their context and implementation, or attempt to explain the mechanisms behind their impact. This study reports process evaluation data from the Ekjut cluster-randomised controlled trial of a participatory learning and action cycle with women's groups to improve maternal and newborn health outcomes in Jharkhand and Orissa, eastern India (2005-2008. The study demonstrated a 45% reduction in neonatal mortality in the last two years of the intervention, largely driven by improvements in safe practices for home deliveries. Methods A participatory learning and action cycle with 244 women's groups was implemented in 18 intervention clusters covering an estimated population of 114 141. We describe the context, content, and implementation of this intervention, identify potential mechanisms behind its impact, and report challenges experienced in the field. Methods included a review of intervention documents, qualitative structured discussions with group members and non-group members, meeting observations, as well as descriptive statistical analysis of data on meeting attendance, activities, and characteristics of group attendees. Results Six broad, interrelated factors influenced the intervention's impact: (1 acceptability; (2 a participatory approach to the development of knowledge, skills and 'critical consciousness'; (3 community involvement beyond the groups; (4 a focus on marginalized communities; (5 the active recruitment of newly pregnant women into groups; (6 high population coverage. We hypothesize that these factors were responsible for the increase in safe delivery and care practices that led to the reduction in neonatal mortality demonstrated in the Ekjut trial. Conclusions Participatory interventions with community groups can influence maternal and child health outcomes if key intervention characteristics are preserved and tailored to

  6. Evaluation of a Sexual and Reproductive Health Education ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Faculty of Health, Sports and Social Work, Research Centre Mental Health Nursing, Inholland ... Evaluation research concerning the impact of sexual and reproductive health (SRH) ..... awareness of the existence of HIV, pregnancy and.

  7. Evaluation of the Impact of an Innovative Immunization Practice Model Designed to Improve Population Health: Results of the Project IMPACT Immunizations Pilot.

    Science.gov (United States)

    Bluml, Benjamin M; Brock, Kelly A; Hamstra, Scott; Tonrey, Lisa

    2018-02-01

    The goal of the initiative was to evaluate the impact of an innovative practice model on identification of unmet vaccination needs and vaccination rates. This was accomplished through a prospective, multisite, observational study in 8 community pharmacy practices with adults receiving an influenza vaccine with a documented vaccination forecast review from October 22, 2015 through March 22, 2016. When patients presented for influenza vaccinations, pharmacists utilized immunization information systems (IIS) data at the point of care to identify unmet vaccination needs, educate patients, and improve vaccination rates. The main outcome measures were the number of vaccination forecast reviews, patients educated, unmet vaccination needs identified and resolved, and vaccines administered. Pharmacists reviewed vaccination forecasts generated by clinical decision-support technology based on patient information documented in the IIS for 1080 patients receiving influenza vaccinations. The vaccination forecasts predicted there were 1566 additional vaccinations due at the time patients were receiving the influenza vaccine. Pharmacist assessments identified 36 contraindications and 196 potential duplications, leaving a net of 1334 unmet vaccination needs eligible for vaccination. In all, 447 of the 1334 unmet vaccinations needs were resolved during the 6-month study period, and the remainder of patients received information about their vaccination needs and recommendations to follow up for their vaccinations. Integration of streamlined principle-centered processes of care in immunization practices that allow pharmacists to utilize actionable point-of-care data resulted in identification of unmet vaccination needs, education of patients about their vaccination needs, a 41.4% increase in the number of vaccines administered, and significant improvements in routinely recommended adult vaccination rates.

  8. Modeling of Local BEAM Structure for Evaluation of MMOD Impacts to Support Development of a Health Monitoring System

    Science.gov (United States)

    Lyle, Karen H.; Vassilakos, Gregory J.

    2015-01-01

    This report summarizes initial modeling of the local response of the Bigelow Expandable Activity Module (BEAM) to micrometeorite and orbital debris (MMOD) impacts using a structural, non-linear, transient dynamic finite element code. Complementary test results for a local BEAM structure are presented for both hammer and projectile impacts. Review of these data provided guidance for the transient dynamic model development. The local model is intended to support predictions using the global BEAM model, described in a companion report. Two types of local models were developed. One mimics the simplified Soft-Goods (fabric envelop) part of the BEAM NASTRAN model delivered by the project. The second investigates through-the-thickness modeling challenges for MMOD-type impacts. Both the testing and the analysis summaries contain lessons learned and areas for future efforts.

  9. Evaluating the impact of method bias in health behaviour research: a meta-analytic examination of studies utilising the theories of reasoned action and planned behaviour.

    Science.gov (United States)

    McDermott, Máirtín S; Sharma, Rajeev

    2017-12-01

    The methods employed to measure behaviour in research testing the theories of reasoned action/planned behaviour (TRA/TPB) within the context of health behaviours have the potential to significantly bias findings. One bias yet to be examined in that literature is that due to common method variance (CMV). CMV introduces a variance in scores attributable to the method used to measure a construct, rather than the construct it represents. The primary aim of this study was to evaluate the impact of method bias on the associations of health behaviours with TRA/TPB variables. Data were sourced from four meta-analyses (177 studies). The method used to measure behaviour for each effect size was coded for susceptibility to bias. The moderating impact of method type was assessed using meta-regression. Method type significantly moderated the associations of intentions, attitudes and social norms with behaviour, but not that between perceived behavioural control and behaviour. The magnitude of the moderating effect of method type appeared consistent between cross-sectional and prospective studies, but varied across behaviours. The current findings strongly suggest that method bias significantly inflates associations in TRA/TPB research, and poses a potentially serious validity threat to the cumulative findings reported in that field.

  10. Impact evaluation of infrastructure interventions

    DEFF Research Database (Denmark)

    Hansen, Henrik; Andersen, Ole Winckler; White, Howard

    2011-01-01

    in this volume. Understanding impact means understanding the context in which an intervention takes place and the channels through which the impact on outcomes is expected to occur. Such analysis typically requires mixing both quantitative and qualitative approaches. The analysis will also anticipate......The focus on results in development agencies has led to increased focus on impact evaluation to demonstrate the effectiveness of development programmes. A range of methods are available for counterfactual analysis of infrastructure interventions, as illustrated by the variety of papers...

  11. Development of Psychosocial Scales for Evaluating the Impact of a Culinary Nutrition Education Program on Cooking and Healthful Eating

    Science.gov (United States)

    Condrasky, Margaret D.; Williams, Joel E.; Catalano, Patricia Michaud; Griffin, Sara F.

    2011-01-01

    Objective: Develop scales to assess the impact of the "Cooking with a Chef" program on several psychosocial constructs. Methods: Cross-sectional design in which parents and caregivers were recruited from child care settings (Head Start, faith-based, public elementary schools), and cooks were recruited from church and school kitchens. Analysis…

  12. The impact of inter-organizational alignment (IOA) on implementation outcomes: evaluating unique and shared organizational influences in education sector mental health.

    Science.gov (United States)

    Lyon, Aaron R; Whitaker, Kelly; Locke, Jill; Cook, Clayton R; King, Kevin M; Duong, Mylien; Davis, Chayna; Weist, Mark D; Ehrhart, Mark G; Aarons, Gregory A

    2018-02-07

    Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise. This study's aims examine the impact of overlapping organizational contexts by evaluating the implementation contexts of externally employed mental health clinicians working in schools-the most common integrated service delivery setting for children and adolescents. Aim 1 is to estimate the effects of unique intra-organizational implementation contexts and combined inter-organizational alignment on implementation outcomes. Aim 2 is to examine the underlying mechanisms through which inter-organizational alignment facilitates or hinders EBP implementation. This study will conduct sequential, exploratory mixed-methods research to evaluate the intra- and inter-organizational implementation contexts of schools and the external community-based organizations that most often employ school-based mental health clinicians, as they relate to mental health EBP implementation. Aim 1 will involve quantitative surveys with school-based, externally-employed mental health clinicians, their supervisors, and proximal school-employed staff (total n = 120 participants) to estimate the effects of each organization's general and implementation-specific organizational factors (e.g., climate, leadership) on implementation outcomes (fidelity, acceptability, appropriateness) and assess the moderating role of the degree of clinician embeddedness in the school setting. Aim 2 will explore the mechanisms

  13. Evaluating the Impact of the Medical Education Partnership Initiative at the University of Zimbabwe College of Health Sciences Using the Most Significant Change Technique.

    Science.gov (United States)

    Connors, Susan C; Nyaude, Shemiah; Challender, Amelia; Aagaard, Eva; Velez, Christine; Hakim, James

    2017-09-01

    In medical education, evaluating outcomes from programs intended to transform attitudes or influence career trajectories using conventional methods of monitoring is often difficult. To address this problem, the authors adapted the most significant change (MSC) technique to gain a more comprehensive understanding of the impact of the Medical Education Partnership Initiative (MEPI) program at the University of Zimbabwe College of Health Sciences. In 2014-2015, the authors applied the MSC to systematically examine the personal significance and level of positive transformation that individuals attributed to their MEPI participation. Interviews were conducted with 28 participants nominated by program leaders. The authors coded results inductively for prevalent themes in participants' stories and prepared profiles with representative quotes to place the stories in context. Stakeholders selected 9 themes and 18 stories to illustrate the most significant changes. Six themes (or outcomes) were expected, as they aligned with MEPI goals-becoming a better teacher, becoming a better clinician, increased interest in teaching, increased interest in research, new career pathways (including commitment to practice in Zimbabwe), and improved research skills. Three themes were unexpected-increased confidence, expanded interprofessional networks, and improved interpersonal interactions. The authors found the MSC to be a useful and systematic evaluation approach for large, complex, and transformative initiatives like MEPI. The MSC seemed to encourage participant reflection, support values inquiry by program leaders, and provide insights into the personal and cultural impacts of MEPI. Additional trial applications of the MSC technique in academic medicine are warranted.

  14. Evaluation of means used to access the impacts of energy production on human health. LASL third life sciences symposium, Los Alamos, New Mexico, October 15--17, 1975

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, E.C.; Sullivan, E.M. (eds.)

    1976-01-01

    The symposium explored the various techniques and methods available to study the potential effects that various energy-producing industries may have on human health. Three papers presented at Session I dealt with national energy needs, resources, and future developments; responsibilities and capabilities in ERDA as related to the health and environmental impacts of energy productions; and health hazards associated with alternate energy sources. Four papers presented at Session II reviewed standards setting for the worker and for the public; the radiation experience; and developing health policies and standards as the responsibility of the scientist. Eight papers in Sessions III and IV, Sources of Information, dealt with developing a health standard from epidemiological and clinical data and from laboratory animal data; carcinogenesis, mutagenesis, teratogenesis, and behavior changes as end points in health impact assessments; new methods and approaches to health impact assessment; problems in sampling for health impact; and the application of scientific data to worker/workplace health decision making. Two papers at Session V covered bases for the application of scientific data to health standards and health and environmental standards from a legal viewpoint. A final discussion, Room for Controversy, was conducted by four panelists. (MCW)

  15. Evaluation of the impact of air pollution on health La evaluación del impacto en salud de la contaminación atmosférica

    Directory of Open Access Journals (Sweden)

    Ferrán Ballester Díez

    2003-12-01

    Full Text Available In recent years, an important number of studies, carried out in different cities, have found that, even bellow air quality levels considered as safe, increases in the levels of air pollution are associated with harmful effects on health. Epidemiology has played a major role in the evaluation of the impact of air pollution on health, since it provides proofs of the association among human populations within natural conditions. Also, toxicology and clinical sciences provide convincing proofs on the etiopathogenic mechanisms of such associations.The purpose of the evaluation of impact on health is to quantify the expected number of people whose health is affected due to a specific exposure situation. In Europe, since three years ago, the APHEIS project, with 26 participating cities, has established an environmental health surveillance system which includes a database of air pollution and health. This is aimed at quantifying the effects of air pollution on public health at local, national and European levels, as well as distributing standardised reports about air pollution impact on public health.En los últimos años un número importante de estudios realizados en distintas ciudades han encontrado que, aún por debajo de los niveles de calidad del aire considerados como seguros, los incrementos de los niveles de la contaminación atmosférica se asocian con efectos nocivos sobre la salud. La epidemiología ha jugado un papel crucial en la evaluación de impacto en salud de la contaminación atmosférica al proporcionar pruebas de la asociación en poblaciones humanas en condiciones naturales. Por su parte la toxicología y las ciencias clínicas aportan pruebas convincentes acerca de los mecanismos etiopatogénicos de dichas asociaciones.El propósito de la evaluación de impacto en salud es cuantificar el número esperado de personas con un efecto en salud que puede ser atribuido a una situación específica de exposición. En Europa, desde hace

  16. Probabilistic Risk Assessment: Impact of Human Factors on Nondestructive Evaluation and Sensor Degradation on Structural Health Monitoring (Preprint)

    National Research Council Canada - National Science Library

    Aldrin, John C; Medina, Enrique A; Allwine, Daniel A; Qadeer Ahmed, Mohammed; Fisher, Joseph; Knopp, Jeremy S; Lindgren, Eric A

    2006-01-01

    .... Quantitative studies are presented evaluating the effects of variations in probability of detection associated with human factors, plus in-situ sensor degradation on life cycle measures such as cost...

  17. Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

    International Nuclear Information System (INIS)

    Buck, J.W.; Gelston, G.M.; Farris, W.T.

    1995-09-01

    The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values

  18. Application of ERICA index to evaluation of soil ecosystem health according to sustainability threshold for industry impact

    DEFF Research Database (Denmark)

    Boriani, Elena; Badermo, Diego; Benfenatti, Emilio

    2013-01-01

    as safe for the environment following impact assessment. In this work we have added new indicators and scoring systems to be used in particular with attention for the soil compartment. Even though it partly starts to be considered by some legislations, there is still an open debate to assess if a compound...... added to a certain scenario will increase risk for human beings and the environment. The prolonged environmental occurrence introduces uncertainty regarding the presence and properties of degradation products and cumulative effects from multiple substances present in the environment. Tools capable...... lead to awareness by industries of minimizing the environmental impact of the whole production chain. In the present study we show how the instrument ERICA may work addressing multiple sources of exposure. An improved version of ERICA and in particular its parameter EF (fate and transport of chemical...

  19. Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and Latinos with Diabetes

    Directory of Open Access Journals (Sweden)

    Gerber Ben S

    2012-10-01

    Full Text Available Abstract Background Given the increasing prevalence of diabetes and the lack of patients reaching recommended therapeutic goals, novel models of team-based care are emerging. These teams typically include a combination of physicians, nurses, case managers, pharmacists, and community-based peer health promoters (HPs. Recent evidence supports the role of pharmacists in diabetes management to improve glycemic control, as they offer expertise in medication management with the ability to collaboratively intensify therapy. However, few studies of pharmacy-based models of care have focused on low income, minority populations that are most in need of intervention. Alternatively, HP interventions have focused largely upon low income minority groups, addressing their unique psychosocial and environmental challenges in diabetes self-care. This study will evaluate the impact of HPs as a complement to pharmacist management in a randomized controlled trial. Methods/Design The primary aim of this randomized trial is to evaluate the effectiveness of clinical pharmacists and HPs on diabetes behaviors (including healthy eating, physical activity, and medication adherence, hemoglobin A1c, blood pressure, and LDL-cholesterol levels. A total of 300 minority patients with uncontrolled diabetes from the University of Illinois Medical Center ambulatory network in Chicago will be randomized to either pharmacist management alone, or pharmacist management plus HP support. After one year, the pharmacist-only group will be intensified by the addition of HP support and maintenance will be assessed by phasing out HP support from the pharmacist plus HP group (crossover design. Outcomes will be evaluated at baseline, 6, 12, and 24 months. In addition, program and healthcare utilization data will be incorporated into cost and cost-effectiveness evaluations of pharmacist management with and without HP support. Discussion The study will evaluate an innovative, integrated

  20. Using Colony Monitoring Devices to Evaluate the Impacts of Land Use and Nutritional Value of Forage on Honey Bee Health

    Directory of Open Access Journals (Sweden)

    Matthew Smart

    2017-12-01

    Full Text Available Colony monitoring devices used to track and assess the health status of honey bees are becoming more widely available and used by both beekeepers and researchers. These devices monitor parameters relevant to colony health at frequent intervals, often approximating real time. The fine-scale record of hive condition can be further related to static or dynamic features of the landscape, such as weather, climate, colony density, land use, pesticide use, vegetation class, and forage quality. In this study, we fit commercial honey bee colonies in two apiaries with pollen traps and digital scales to monitor floral resource use, pollen quality, and honey production. One apiary was situated in low-intensity agriculture; the other in high-intensity agriculture. Pollen traps were open for 72 h every two weeks while scales recorded weight every 15 min throughout the growing season. From collected pollen, we determined forage quantity per day, species identity using DNA sequencing, pesticide residues, amino acid content, and total protein content. From scales, we determined the accumulated hive weight change over the growing season, relating to honey production and final colony weight going into winter. Hive scales may also be used to identify the occurrence of environmental pollen and nectar dearth, and track phenological changes in plant communities. We provide comparisons of device-derived data between two apiaries over the growing season and discuss the potential for employing apiary monitoring devices to infer colony health in the context of divergent agricultural land use conditions.

  1. Using colony monitoring devices to evaluate the impacts of land use and nutritional value of forage on honey bee health

    Science.gov (United States)

    Smart, Matthew; Otto, Clint R.; Cornman, Robert S.; Iwanowicz, Deborah

    2018-01-01

    Colony monitoring devices used to track and assess the health status of honey bees are becoming more widely available and used by both beekeepers and researchers. These devices monitor parameters relevant to colony health at frequent intervals, often approximating real time. The fine-scale record of hive condition can be further related to static or dynamic features of the landscape, such as weather, climate, colony density, land use, pesticide use, vegetation class, and forage quality. In this study, we fit commercial honey bee colonies in two apiaries with pollen traps and digital scales to monitor floral resource use, pollen quality, and honey production. One apiary was situated in low-intensity agriculture; the other in high-intensity agriculture. Pollen traps were open for 72 h every two weeks while scales recorded weight every 15 min throughout the growing season. From collected pollen, we determined forage quantity per day, species identity using DNA sequencing, pesticide residues, amino acid content, and total protein content. From scales, we determined the accumulated hive weight change over the growing season, relating to honey production and final colony weight going into winter. Hive scales may also be used to identify the occurrence of environmental pollen and nectar dearth, and track phenological changes in plant communities. We provide comparisons of device-derived data between two apiaries over the growing season and discuss the potential for employing apiary monitoring devices to infer colony health in the context of divergent agricultural land use conditions.

  2. Health Impacts of Environmental Mycobacteria†

    OpenAIRE

    Primm, Todd P.; Lucero, Christie A.; Falkinham, Joseph O.

    2004-01-01

    Environmental mycobacteria are emerging pathogens causing opportunistic infections in humans and animals. The health impacts of human-mycobacterial interactions are complex and likely much broader than currently recognized. Environmental mycobacteria preferentially survive chlorination in municipal water, using it as a vector to infect humans. Widespread chlorination of water has likely selected more resistant environmental mycobacteria species and potentially explains the shift from M. scrof...

  3. Health-oriented electronic oral health record: development and evaluation.

    Science.gov (United States)

    Wongsapai, Mansuang; Suebnukarn, Siriwan; Rajchagool, Sunsanee; Beach, Daryl; Kawaguchi, Sachiko

    2014-06-01

    This study aims to develop and evaluate a new Health-oriented Electronic Oral Health Record that implements the health-oriented status and intervention index. The index takes the principles of holistic oral healthcare and applies them to the design and implementation of the Health-oriented Electronic Oral Health Record. We designed an experiment using focus groups and a consensus (Delphi process) method to develop a new health-oriented status and intervention index and graphical user interface. A comparative intervention study with qualitative and quantitative methods was used to compare an existing Electronic Oral Health Record to the Health-oriented Electronic Oral Health Record, focusing on dentist satisfaction, accuracy, and completeness of oral health status recording. The study was conducted by the dental staff of the Inter-country Center for Oral Health collaborative hospitals in Thailand. Overall, the user satisfaction questionnaire had a positive response to the Health-oriented Electronic Oral Health Record. The dentists found it easy to use and were generally satisfied with the impact on their work, oral health services, and surveillance. The dentists were significantly satisfied with the Health-oriented Electronic Oral Health Record compared to the existing Electronic Oral Health Record (p health information recorded using the Health-oriented Electronic Oral Health Record were 97.15 and 93.74 percent, respectively. This research concludes that the Health-oriented Electronic Oral Health Record satisfied many dentists, provided benefits to holistic oral healthcare, and facilitated the planning, managing, and evaluation of the healthcare delivery system.

  4. Health economic evaluation: important principles and methodology.

    Science.gov (United States)

    Rudmik, Luke; Drummond, Michael

    2013-06-01

    To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Lessons learned from evaluating Maryland's anti-drunk driving campaign: assessing the evidence for cognitive, behavioral, and public health impact.

    Science.gov (United States)

    Beck, Kenneth H

    2009-07-01

    The evidence concerning Maryland's anti-drunk driving program, Checkpoint Strikeforce, is reviewed. To date, there is no evidence to indicate that this campaign, which involves a number of sobriety checkpoints and media activities to promote these efforts, has had any impact on public perceptions, driver behaviors, or alcohol-related motor vehicle crashes and injuries. This conclusion is drawn after examining statistics for alcohol-related crashes, police citations for impaired driving, and public perceptions of alcohol-impaired driving risk. Comparisons are also made with other states in the mid-Atlantic region, where similar campaign activities have occurred. Reasons for this failure in Maryland include insufficient levels of enforcement (e.g., too few sobriety checkpoints and vehicle contacts occurred to raise public perceptions of risk pertaining to impaired driving) and inadequate publicity surrounding this campaign. Suggestions for overcoming these problems are offered.

  6. Perceived Impact of Health Sector Reform on Motivation of Health ...

    African Journals Online (AJOL)

    Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care in Tanzania: the Perspectives of Healthcare Workers and District Council Health Managers in Four Districts.

  7. Health Economic Evaluation of Telehealthcare

    DEFF Research Database (Denmark)

    Udsen, Flemming Witt

    for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...

  8. An adequacy evaluation of a maternal health intervention in rural Honduras: the impact of engagement of men and empowerment of women.

    Science.gov (United States)

    Berti, Peter R; Sohani, Salim; Costa, Edith da; Klaas, Naomi; Amendola, Luis; Duron, Joel

    2015-02-01

    To determine the impact that a 6-year maternal and child health project in rural Honduras had on maternal health services and outcomes, and to test the effect of level of father involvement on maternal health. This was a program evaluation conducted through representative household surveys administered at baseline in 2007 and endline in 2011 using 30 cluster samples randomly-selected from the 229 participating communities. Within each cluster, 10 households having at least one mother-child pair were randomly selected to complete a questionnaire, for a total of about 300 respondents answering close to 100 questions each. Changes in key outcome variables from baseline to endline were tested using logistic regression, controlling for mother's education and father's involvement. There were improvements in most maternal health indicators, including an increase in women attending prenatal checkups (84% to 92%, P = 0.05) and institutional births (44% to 63%, P = 0.002). However, the involvement of the fathers decreased as reflected by the percentage of fathers accompanying mothers to prenatal checkups (48% to 41%, P = 0.01); the fathers' reported interest in prenatal care (74% to 52%, P = 0.0001); and fathers attending the birth (66% to 54%, P = 0.05). There was an interaction between the fathers' scores and the maternal outcomes, with a larger increase in institutional births among mothers with the least-involved fathers. Rather than the father's involvement being key, changes in the mothers may have led to increased institutional births. The project may have empowered women through early identification of pregnancy and stronger social connections encouraged by home visits and pregnancy clubs. This would have enabled even the women with unsupportive fathers to make healthier choices and achieve higher rates of institutional births.

  9. An adequacy evaluation of a maternal health intervention in rural Honduras: the impact of engagement of men and empowerment of women

    Directory of Open Access Journals (Sweden)

    Peter R. Berti

    2015-02-01

    Full Text Available Objective. To determine the impact that a 6-year maternal and child health project in rural Honduras had on maternal health services and outcomes, and to test the effect of level of father involvement on maternal health. Methods. This was a program evaluation conducted through representative household surveys administered at baseline in 2007 and endline in 2011 using 30 cluster samples randomly-selected from the 229 participating communities. Within each cluster, 10 households having at least one mother-child pair were randomly selected to complete a questionnaire, for a total of about 300 respondents answering close to 100 questions each. Changes in key outcome variables from baseline to endline were tested using logistic regression, controlling for mother's education and father's involvement. Results. There were improvements in most maternal health indicators, including an increase in women attending prenatal checkups (84% to 92%, P = 0.05 and institutional births (44% to 63%, P = 0.002. However, the involvement of the fathers decreased as reflected by the percentage of fathers accompanying mothers to prenatal checkups (48% to 41%, P = 0.01; the fathers' reported interest in prenatal care (74% to 52%, P = 0.0001; and fathers attending the birth (66% to 54%, P = 0.05. There was an interaction between the fathers' scores and the maternal outcomes, with a larger increase in institutional births among mothers with the least-involved fathers. Conclusions. Rather than the father's involvement being key, changes in the mothers may have led to increased institutional births. The project may have empowered women through early identification of pregnancy and stronger social connections encouraged by home visits and pregnancy clubs. This would have enabled even the women with unsupportive fathers to make healthier choices and achieve higher rates of institutional births.

  10. Re-evaluating the health of coral reef communities: baselines and evidence for human impacts across the central Pacific.

    Science.gov (United States)

    Smith, Jennifer E; Brainard, Rusty; Carter, Amanda; Grillo, Saray; Edwards, Clinton; Harris, Jill; Lewis, Levi; Obura, David; Rohwer, Forest; Sala, Enric; Vroom, Peter S; Sandin, Stuart

    2016-01-13

    Numerous studies have documented declines in the abundance of reef-building corals over the last several decades and in some but not all cases, phase shifts to dominance by macroalgae have occurred. These assessments, however, often ignore the remainder of the benthos and thus provide limited information on the present-day structure and function of coral reef communities. Here, using an unprecedentedly large dataset collected within the last 10 years across 56 islands spanning five archipelagos in the central Pacific, we examine how benthic reef communities differ in the presence and absence of human populations. Using islands as replicates, we examine whether benthic community structure is associated with human habitation within and among archipelagos and across latitude. While there was no evidence for coral to macroalgal phase shifts across our dataset we did find that the majority of reefs on inhabited islands were dominated by fleshy non-reef-building organisms (turf algae, fleshy macroalgae and non-calcifying invertebrates). By contrast, benthic communities from uninhabited islands were more variable but in general supported more calcifiers and active reef builders (stony corals and crustose coralline algae). Our results suggest that cumulative human impacts across the central Pacific may be causing a reduction in the abundance of reef builders resulting in island scale phase shifts to dominance by fleshy organisms. © 2016 The Author(s).

  11. Coffee: biochemistry and potential impact on health.

    Science.gov (United States)

    Ludwig, Iziar A; Clifford, Michael N; Lean, Michael E J; Ashihara, Hiroshi; Crozier, Alan

    2014-08-01

    This review provides details on the phytochemicals in green coffee beans and the changes that occur during roasting. Key compounds in the coffee beverage, produced from the ground, roasted beans, are volatile constituents responsible for the unique aroma, the alkaloids caffeine and trigonelline, chlorogenic acids, the diterpenes cafestol and kahweol, and melanoidins, which are Maillard reaction products. The fate of these compounds in the body following consumption of coffee is discussed along with evidence of the mechanisms by which they may impact on health. Finally, epidemiological findings linking coffee consumption to potential health benefits including prevention of several chronic and degenerative diseases, such as cancer, cardiovascular disorders, diabetes, and Parkinson's disease, are evaluated.

  12. Influence of updating global emission inventory of black carbon on evaluation of the climate and health impact

    Science.gov (United States)

    Wang, Rong; Tao, Shu; Balkanski, Yves; Ciais, Philippe

    2013-04-01

    Black carbon (BC) is an air component of particular concern in terms of air quality and climate change. Black carbon emissions are often estimated based on the fuel data and emission factors. However, large variations in emission factors reported in the literature have led to a high uncertainty in previous inventories. Here, we develop a new global 0.1°×0.1° BC emission inventory for 2007 with full uncertainty analysis based on updated source and emission factor databases. Two versions of LMDz-OR-INCA models, named as INCA and INCA-zA, are run to evaluate the new emission inventory. INCA is built up based on a regular grid system with a resolution of 1.27° in latitude and 2.50° in longitude, while INCA-zA is specially zoomed to 0.51°×0.66° (latitude×longitude) in Asia. By checking against field observations, we compare our inventory with ACCMIP, which is used by IPCC in the 5th assessment report, and also evaluate the influence of model resolutions. With the newly calculated BC air concentrations and the nested model, we estimate the direct radiative forcing of BC and the premature death and mortality rate induced by BC exposure with Asia emphasized. Global BC direct radiative forcing at TOA is estimated to be 0.41 W/m2 (0.2 - 0.8 as inter-quartile range), which is 17% higher than that derived from the inventory adopted by IPCC-AR5 (0.34 W/m2). The estimated premature deaths induced by inhalation exposure to anthropogenic BC (0.36 million in 2007) and the percentage of high risk population are higher than those previously estimated. Ninety percents of the global total anthropogenic PD occur in Asia with 0.18 and 0.08 million deaths in China and India, respectively.

  13. Constructive eHealth evaluation

    DEFF Research Database (Denmark)

    Høstgaard, Anna Marie Balling; Bertelsen, Pernille Scholdan; Nøhr, Christian

    2017-01-01

    Abstract Background: Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using...... traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process...... by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented...

  14. First outline and baseline data of a randomized, controlled multicenter trial to evaluate the health economic impact of home telemonitoring in chronic heart failure - CardioBBEAT.

    Science.gov (United States)

    Hofmann, Reiner; Völler, Heinz; Nagels, Klaus; Bindl, Dominik; Vettorazzi, Eik; Dittmar, Ronny; Wohlgemuth, Walter; Neumann, Till; Störk, Stefan; Bruder, Oliver; Wegscheider, Karl; Nagel, Eckhard; Fleck, Eckart

    2015-08-11

    Evidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Between January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva®). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups' difference in total cost and in the combined clinical endpoint "days alive and not in hospital nor inpatient care per potential days in study" within the follow-up of 12 months. A total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III-IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances. CardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic

  15. Evaluation of the oxidative status in Oreochromis niloticus fed with tuna by-product meal: possible human health impact.

    Science.gov (United States)

    Saїdi, Saber Abdelkader; Azaza, Mohamed Salah; van Pelt, Jos; El Feki, Abdelfattah

    2014-10-01

    The influence of tuna by-product meal (TBM) diets on the activities of antioxidant enzymes in the muscles, gill and kidney of tilapia was evaluated. The control diet (A0) used fish meal (FM) as the sole source of animal protein and the other three diets (A10-A30), 33%-100% of FM was substituted by TBM at 10% increments. The cytotoxicity of liver and muscles cytosol extracts in human liver cell HepG2 was undertaken. The activities of glutathione S-transferase, superoxide dismutase, catalase and TBARS values in the kidney of fish fed with diet A30 were significantly different (p<0.05) and no alterations were observed in muscle and gill anti-oxidant activities. Our study has confirmed that the cytosol extract does not exhibit cytotoxic effects on the HepG2 cells. These results indicate that the use of TBM as a total replacement for FM into tilapia diets seems to have oxidative stress, thus generating effect on fish metabolism.

  16. Cardinal scales for health evaluation

    DEFF Research Database (Denmark)

    Harvey, Charles; Østerdal, Lars Peter Raahave

    2010-01-01

    Policy studies often evaluate health for an individual or for a population by using measurement scales that are ordinal scales or expected-utility scales. This paper develops scales of a different type, commonly called cardinal scales, that measure changes in health. Also, we argue that cardinal...... scales provide a meaningful and useful means of evaluating health policies. Thus, we develop a means of using the perspective of early neoclassical welfare economics as an alternative to ordinalist and expected-utility perspectives....

  17. A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

    Science.gov (United States)

    McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

    2015-12-01

    It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Evaluating Health Information

    Science.gov (United States)

    Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. How can ... the site have an editorial board? Is the information reviewed before it is posted? Be skeptical. Things ...

  19. What is Health Impact Assessment?

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2010-12-01

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

  20. Evaluating Environmental, Health and Safety Impacts from Two Nuclear Fuel Cycles: A Comparative Analysis of Once-Through Uranium Use and Plutonium Recycle in Light Water Reactors

    Science.gov (United States)

    Smith, Bethan L.

    The work presented in this dissertation represents a systems-level approach to investigate potential net impacts with respect to human health and the environment associated with transitioning to the MOC for the U.S. In Chapter 2, an updated systems-level conceptual model of the OTC is presented to more accurately portray the OTC as currently implemented in the U.S. The conceptual model is the basis for estimating the worker collective doses at each operational stage, and the first demonstration of a quantitative comparative radiological impact assessment from expected normal operations is presented. In the course of evaluating worker collective dose associated with modern OTC practices, it was found that the relative contributions from the two grouped operations (front-end operations for preparing reactor fuel and reactor operations) were substantially different from historical data and conventional wisdom. As a bookend to Chapter 2, a summary is provided that describes the nature of the differences and factors that led to these differences. Detailed information of the work as part of the published journal article based off of this corollary work is included as an Appendix (C). In Chapter 3, the study of worker collective doses from the phased introduction of reprocessing in the MOC scenario, and is presented similarly to the results in Chapter 2. MOC performance was also estimated by evaluating the radioactive waste generated that can be disposed and managed through known disposal practices in shallow-land burial. Relative to the OTC, MOC performance with respect to worker collective dose was not discernibly different; while the volume of radioactive waste generated decreased. It was found that although the sheer volume of radioactive waste avoided is large, the waste disposition pathway is known for the majority of this waste. The radioactive waste that requires disposal at a licensed off-site facility is examined in closer detail. The verification process for

  1. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

    Directory of Open Access Journals (Sweden)

    Fiifi Amoako Johnson

    Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  2. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

    Science.gov (United States)

    Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Matthews, Zoe; Harfoot, Andrew J P; Nyarko, Philomena; Baschieri, Angela; Gething, Peter W; Falkingham, Jane; Atkinson, Peter M

    2015-01-01

    The Community-based Health Planning and Services (CHPS) initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas. Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km. Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  3. Smoking cessation treatment and outcomes patterns simulation: a new framework for evaluating the potential health and economic impact of smoking cessation interventions.

    Science.gov (United States)

    Getsios, Denis; Marton, Jenő P; Revankar, Nikhil; Ward, Alexandra J; Willke, Richard J; Rublee, Dale; Ishak, K Jack; Xenakis, James G

    2013-09-01

    Most existing models of smoking cessation treatments have considered a single quit attempt when modelling long-term outcomes. To develop a model to simulate smokers over their lifetimes accounting for multiple quit attempts and relapses which will allow for prediction of the long-term health and economic impact of smoking cessation strategies. A discrete event simulation (DES) that models individuals' life course of smoking behaviours, attempts to quit, and the cumulative impact on health and economic outcomes was developed. Each individual is assigned one of the available strategies used to support each quit attempt; the outcome of each attempt, time to relapses if abstinence is achieved, and time between quit attempts is tracked. Based on each individual's smoking or abstinence patterns, the risk of developing diseases associated with smoking (chronic obstructive pulmonary disease, lung cancer, myocardial infarction and stroke) is determined and the corresponding costs, changes to mortality, and quality of life assigned. Direct costs are assessed from the perspective of a comprehensive US healthcare payer ($US, 2012 values). Quit attempt strategies that can be evaluated in the current simulation include unassisted quit attempts, brief counselling, behavioural modification therapy, nicotine replacement therapy, bupropion, and varenicline, with the selection of strategies and time between quit attempts based on equations derived from survey data. Equations predicting the success of quit attempts as well as the short-term probability of relapse were derived from five varenicline clinical trials. Concordance between the five trials and predictions from the simulation on abstinence at 12 months was high, indicating that the equations predicting success and relapse in the first year following a quit attempt were reliable. Predictions allowing for only a single quit attempt versus unrestricted attempts demonstrate important differences, with the single quit attempt

  4. Environmentally-induced malignancies: An in vivo model to evaluate the health impact of chemicals in mixed waste. 1997 annual progress report

    International Nuclear Information System (INIS)

    Pallavicini, M.

    1997-01-01

    'Occupational or environmental exposure to organic ligands, solvents, fuel hydrocarbons, and polychlorinated biphenyls is linked to increased risk of developing leukemia, a blood cancer. The long term health effects of exposure to complex mixtures of chemicals and radionuclides are of particular concern because their biologic effects may synergize to increase risk of malignancy. Increased understanding of steps in the progression pathway of a normal cell to a cancer cell is important for biomonitoring, risk assessment and intervention in exposed individuals. Leukemias are characterized by multiple genetic aberrations. Accumulation of multiple genomic changes may reflect genomic instability in the affected ceils. Thus agents that induce DNA damage or genomic instability may increase accumulation of genomic alterations, thereby predisposing cells to transformation. However, not all DNA damaging agents predispose to transformation. Other factors such as genetic susceptibility, cell and tissue response to genotoxicity and cytotoxicity, DNA repair, etc. will impact malignant progression. The author proposed a progression model (Figure 1) of environmentally-induced leukemia that can be evaluated using mouse models.'

  5. Constructive eHealth evaluation

    DEFF Research Database (Denmark)

    Høstgaard, Anna Marie Balling

    2016-01-01

    Despite the existence of an extensive body of knowledge about best practices and factors that contribute to the successful development and adoption of eHealth, many eHealth development-projects still face a number of problems - many of them of an organizational nature. This chapter presents a new...... method: “The Constructive eHealth evaluation method” aimed at supporting real end-user participation - a well-known success factor in eHealth development. It provides an analytical framework for achieving real end-user participation during the different phases in the eHealth lifecycle. The method...... was developed and used for the first time during the evaluation of an EHR planning process in a Danish region. It has proven effective for providing management at more levels on-going information and feedback from end-users, allowing management to change direction during eHealth development in order to achieve...

  6. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  7. Health economic evaluation in Greece.

    Science.gov (United States)

    Rovithis, Dimitrios

    2006-01-01

    There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.

  8. Did you have an impact? A theory-based method for planning and evaluating knowledge-transfer and exchange activities in occupational health and safety.

    Science.gov (United States)

    Kramer, Desré M; Wells, Richard P; Carlan, Nicolette; Aversa, Theresa; Bigelow, Philip P; Dixon, Shane M; McMillan, Keith

    2013-01-01

    Few evaluation tools are available to assess knowledge-transfer and exchange interventions. The objective of this paper is to develop and demonstrate a theory-based knowledge-transfer and exchange method of evaluation (KEME) that synthesizes 3 theoretical frameworks: the promoting action on research implementation of health services (PARiHS) model, the transtheoretical model of change, and a model of knowledge use. It proposes a new term, keme, to mean a unit of evidence-based transferable knowledge. The usefulness of the evaluation method is demonstrated with 4 occupational health and safety knowledge transfer and exchange (KTE) implementation case studies that are based upon the analysis of over 50 pre-existing interviews. The usefulness of the evaluation model has enabled us to better understand stakeholder feedback, frame our interpretation, and perform a more comprehensive evaluation of the knowledge use outcomes of our KTE efforts.

  9. Evaluation of environmental impact predictions

    International Nuclear Information System (INIS)

    Cunningham, P.A.; Adams, S.M.; Kumar, K.D.

    1977-01-01

    An analysis and evaluation of the ecological monitoring program at the Surry Nuclear Power Plant showed that predictions of potential environmental impact made in the Final Environmental Statement (FES), which were based on generally accepted ecological principles, were not completely substantiated by environmental monitoring data. The Surry Nuclear Power Plant (Units 1 and 2) was chosen for study because of the facility's relatively continuous operating history and the availability of environmental data adequate for analysis. Preoperational and operational fish monitoring data were used to assess the validity of the FES prediction that fish would congregate in the thermal plume during winter months and would avoid the plume during summer months. Analysis of monitoring data showed that fish catch per unit effort (CPE) was generally high in the thermal plume during winter months; however, the highest fish catches occurred in the plume during the summer. Possible explanations for differences between the FES prediction and results observed in analysis of monitoring data are discussed, and general recommendations are outlined for improving impact assessment predictions

  10. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

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

  11. Office-based narrow band imaging-guided flexible laryngoscopy tissue sampling: A cost-effectiveness analysis evaluating its impact on Taiwanese health insurance program

    OpenAIRE

    Fang, Tuan-Jen; Li, Hsueh-Yu; Liao, Chun-Ta; Chiang, Hui-Chen; Chen, I-How

    2015-01-01

    Narrow band imaging (NBI)-guided flexible laryngoscopy tissue sampling for laryngopharyngeal lesions is a novel technique. Patients underwent the procedure in an office-based setting without being sedated, which is different from the conventional technique performed using direct laryngoscopy. Although the feasibility and effects of this procedure were established, its financial impact on the institution and Taiwanese National Health Insurance program was not determined. Methods: This is a ...

  12. Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

    Science.gov (United States)

    Gibbons, M C

    2013-01-01

    The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

  13. Evaluating the Impacts of Health, Social Network and Capital on Craft Efficiency and Productivity: A Case Study of Construction Workers in China

    Directory of Open Access Journals (Sweden)

    Jingfeng Yuan

    2018-02-01

    Full Text Available The construction industry has been recognized, for many years, as among those having a high likelihood of accidents, injuries and occupational illnesses. Such risks of construction workers can lead to low productivity and social problems. As a result, construction workers’ well-being should be highly addressed to improve construction workers’ efficiency and productivity. Meanwhile, the social support from a social network and capital (SNC of construction workers has been considered as an effective approach to promote construction workers’ physical and mental health (P&M health, as well as their work efficiency and productivity. Based on a comprehensive literature review, a conceptual model, which aims to improve construction workers’ efficiency and productivity from the perspective of health and SNC, was proposed. A questionnaire survey was conducted to investigate the construction workers’ health, SNC and work efficiency and productivity in Nanjing, China. A structural equation model (SEM was employed to test the three hypothetical relationships among construction workers’ P&M health, SNC and work efficiency and productivity. The results indicated that the direct impacts from construction workers’ P&M health on work efficiency and productivity were more significant than that from the SNC. In addition, the construction workers’ social capital and the network can indirectly influence the work efficiency and productivity by affecting the construction workers’ P&M health. Therefore, strategies for enhancing construction workers’ efficiency and productivity were proposed. Furthermore, many useable suggestions can be drawn from the research findings from the perspective of a government. The identified indicators and relationships would contribute to the construction work efficiency and productivity assessment and health management from the perspective of the construction workers.

  14. Evaluating the Impacts of Health, Social Network and Capital on Craft Efficiency and Productivity: A Case Study of Construction Workers in China.

    Science.gov (United States)

    Yuan, Jingfeng; Yi, Wen; Miao, Mengyi; Zhang, Lei

    2018-02-15

    The construction industry has been recognized, for many years, as among those having a high likelihood of accidents, injuries and occupational illnesses. Such risks of construction workers can lead to low productivity and social problems. As a result, construction workers' well-being should be highly addressed to improve construction workers' efficiency and productivity. Meanwhile, the social support from a social network and capital (SNC) of construction workers has been considered as an effective approach to promote construction workers' physical and mental health (P&M health), as well as their work efficiency and productivity. Based on a comprehensive literature review, a conceptual model, which aims to improve construction workers' efficiency and productivity from the perspective of health and SNC, was proposed. A questionnaire survey was conducted to investigate the construction workers' health, SNC and work efficiency and productivity in Nanjing, China. A structural equation model (SEM) was employed to test the three hypothetical relationships among construction workers' P&M health, SNC and work efficiency and productivity. The results indicated that the direct impacts from construction workers' P&M health on work efficiency and productivity were more significant than that from the SNC. In addition, the construction workers' social capital and the network can indirectly influence the work efficiency and productivity by affecting the construction workers' P&M health. Therefore, strategies for enhancing construction workers' efficiency and productivity were proposed. Furthermore, many useable suggestions can be drawn from the research findings from the perspective of a government. The identified indicators and relationships would contribute to the construction work efficiency and productivity assessment and health management from the perspective of the construction workers.

  15. Evaluating the Impacts of Health, Social Network and Capital on Craft Efficiency and Productivity: A Case Study of Construction Workers in China

    Science.gov (United States)

    Yi, Wen; Miao, Mengyi; Zhang, Lei

    2018-01-01

    The construction industry has been recognized, for many years, as among those having a high likelihood of accidents, injuries and occupational illnesses. Such risks of construction workers can lead to low productivity and social problems. As a result, construction workers’ well-being should be highly addressed to improve construction workers’ efficiency and productivity. Meanwhile, the social support from a social network and capital (SNC) of construction workers has been considered as an effective approach to promote construction workers’ physical and mental health (P&M health), as well as their work efficiency and productivity. Based on a comprehensive literature review, a conceptual model, which aims to improve construction workers’ efficiency and productivity from the perspective of health and SNC, was proposed. A questionnaire survey was conducted to investigate the construction workers’ health, SNC and work efficiency and productivity in Nanjing, China. A structural equation model (SEM) was employed to test the three hypothetical relationships among construction workers’ P&M health, SNC and work efficiency and productivity. The results indicated that the direct impacts from construction workers’ P&M health on work efficiency and productivity were more significant than that from the SNC. In addition, the construction workers’ social capital and the network can indirectly influence the work efficiency and productivity by affecting the construction workers’ P&M health. Therefore, strategies for enhancing construction workers’ efficiency and productivity were proposed. Furthermore, many useable suggestions can be drawn from the research findings from the perspective of a government. The identified indicators and relationships would contribute to the construction work efficiency and productivity assessment and health management from the perspective of the construction workers. PMID:29462861

  16. Health economic evaluation in England.

    Science.gov (United States)

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness. Copyright © 2014. Published by Elsevier GmbH.

  17. Impact of organisational characteristics on health and safety ...

    African Journals Online (AJOL)

    The construction industry makes a contribution to occupational accidents and ill health records in Nigeria. This study was designed to evaluate the impact of organisational characteristics on health and safety (H&S) management practices of Nigerian small and medium-sized construction enterprises (SMEs). The study ...

  18. Impact of the environment on reproductive health.

    Science.gov (United States)

    1991-01-01

    The WHO workshop on the impact of the environment on reproductive health is summarized. Topics include the nature of environmental factors affecting reproductive health, environmental factors blamed for declining sperm quantity and quality, the effects of natural and man-made disasters on reproductive health, chemical pollutants, how the environment damages reproductive health, and research needs for better research methodologies and surveillance data. Recommendations are made to: 1) promote international research collaboration with an emphasis on consistency of methodological approaches for assessing developmental and reproductive toxicity, on development of improved surveillance systems and data bases, an strengthening international disaster alert and evaluation systems; 2) promote research capabilities for multidisciplinary studies, for interactive studies of the environment and cellular processes, and for expansion of training and education; and 3) take action on priority problems of exposure to chemical, physical, and biological agents, of exposure to pesticides among specific populations, and of inadequate screening methods for identification of environmental chemicals. The costs of environmental injury to reproduction include subfertility, intrauterine growth retardation, spontaneous abortion, and various birth defects. Developed country's primary threats are from chemical pollution, radiation, and stress. There is a large gap in knowledge. Caution is urged in understanding the direct relationship between environmental causes and infertility. Sexual health is difficult to assess and research is suggested. Exposure to excessive vitamin A and toxic chemicals are cited as agents probably having serious effects on malformations. Sperm quality has declined over the decades; there is speculation about the potential causes. The effects of radiation such as at Chernobyl are described. Toxic chemical exposure such as in Bhopal, India killed thousands. Neurological

  19. Coded Statutory Data Sets for Evaluation of Public Health Law

    Science.gov (United States)

    Costich, Julia Field

    2012-01-01

    Background and objectives: The evaluation of public health law requires reliable accounts of underlying statutes and regulations. States often enact public health-related statutes with nonuniform provisions, and variation in the structure of state legal codes can foster inaccuracy in evaluating the impact of specific categories of law. The optimal…

  20. Evaluation of the 2012 18th Maternal and Child Health (MCH) Epidemiology and 22nd CityMatCH MCH Urban Leadership Conference: six month impact on science, program, and policy.

    Science.gov (United States)

    Arellano, Danielle E; Goodman, David A; Howlette, Travis; Kroelinger, Charlan D; Law, Mark; Phillips, Donna; Jones, Jessica; Brantley, Mary D; Fitzgerald, Maureen

    2014-09-01

    The 18th Maternal and Child Health (MCH) Epidemiology and 22nd CityMatCH MCH Urban Leadership Conference took place in December 2012, covering MCH science, program, and policy issues. Assessing the impact of the Conference on attendees' work 6 months post-Conference provides information critical to understanding the impact and the use of new partnerships, knowledge, and skills gained during the Conference. Evaluation assessments, which included collection of quantitative and qualitative data, were administered at two time points: at Conference registration and 6 months post-Conference. The evaluation files were merged using computer IP address, linking responses from each assessment. Percentages of attendees reporting Conference impacts were calculated from quantitative data, and common themes and supporting examples were identified from qualitative data. Online registration was completed by 650 individuals. Of registrants, 30 % responded to the 6 month post-Conference assessment. Between registration and 6 month post-Conference evaluation, the distribution of respondents did not significantly differ by organizational affiliation. In the 6 months following the Conference, 65 % of respondents reported pursuing a networking interaction; 96 % shared knowledge from the Conference with co-workers and others in their agency; and 74 % utilized knowledge from the Conference to translate data into public health action. The Conference produced far-reaching impacts among Conference attendees. The Conference served as a platform for networking, knowledge sharing, and attaining skills that advance the work of attendees, with the potential of impacting organizational and workforce capacity. Increasing capacity could improve MCH programs, policies, and services, ultimately impacting the health of women, infants, and children.

  1. Evaluating Health Advice in a Web 2.0 Environment: The Impact of Multiple User-Generated Factors on HIV Advice Perceptions.

    Science.gov (United States)

    Walther, Joseph B; Jang, Jeong-Woo; Hanna Edwards, Ashley A

    2018-01-01

    Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.

  2. EVALUATION OF HEALTH CARE QUALITY

    Directory of Open Access Journals (Sweden)

    Zlatko Fras

    2002-12-01

    Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.

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

    OpenAIRE

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

    2016-01-01

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

  4. Impact of the Prevention Plan on Employee Health Risk Reduction

    OpenAIRE

    Loeppke, Ronald; Edington, Dee W.; Bég, Sami

    2010-01-01

    This study evaluated the impact of The Prevention Plan™ on employee health risks after 1 year of integrated primary prevention (wellness and health promotion) and secondary prevention (biometric and lab screening as well as early detection) interventions. The Prevention Plan is an innovative prevention benefit that provides members with the high-tech/high-touch support and encouragement they need to adopt healthy behaviors. Support services include 24/7 nurse hotlines, one-on-one health coach...

  5. The impact of economic globalisation on health.

    Science.gov (United States)

    Koivusalo, Meri

    2006-01-01

    The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.

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

    Science.gov (United States)

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

    2018-05-03

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

  7. We are all experts! Does stakeholder engagement in health impact scoping lead to consensus? A Dutch case study

    NARCIS (Netherlands)

    Broeder, den Lea; Yin Chung, Kai; Geelen, Loes; Schuit, Albertina Jantine; Wagemakers, A.

    2016-01-01

    Stakeholder engagement in Environmental Impact Assessment (EIA) and Health Impact Assessment (HIA) provides opportunities for inclusive environmental decision-making contributing to the attainment of agreement about the potential environmental and health impacts of a plan. A case evaluation of

  8. Impact of organisational change on mental health

    DEFF Research Database (Denmark)

    Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia

    2012-01-01

    Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowle......Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web...

  9. Leadership for health improvement--implementation and evaluation.

    Science.gov (United States)

    Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

    2009-01-01

    The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

  10. IMPACT OF WIRELESS TECHNOLOGIES ON HUMAN HEALTH

    OpenAIRE

    Pejnović, Natalija

    2009-01-01

    SUMMARY: This paper explores adverse impacts of wireless technologies on user health. A wide range of situations in which radiation may influence the user was investigated. Emphasis was placed on the adverse impact of non-ionizing radiation. Thermal and non-thermal effects of non-ionizing radiation were explained in accordance with the operating principle of wireless devices. It is necessary to implement appropriate forms of protection in order to eliminate health risks or reduce them to the ...

  11. The impact of leadership development on GP mental health commissioning.

    Science.gov (United States)

    Dickerson, Emma; Fenge, Lee-Ann; Rosenorn-Lanng, Emily

    2017-07-03

    Purpose This paper aims to explore the learning needs of general practitioners (GPs) involved in commissioning mental health provision in England, and offer an evaluation of a leadership and commissioning skills development programme for Mental Health Commissioners. Design/methodology/approach Retrospective mixed method, including online mixed method survey, rating participants' knowledge, skills, abilities, semi-structured telephone interviews and third-party questionnaires were used. Results were analysed for significant differences using the Wilcoxon Signed Ranks test. Open-ended responses and interview transcripts were analysed thematically. Findings Indicative results showed that participants perceived significant impacts in ability across eight key question groups evaluated. Differences were found between the perceived and observed impact in relation to technical areas covered within the programme which were perceived as the highest scoring impacts by participants. Research limitations/implications The indicative results show a positive impact on practice has been both perceived and observed. Findings illustrate the value of this development programme on both the personal development of GP Mental Health Commissioners and commissioning practice. Although the findings of this evaluation increase understanding in relation to an important and topical area, larger scale, prospective evaluations are required. Impact evaluations could be embedded within future programmes to encourage higher participant and third-party engagement. Future evaluations would benefit from collection and analysis of attendance data. Further research could involve patient, service user and carer perspectives on mental health commissioning. Originality value Results of this evaluation could inform the development of future learning programmes for mental health commissioners as part of a national approach to improve mental health provision.

  12. IMPACT OF FLUORIDE ON DENTAL HEALTH QUALITY.

    Science.gov (United States)

    Medjedovic, Eida; Medjedovic, Senad; Deljo, Dervis; Sukalo, Aziz

    2015-12-01

    Fluoride is natural element that strengthens teeth and prevents their decay. Experts believe that the best way to prevent cavities is the use of fluoride from multiple sources. Studies even show that in some cases, fluoride can stop already started damage of the teeth. In children younger than 6 years fluoride is incorporated into the enamel of permanent teeth, making the teeth more resistant to the action of bacterial and acids in food. The aim of this study is to determine the effects of improving the health status of teeth after six months treatment with the use of topical fluoridation 0.5% NaF, and the level and quality of the impact of treatment with chemical 0.5% NaF on the dental health of children at age from 8 to 15 years, in relation to gender and chronological age. This study included school children aged 8 to 15 years who visited health and dental services dependent in Mostar. It is obvious that after the implementation of treatment with 5% NaF by the method of topical fluoridation, health status of subjects from the experimental group significantly improved, so that at the final review 89.71% or 61 subjects of the experimental group had healthy (cured teeth), tooth with dental caries only 5.88% or 4 respondents tooth with dental caries and filling 4.41% or 3 respondents, extracted baby tooth 14.71% or 10 respondents, while for 13.24% of respondents was identified state with still unerupted teeth. Our findings are indirectly confirmed that the six-month treatment of fluoridation with 5% NaF, contributed to statistically significant improvement in overall oral health of the experimental group compared to the control group which was not treated by any dental treatment. It can be concluded that there is a statistically significant difference in the evaluated parameters of oral health of children in the control group compared to the studied parameters of oral health the experimental group of children at the final dental examination.

  13. Evaluating the Relative Environmental Impact of Countries

    OpenAIRE

    Bradshaw, Corey J. A.; Giam, Xingli; Sodhi, Navjot Singh

    2010-01-01

    Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy ?models? can be identified. We provide novel metrics of country-specific environmental impact ranks ? one proportional to total resource availability per country and an absolute (total) measure of impact ? that explicitly avoid incorporating confounding human health or economic i...

  14. Socioeconomic Disparities and Health: Impacts and Pathways

    Science.gov (United States)

    Kondo, Naoki

    2012-01-01

    Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997–98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society. PMID:22156290

  15. Socioeconomic disparities and health: impacts and pathways.

    Science.gov (United States)

    Kondo, Naoki

    2012-01-01

    Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.

  16. Genomics and Health Impact Update

    Science.gov (United States)

    ... Health Events Weekly AMD Clips News Events/ Training/ Web Resources Concepts/ Comments Pathogenicity/ Antimicrobial Resistance Evolution/ Ecology/ ... target=”_blank” class=”noLinking noscript”>3.0/images/TwitterFailoverButton.png” alt=”Follow CDC on Twitter” ...

  17. Medico-economic evaluation of healthcare products. Methodology for defining a significant impact on French health insurance costs and selection of benchmarks for interpreting results.

    Science.gov (United States)

    Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Biot, Claire; Blachier, Corinne; Braun, Eric; Debroucker, Frédérique; Detournay, Bruno; Ferretti, Carine; Granger, Muriel; Jouan-Flahault, Chrystel; Lussier, Marie-Dominique; Meyer, Arlette; Muller, Sophie; Pigeon, Martine; De Sahb, Rima; Sannié, Thomas; Sapède, Claudine; Vray, Muriel

    2014-01-01

    Decree No. 2012-1116 of 2 October 2012 on medico-economic assignments of the French National Authority for Health (Haute autorité de santé, HAS) significantly alters the conditions for accessing the health products market in France. This paper presents a theoretical framework for interpreting the results of the economic evaluation of health technologies and summarises the facts available in France for developing benchmarks that will be used to interpret incremental cost-effectiveness ratios. This literature review shows that it is difficult to determine a threshold value but it is also difficult to interpret then incremental cost effectiveness ratio (ICER) results without a threshold value. In this context, round table participants favour a pragmatic approach based on "benchmarks" as opposed to a threshold value, based on an interpretative and normative perspective, i.e. benchmarks that can change over time based on feedback. © 2014 Société Française de Pharmacologie et de Thérapeutique.

  18. An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

    Directory of Open Access Journals (Sweden)

    Pesa JA

    2012-01-01

    Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

  19. Evaluating the impact of pharmacist health education on the perceptions of the pharmacist’s role among women living in a homeless shelter

    Directory of Open Access Journals (Sweden)

    Tsu L

    2015-12-01

    Full Text Available Objectives: To determine the impact of pharmacist-provided educational seminars on the participant’s perception of the pharmacist’s role in providing women’s health education. Secondary objectives include the participant’s level of perceived benefit from the information provided during each presentation, as well as determining characteristics of participants who are interested in attending seminars. Methods: This is a prospective study conducted within a homeless women’s shelter in Phoenix, Arizona. Pharmacists and pharmacy students provided 10 monthly educational seminars on topics related to women’s health. Participants completed a pre- and post-seminar survey regarding their perceptions of the presentations and pharmacists. Results: Fifty-six participants attended at least one of 10 seminars from January to November 2014. The average age was 46 years old, taking approximately 3 medications, and 66% completed a high school degree or lower. Prior to the presentations, 30% of participants agreed or strongly agreed that they would seek advice from a pharmacist on the topic presented, which increased significantly to 82% of participants after the presentation (p<0.001. Similarly, 55% of participants rated themselves as agreeing or strongly agreeing with being knowledgeable on the topic presented prior to the presentation, and this increased significantly to 77% after the presentation (p=0.001. After attending the educational session, 70% of participants agreed or strongly agreed that they would make changes to their health, and that they would attend an additional session. The participants noted their increased learning about the topic, the clarity of visual aids and presentation, and knowledge of the presenters as the best parts of the presentation. Conclusion: Pharmacist’s participation in providing educational seminars in the homeless women’s population increases the participant’s knowledge and perception of the pharmacist

  20. Health impacts of geothermal energy

    International Nuclear Information System (INIS)

    Layton, D.W.; Anspaugh, L.R.

    1982-01-01

    Geothermal resources are used to produce electrical energy and to supply heat for non-electric applications like residential heating and crop drying. The utilization of geothermal energy consists of the extraction of hot water or steam from an underground reservoir followed by different methods of surface processing along with the disposal of liquid, gaseous, and even solid wastes. The focus of this paper is on electric power production using geothermal resources greater than 150 0 C because this form of geothermal energy utilization has the most serious health-related consequences. Based on measurements and experience at existing geothermal power plants, atmospheric emissions of non-condensing gases such as hydrogen sulphide and benzene pose the greatest hazards to public health. Surface and ground waters contaminated by discharges of spent geothermal fluids constitute another health hazard. In this paper it is shown that hydrogen sulphide emissions from most geothermal power plants are apt to cause odour annoyances among members of the exposed public -some of whom can detect this gas at concentrations as low as 0.002 ppmv. A risk-assessment model is used to estimate the lifetime risk of incurring leukaemia from atmospheric benzene caused by 2000 MW(e) of geothermal development in California's Imperial Valley. Also assessed is the risk of skin cancer due to the ingestion of river water in New Zealand that is contaminated by waste geothermal fluids containing arsenic. Finally, data on the occurrence of occupational disease in the geothermal industry is briefly summarized. (author)

  1. Potential health impact of wind turbines

    International Nuclear Information System (INIS)

    2010-05-01

    In response to public health concerns about wind turbines, a study was conducted to review the scientific evidence on the potential health effects of wind turbines. Several research questions were examined, including scientific evidence on the potential health impacts of wind turbines; the relationship between wind turbine noise and health; the relationship between low frequency sound, infrasound and health; assessment of exposure to wind turbines; wind turbine health and safety hazards and Ontario wind turbine setbacks; community consultation prior to wind farm construction and data gaps and research needs. The study showed that although some people living near wind turbines reported symptoms such as dizziness, headaches, and sleep disturbance, the scientific evidence available to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects. The sound level from wind turbines at common residential setbacks is not sufficient to cause hearing impairment or other direct health effects, although some people may find it annoying. 41 refs., 1 appendix.

  2. 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...

  3. Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients.

    Science.gov (United States)

    Lopez, Priscilla M; Zanowiak, Jennifer; Goldfeld, Keith; Wyka, Katarzyna; Masoud, Ahmad; Beane, Susan; Kumar, Rashi; Laughlin, Phoebe; Trinh-Shevrin, Chau; Thorpe, Lorna; Islam, Nadia

    2017-12-06

    The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building upon this initiative, we present the protocol and preliminary results of a research study, Project IMPACT, designed to fill this gap in knowledge. Project IMPACT is a stepped wedge quasi-experimental study designed to test the feasibility, adoption, and impact of integrating CHW-led health coaching with electronic health record (EHR)-based interventions to improve hypertension control among South Asian patients in New York City primary care practices. EHR intervention components include the training and implementation of hypertension-specific registry reports, alerts, and order sets. Fidelity to the EHR intervention is assessed by collecting the type, frequency, and utilization of intervention components for each practice. CHW intervention components consist of health coaching sessions on hypertension and related risk factors for uncontrolled hypertensive patients. The outcome, hypertension control (informs the effectiveness of these interventions in team-based care approaches, thereby, helping to develop relevant sustainability strategies for improving hypertension control among targeted racial/ethnic minority populations at small primary care practices. This study protocol has been approved and is made available on Clinicaltrials.gov by NCT

  4. The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.

    Science.gov (United States)

    Friedman, Sarah; Xu, Haiyong; Harwood, Jessica M; Azocar, Francisca; Hurley, Brian; Ettner, Susan L

    2017-09-01

    The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between behavioral health and medical health insurance benefits among the commercially insured. This study determines whether MHPAEA was associated with increased BH expenditures and utilization among a population with substance use disorder (SUD) diagnoses. Claims and eligibility data from 5,987,776 enrollees, 2008-2013, were obtained from a national, commercial, managed behavioral health organization. An interrupted time series study design with segmented regression analysis estimated time trends of per-member-per-month (PMPM) spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance. The study sample contained individuals with drug or alcohol use disorder diagnosis during study period (N=2,716,473 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual, group and family psychotherapy, and structured outpatient care); intermediate care utilization (day treatment; recovery home and residential); and inpatient utilization. Starting at the beginning of the post-parity period, MHPAEA was associated with increased levels of PMPM total and plan spending ($25.80 [p=0.01]; $28.33 [p=0.00], respectively), as well as the number of PMPM assessment/evaluation, individual psychotherapy, and group psychotherapy visits, and inpatient days (0.01 visits [p=0.01]; 0.02 visits [p=0.01]; 0.01 visits [p=0.03]; 0.01days [p=0.01], respectively). Following these initial level changes, MHPAEA was also associated with monthly increases in PMPM total, plan, and patent out-of-pocket spending ($2.56/month [p=0.00]; $2.25/month [p=0.00]; $0.27 [p=0.03], respectively), as well as structured outpatient visits and inpatient days (0.0012 visits/month [p=0.01]; 0.0012days/month [p=0.00]). MHPAEA was associated with modest

  5. Health impact of wind farms.

    Science.gov (United States)

    Kurpas, Donata; Mroczek, Bozena; Karakiewicz, Beata; Kassolik, Krzysztof; Andrzejewski, Waldemar

    2013-01-01

    Wind power is employed worldwide as an alternative source of energy. At the same time, however, the health effects of wind turbines have become a matter of discussion. The purpose of this study is a critical review of available reports providing arguments both for and against the construction of wind farms. The authors also attempt to propose recommendations in accordance with the Evidence-Based Medicine (EBM) guidelines. In the case of exposure to wind farms, a randomized controlled trial (RCT) is impossible. To obtain the highest-level recommendations, analysis of case-control studies or cohort studies with control groups should be performed. Preferably, it should include geostatistical analysis conducted with the use of variograms and the kriging technique. Combinations of key words were entered into the Thomson Reuters Web of Knowledge (SM) and the Internet search engine Google. SHORT DESCRIPTION OF STATE OF THE ART: The nuisance caused by wind turbines is stereotypically linked with the noise that they produce. Nevertheless, the visual aspect of wind farms, opinions about them, and sensitivity to sound seem to be of the greater importance. To date, the direct correlations between the vicinity of modern wind farms, the noise that wind turbines make, and possible consequences to health have not been described in peer reviewed articles. Health effects are more probably associated with some environmental factors leading to annoyance or frustration. All types of studies share the same conclusion: wind turbines can provoke annoyance. As with any project involving changes in the local environment, a certain level of irritation among the population can be expected. There are elected officials and government representatives who should decide what level of social annoyance is acceptable, and whether wind power advantages outweigh its potential drawbacks. The influence of wind turbines on human emotional and physical health is a relatively new field of research. Further

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

    Science.gov (United States)

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

    2015-09-16

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

  7. Nurse Bullying: Impact on Nurses' Health.

    Science.gov (United States)

    Sauer, Penny A; McCoy, Thomas P

    2017-12-01

    Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

  8. Evaluating the impact of your library

    CERN Document Server

    Streatfield, David

    2012-01-01

    Outlining a rigorously tested approach to library evaluation and offering practical tools and highly relevant examples, this brand new edition enables LIS managers to get to grips with the slippery concept of service impact and to address their own impact questions in their planning.

  9. Methodological principles for the evaluation of impact of the variability and the climatic change in the human health, a statistical focus

    International Nuclear Information System (INIS)

    Ortiz Bulto, Paulo Lazaro; Vladimir Guevara, Antonio; Ulloa, Jacqueline; Aparicio, Marilyn

    2001-01-01

    Signal detection of climate variability or change and the evaluation of its specific effects, requires an understanding of the variations in the observed data, which describe the natural climate variability and change signals. It is also necessary to understand the complex interactions that make up the climate system. In the present work, an unusual methodological approach is taken to evaluate the effects and impacts of climate variability and change on the behaviour of different diseases, on the basis of practical experience of its application in four countries of the Caribbean, Central and South America: Cuba, Panama, Bolivia and Paraguay. For the determination of the climate signal change multivariate analysis techniques (empirical orthogonal functions) were used, combined with robust methods of time series decomposition (decomposition by median). They allowed us to describe the changes observed in the seasonal patterns of climate and epidemiological diseases for the period 1991-1999, with respect to the period 1961-1990. These results were used to build an autoregressive model with non-constant variance, with a climate index based on the signals obtained from the decompositions, which enters the model as an exogenous variable in order to make projections of the diseases

  10. Control of urinary schistosomiasis on Zanzibar (Unguja Island: a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

    Directory of Open Access Journals (Sweden)

    JR Stothard

    2006-10-01

    Full Text Available To improve health education within primary schools, the health education booklet Juma na kichocho was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact.

  11. Office-based narrow band imaging-guided flexible laryngoscopy tissue sampling: A cost-effectiveness analysis evaluating its impact on Taiwanese health insurance program.

    Science.gov (United States)

    Fang, Tuan-Jen; Li, Hsueh-Yu; Liao, Chun-Ta; Chiang, Hui-Chen; Chen, I-How

    2015-07-01

    Narrow band imaging (NBI)-guided flexible laryngoscopy tissue sampling for laryngopharyngeal lesions is a novel technique. Patients underwent the procedure in an office-based setting without being sedated, which is different from the conventional technique performed using direct laryngoscopy. Although the feasibility and effects of this procedure were established, its financial impact on the institution and Taiwanese National Health Insurance program was not determined. This is a retrospective case-control study. From May 2010 to April 2011, 20 consecutive patients who underwent NBI flexible laryngoscopy tissue sampling were recruited. During the same period, another 20 age-, sex-, and lesion-matched cases were enrolled in the control group. The courses for procedures and financial status were analyzed and compared between groups. Office-based NBI flexible laryngoscopy tissue sampling procedure took 27 minutes to be completed, while 191 minutes were required for the conventional technique. Average reimbursement for each case was New Taiwan Dollar (NT$)1264 for patients undergoing office-based NBI flexible laryngoscopy tissue sampling, while NT$10,913 for those undergoing conventional direct laryngoscopy in the operation room (p institution suffered a loss of at least NT$690 when performing NBI flexible laryngoscopy tissue sampling. Office-based NBI flexible laryngoscopy tissue sampling is a cost-saving procedure for patients and the Taiwanese National Health Insurance program. It also saves the procedure time. However, the net financial loss for the institution and physician would limit its popularization unless reimbursement patterns are changed. Copyright © 2013. Published by Elsevier B.V.

  12. Health impact assessment – A survey on quantifying tools

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

  13. Health impact assessment – A survey on quantifying tools

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  14. Impact Evaluation of a System-Wide Chronic Disease Management Program on Health Service Utilisation: A Propensity-Matched Cohort Study.

    Science.gov (United States)

    Billot, Laurent; Corcoran, Kate; McDonald, Alina; Powell-Davies, Gawaine; Feyer, Anne-Marie

    2016-06-01

    The New South Wales Health (NSW Health) Chronic Disease Management Program (CDMP) delivers interventions to adults at risk of hospitalisation for five target chronic conditions that respond well to ambulatory care: diabetes, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and coronary artery disease. The intervention consists of two main components: (1) care coordination across sectors (acute, ambulatory, and community care from both public and private sectors) and clinical specialties, facilitated by program care coordinators, and (2) health coaching including management of lifestyle risk factors and medications and self-management. These components were broadly prescribed by the head office of NSW Health, which funded the program, and were implemented by regional health services (local health districts) in ways that best suited their own history, environment, workforce, and patient need. We used a propensity-matched cohort study to evaluate health service utilisation after enrolment in the CDMP. The evaluation cohort included 41,303 CDMP participants enrolled between 1 January 2011 and 31 December 2013 who experienced at least one hospital admission or emergency department (ED) presentation for a target condition in the 12 mo preceding enrolment. Potential controls were selected from patients not enrolled in the CDMP but experiencing at least one hospital admission or ED presentation over the same period. Each CDMP patient in the evaluation cohort was matched to one control using 1:1 propensity score matching. The primary outcome was avoidable hospitalisations. Secondary outcomes included avoidable readmissions, avoidable bed days, unplanned hospitalisations, unplanned readmissions, unplanned bed days, ED presentations, and all-cause death. The primary analysis consisted of 30,057 CDMP participants and 30,057 matched controls with a median follow-up of 15 mo. Of those, 25,638 (85.3%) and 25,597 (85.2%) were alive by the end of

  15. How have Global Health Initiatives impacted on health equity?

    Science.gov (United States)

    Hanefeld, Johanna

    2008-01-01

    This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases - together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS. This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources. However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities. The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities.

  16. Integrating health and environmental impact analysis

    DEFF Research Database (Denmark)

    Reis, S; Morris, G.; Fleming, L. E.

    2015-01-01

    which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose...... while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding...... the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession...

  17. Impact of diabetes continuing education on health care ...

    African Journals Online (AJOL)

    Purpose: To evaluate the impact of a continuing education (CE) program on the attitudes of health care professionals (HCPs) towards diabetes care in Yemen. Methods: A pre- and post-intervention study was carried out in Mukalla City, Hadramout, Yemen and was offered to all physicians, pharmacists, and nurses ...

  18. Evaluating and measuring impact: where and how?

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    On 12 and 13 November, a workshop on “Evaluation in international organisations” took place at CERN. Fourteen internal auditors and planning and policy analysts, from six different international organisations, discussed whether and how to evaluate the impact of their organisations’ programmes on the target beneficiaries.      Participants of the “Evaluation in international organisations” workshop at CERN. “Evaluation”, a relatively recent but fast growing discipline, deals with the systematic and objective assessment of the impact of policies and programmes on the target beneficiaries – often society at large. In the past few years, other international organisations have created an evaluation function within their internal structure, whose role is to measure the impact of their public policies. “In the first instance we wanted to understand what the difference between evaluation a...

  19. Evaluating a Sexual Health Patient Education Resource.

    Science.gov (United States)

    Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty

    2015-01-01

    This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncology professionals are committed to addressing quality-of-life concerns for patients across the trajectory of illness. Sexuality is a key concern for patients and impacts relationships and overall quality of life. Through careful assessment, patient education, and support, clinicians can ensure that sexuality is respected as an essential part of patient-centered care.

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

    Science.gov (United States)

    Fantke, Peter; Friedrich, Rainer; Jolliet, Olivier

    2012-11-15

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

  1. Evaluating the effectiveness of impact assessment instruments

    DEFF Research Database (Denmark)

    Cashmore, Matthew; Richardson, Tim; Hilding-Ryedvik, Tuija

    2010-01-01

    to sharpen effectiveness evaluation theory for impact assessment instruments this article critically examines the neglected issue of their political constitution. Analytical examples are used to concretely explore the nature and significance of the politicisation of impact assessment. It is argued......The central role of impact assessment instruments globally in policy integration initiatives has been cemented in recent years. Associated with this trend, but also reflecting political emphasis on greater accountability in certain policy sectors and a renewed focus on economic competitiveness...... that raising awareness about the political character of impact assessment instruments, in itself, is a vital step in advancing effectiveness evaluation theory. Broader theoretical lessons on the framing of evaluation research are also drawn from the political analysis. We conclude that, at least within...

  2. Evaluation of the feasibility, economic impact, and effectiveness of underground nuclear power plants. Final technical report

    International Nuclear Information System (INIS)

    1978-05-01

    Information on underground nuclear power plants is presented concerning underground nuclear power plant concepts; public health impacts; technical feasibility of underground concepts; economic impacts of underground construction; and evaluation of related issues

  3. Study design considerations in evaluating environmental impacts

    Science.gov (United States)

    Stan T. Lebow; Paul A. Cooper; Patricia Lebow

    2006-01-01

    The purpose of this chapter is to make the reader aware of how choices in study parameters may influence the outcome of treated-wood environmental impact evaluations. Evaluation of the leaching and environmental accumulation of preservatives from treated wood is a complex process. and many factors can influence the results of such studies. In laboratory studies, the...

  4. Impacts on power reactor health physics programs

    International Nuclear Information System (INIS)

    Meyer, B.A.

    1991-01-01

    The impacts on power reactor health physics programs form implementing the revised 10 CFR Part 20 will be extensive and costly. Every policy, program, procedure and training lesson plan involving health physics will require changes and the subsequent retraining of personnel. At each power reactor facility, hundreds of procedures and thousands of people will be affected by these changes. Every area of a power reactor health physics program will be affected. These areas include; ALARA, Respiratory Protection, Exposure Control, Job Coverage, Dosimetry, Radwaste, Effluent Accountability, Emergency Planning and Radiation Worker Training. This paper presents how power reactor facilities will go about making these changes and gives possible examples of some of these changes and their impact on each area of power reactor health physics program

  5. Surfing for health: user evaluation of a health information website. Part one: Background and literature review.

    Science.gov (United States)

    Williams, Peter; Nicholas, David; Huntington, Paul; McLean, Fiona

    2002-06-01

    The Government in Britain is set on using the Internet to expand the provision of health information to the general public. Concerns over the quality of the health information have preoccupied commentators and organizations rather than the way users interact with health information systems. This report examines the issues surrounding the provision of electronic health information, and describes an evaluation undertaken of a commercial health website-that of Surgerydoor (http://www.surgerydoor.co.uk/), and comprises two parts. Part one outlines the literature on electronic health information evaluation. It discusses quality issues, but also redresses the imbalance by exploring other evaluative perspectives. Part two describes an evaluation of a health information Internet site in terms of its usability and appeal, undertaken as part of a Department of Health funded study on the impact of such systems.

  6. Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

    Directory of Open Access Journals (Sweden)

    Luis Velez Lapão

    2015-10-01

    Full Text Available Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa.

  7. Sulfur impacts on forest health in west-central Alberta

    International Nuclear Information System (INIS)

    Maynard, D.G.; Stadt, J.J.; Mallett, K.I.; Volney, W.J.A.

    1994-01-01

    A study was conducted to evaluate forest health and tree growth in relation to sulfur deposition in mature and immature lodgepole pine and mature trembling aspen. Soil samples were taken in forests near two sour gas processing plants in west-central Alberta. The soil sample sites were classified into high, medium and low deposition classes. The impact of sulfur deposition on soil and foliar chemistry, tree growth, and forest health was evaluated. The analysis of tree growth, using radial increments, revealed no impact associated with the sulfur deposition class. The only indicators of extensive sulfur impacts on major forest communities detected to date are elevated sulfur concentrations in the surface organic horizon and foliage, the proportion of healthy lodgepole pines, and a depression in the annual specific volume increment. No evidence of widespread forest decline has been found. 42 refs., 35 tabs., 29 figs

  8. Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes up to one year.

    Science.gov (United States)

    Bäuerle, Kathrin; Feicke, Janine; Scherer, Wolfgang; Spörhase, Ulrike; Bitzer, Eva-Maria

    2017-05-01

    To modify and evaluate a patient education program for adult asthma patients in consideration of quality criteria for teaching. This was a prospective single-center controlled trial in an inpatient rehabilitation center. The control group (n=215) received the usual lecture-based education program, and the intervention group (n=209) the modified patient education program. Data were assessed at admission, discharge, 6 and 12 months post discharge. The primary outcome was asthma control, the secondary outcomes were asthma knowledge, quality of life, and program acceptance. Analysis of change was performed by ANCOVA for each follow-up, adjusting for baseline values. Statistically significant increases in all health outcomes and in asthma control were maintained in both groups at 12 months: CG: +1.9 (95%-CI 1.3-2.6) IG: +1.6 (95%-CI 0.8-2.3). We observed no significant differences between the programs for asthma control and quality of life. Regarding practical asthma knowledge, after 12 months, a group*time interaction emerged with a small effect size (P=0.06, η2=0.01). The modified program was not superior to traditional patient education concerning asthma control. It permanently increased self-management knowledge. Structured and behavioral patient education fosters patient's disease management ability. Possible ways of improving asthma control need to be explored. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Can health insurance improve employee health outcome and reduce cost? An evaluation of Geisinger's employee health and wellness program.

    Science.gov (United States)

    Maeng, Daniel D; Pitcavage, James M; Tomcavage, Janet; Steinhubl, Steven R

    2013-11-01

    To evaluate the impact of a health plan-driven employee health and wellness program (known as MyHealth Rewards) on health outcomes (stroke and myocardial infarction) and cost of care. A cohort of Geisinger Health Plan members who were Geisinger Health System (GHS) employees throughout the study period (2007 to 2011) was compared with a comparison group consisting of Geisinger Health Plan members who were non-GHS employees. The GHS employee cohort experienced a stroke or myocardial infarction later than the non-GHS comparison group (hazard ratios of 0.73 and 0.56; P employee health and wellness programs similarly designed as MyHealth Rewards can potentially have a desirable impact on employee health and cost.

  10. The public health impact of obesity

    NARCIS (Netherlands)

    Visscher, T.L.S.

    2001-01-01

    The prevalence of obesity (severe overweight) has been increasing in western societies during the last decades. Epidemiological studies to the public health impact of obesity are therefore warranted. This thesis aimed at describing the long-term and recent time trends of obesity in the

  11. Planning the International Competition Schedules for the Health of Elite Athletes: A 21-Year Retrospective Study Evaluating the Effectiveness and Economic Impact in an Olympic Sport.

    Directory of Open Access Journals (Sweden)

    Anna Maria Malagoni

    Full Text Available The increased number of trips and competitions scheduled in the international agonistic calendars meets commercial demands while acting as a source of stress for the athletes. A model, developed in biathlons to monitor the so-called competition load, revealed an upward trend over time. The aim of this study was to evaluate, in a 21-year period, the effects of the International Biathlon Union's rescheduling of the competitive calendars to control the competition load, as well as its stability over time and the economic impact of this intervention.For each season competition, the load factors from the international agonistic calendar (number of venues/events, competition days/distance were considered, and the athletes' daily and maximal stress scores were calculated. The calendar rescheduling, which started in 2001, involved the length of competitions, number of resting days and frequency of travels. Data from the period pre (1994-2000 and post (2001-2007 the intervention, as well as follow-up (2008-2015, were compared and analyzed in relation to the federation's budget.The competition load and athletes' daily stress score progressively increased pre, plateaued post and remained stable in follow-up. Their annual variations within the final two periods were significantly lower than in the pre period, in spite of the higher average values. The maximal stress score decreased over time. The direct correlation between most of the competition load factors with the economic budget present in pre was lost in post and follow-up. Similarly, the athletes' daily stress score had a stable trend in post and follow-up, while budget continued to increase.The management of an athlete's potential source of stress by an international federation stabilized the competition load over time, but it did not affect the budget. Furthermore, it uncoupled the relationship between the athlete's effort and federation income.

  12. Planning the International Competition Schedules for the Health of Elite Athletes: A 21-Year Retrospective Study Evaluating the Effectiveness and Economic Impact in an Olympic Sport.

    Science.gov (United States)

    Malagoni, Anna Maria; Lamberti, Nicola; Carrabre, James E; Litmanen, Hannu; Jeannier, Pierre; Zhukovskaja, Larisa; Dal Follo, Donatella; Zambon, Christel; Resch, Nicole; Manfredini, Fabio

    2015-01-01

    The increased number of trips and competitions scheduled in the international agonistic calendars meets commercial demands while acting as a source of stress for the athletes. A model, developed in biathlons to monitor the so-called competition load, revealed an upward trend over time. The aim of this study was to evaluate, in a 21-year period, the effects of the International Biathlon Union's rescheduling of the competitive calendars to control the competition load, as well as its stability over time and the economic impact of this intervention. For each season competition, the load factors from the international agonistic calendar (number of venues/events, competition days/distance) were considered, and the athletes' daily and maximal stress scores were calculated. The calendar rescheduling, which started in 2001, involved the length of competitions, number of resting days and frequency of travels. Data from the period pre (1994-2000) and post (2001-2007) the intervention, as well as follow-up (2008-2015), were compared and analyzed in relation to the federation's budget. The competition load and athletes' daily stress score progressively increased pre, plateaued post and remained stable in follow-up. Their annual variations within the final two periods were significantly lower than in the pre period, in spite of the higher average values. The maximal stress score decreased over time. The direct correlation between most of the competition load factors with the economic budget present in pre was lost in post and follow-up. Similarly, the athletes' daily stress score had a stable trend in post and follow-up, while budget continued to increase. The management of an athlete's potential source of stress by an international federation stabilized the competition load over time, but it did not affect the budget. Furthermore, it uncoupled the relationship between the athlete's effort and federation income.

  13. School Health: Findings from Evaluated Programs.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

    This publication presents findings from evaluations of many school health programs from across the United States. Each program includes at least one of the following eight components of a comprehensive school health program: health education, clinical services, counseling and mental health services, school environment, school food programs,…

  14. An evaluation paradigm for cumulative impact analysis

    Science.gov (United States)

    Stakhiv, Eugene Z.

    1988-09-01

    Cumulative impact analysis is examined from a conceptual decision-making perspective, focusing on its implicit and explicit purposes as suggested within the policy and procedures for environmental impact analysis of the National Environmental Policy Act of 1969 (NEPA) and its implementing regulations. In this article it is also linked to different evaluation and decision-making conventions, contrasting a regulatory context with a comprehensive planning framework. The specific problems that make the application of cumulative impact analysis a virtually intractable evaluation requirement are discussed in connection with the federal regulation of wetlands uses. The relatively familiar US Army Corps of Engineers' (the Corps) permit program, in conjunction with the Environmental Protection Agency's (EPA) responsibilities in managing its share of the Section 404 regulatory program requirements, is used throughout as the realistic context for highlighting certain pragmatic evaluation aspects of cumulative impact assessment. To understand the purposes of cumulative impact analysis (CIA), a key distinction must be made between the implied comprehensive and multiobjective evaluation purposes of CIA, promoted through the principles and policies contained in NEPA, and the more commonly conducted and limited assessment of cumulative effects (ACE), which focuses largely on the ecological effects of human actions. Based on current evaluation practices within the Corps' and EPA's permit programs, it is shown that the commonly used screening approach to regulating wetlands uses is not compatible with the purposes of CIA, nor is the environmental impact statement (EIS) an appropriate vehicle for evaluating the variety of objectives and trade-offs needed as part of CIA. A heuristic model that incorporates the basic elements of CIA is developed, including the idea of trade-offs among social, economic, and environmental protection goals carried out within the context of environmental

  15. Evaluating the relative environmental impact of countries.

    Science.gov (United States)

    Bradshaw, Corey J A; Giam, Xingli; Sodhi, Navjot S

    2010-05-03

    Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy 'models' can be identified. We provide novel metrics of country-specific environmental impact ranks - one proportional to total resource availability per country and an absolute (total) measure of impact - that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional) and 171 (absolute) had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened). Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in less

  16. Evaluating the Relative Environmental Impact of Countries

    Science.gov (United States)

    Bradshaw, Corey J. A.; Giam, Xingli; Sodhi, Navjot S.

    2010-01-01

    Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy ‘models’ can be identified. We provide novel metrics of country-specific environmental impact ranks – one proportional to total resource availability per country and an absolute (total) measure of impact – that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional) and 171 (absolute) had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened). Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in less

  17. Evaluating the relative environmental impact of countries.

    Directory of Open Access Journals (Sweden)

    Corey J A Bradshaw

    Full Text Available Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy 'models' can be identified. We provide novel metrics of country-specific environmental impact ranks - one proportional to total resource availability per country and an absolute (total measure of impact - that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional and 171 (absolute had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened. Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in

  18. Integrating health and environmental impact analysis.

    Science.gov (United States)

    Reis, S; Morris, G; Fleming, L E; Beck, S; Taylor, T; White, M; Depledge, M H; Steinle, S; Sabel, C E; Cowie, H; Hurley, F; Dick, J McP; Smith, R I; Austen, M

    2015-10-01

    Scientific investigations have progressively refined our understanding of the influence of the environment on human health, and the many adverse impacts that human activities exert on the environment, from the local to the planetary level. Nonetheless, throughout the modern public health era, health has been pursued as though our lives and lifestyles are disconnected from ecosystems and their component organisms. The inadequacy of the societal and public health response to obesity, health inequities, and especially global environmental and climate change now calls for an ecological approach which addresses human activity in all its social, economic and cultural complexity. The new approach must be integral to, and interactive, with the natural environment. We see the continuing failure to truly integrate human health and environmental impact analysis as deeply damaging, and we propose a new conceptual model, the ecosystems-enriched Drivers, Pressures, State, Exposure, Effects, Actions or 'eDPSEEA' model, to address this shortcoming. The model recognizes convergence between the concept of ecosystems services which provides a human health and well-being slant to the value of ecosystems while equally emphasizing the health of the environment, and the growing calls for 'ecological public health' as a response to global environmental concerns now suffusing the discourse in public health. More revolution than evolution, ecological public health will demand new perspectives regarding the interconnections among society, the economy, the environment and our health and well-being. Success must be built on collaborations between the disparate scientific communities of the environmental sciences and public health as well as interactions with social scientists, economists and the legal profession. It will require outreach to political and other stakeholders including a currently largely disengaged general public. The need for an effective and robust science-policy interface has

  19. Climate change and Public health: vulnerability, impacts, and adaptation

    Science.gov (United States)

    Guzzone, F.; Setegn, S.

    2013-12-01

    on public health and identify appropriate adaptation strategies. Several studies have evaluated the impact of climate change on health, which have included evaluating the current associations between the recent changes in climate, and the evidence base analysis of current, as well as projecting the future impacts of climate change on health. This study will document the use of building an integrated approach for sustainable management of climate, environmental, health surveillance and epidemiological data that will support the assessment of vulnerability, impact and adaption to climate change.

  20. Health impacts of coal: facts and fallacies

    Energy Technology Data Exchange (ETDEWEB)

    Finkelman, R.B. [University of Texas, Dallas, TX (United States)

    2007-02-15

    Coal has contributed enormously to the advance of civilization by providing an abundant, inexpensive, and convenient source of energy. Concurrent with its contributions, coal has extracted a high cost in terms of environmental damage and human health impacts. Unfortunately, the links between coal use and human health are distorted by a great deal of ignorance and misinformation. This paper discusses the facts and fallacies of the direct health impacts caused by coal. These include health problems caused by arsenic, fluorine, mercury and selenium released in coal use in the residential sector. The trace element iodine however may help prevent iodine deficiency disorder. Lignite in the ground in some Balkan areas has been associated with a urinary tract cancer known as Balkan endemic nephropathy (BEN). Uncontrolled burning coal seams and coal waste piles contribute to global warming and to respiratory problems. The 10-fold enrichment of trace elements in fly ash and the fine particles released from power plants could present a health threat but where good pollution control technology and disposal practices are applied the health threat is probably minimal. Radioactivity levels in coal are thought to be too low to cause concern. 27 refs., 2 figs.

  1. Understanding Stakeholder Interests and Perspectives in Evaluations of Health IT.

    Science.gov (United States)

    Lee, Lisa; Sheikh, Aziz

    2016-01-01

    Appropriately identifying and representing stakeholders' interests and viewpoints in evaluations of health information technology (health IT) is a critical part of ensuring continued progress and innovation in eHealth. This contribution therefore seeks to clarify the principles of stakeholder analysis in an eHealth context. We describe this with reference to a mixed methods national evaluation of ePrescribing systems in English hospitals. We use this evaluation to exemplify the engagement and analytical tools required to ensure a detailed understanding of the issues, challenges and lessons learnt across stakeholder groups. We conclude that this type of approach may support the robustness of evaluations of health IT as well as their longer term impact on innovation in the field.

  2. Exploratory Shaft Facility quality assurance impact evaluation

    International Nuclear Information System (INIS)

    1987-08-01

    This report addresses the impact of the quality assurance practices used for the Exploratory Shaft Facility (ESF) design, and construction in licensing as part of the repository. Acceptance criteria used for evaluating the suitability of ESF QA practices are based on documents that had not been invoked for repository design or construction activities at the time of this evaluation. This report identifies the QA practices necessary for ESF design and construction licensability. A review and evaluation of QA practices for ESF design and construction resulted in the following conclusions. QA practices were found to be acceptable with a few exceptions. QA practices for construction activities were found to be insufficiently documented in implementing procedures to allow a full and effective evaluation for licensing purposes. Recommendations are provided for mitigating impacts to ensure compatibility of the QA practices with those considered necessary for repository licensing. 8 refs., 3 tabs

  3. Mutagenesis and teratogenesis as end points in health impact assessment

    International Nuclear Information System (INIS)

    Bender, M.A.

    1976-01-01

    The genetic and teratogenic effects of agents released to the environment as a consequence of energy production are exceedingly difficult to evaluate. Nevertheless, these effects on human health may be very costly in the context of cost-benefit analysis. In fact, the procedures required to limit mutagenic or teratogenic agents to the levels considered acceptable by regulatory bodies may constitute a major fraction of the cost of energy, especially where prudence dictates that a lack of empirical data requires extremely conservative regulations. Experience with ionizing radiation and with regulation of nuclear power installations illustrates the difficulty of genetic and teratogenic health impact assessment and the great uncertainties involved, as well as the influence of these impacts on the regulatory process and the consequent increased cost of power from this source. Data on genetic and teratogenic impacts on human health from chemical agents released to the environment by other energy technologies are much less complete, and, because of the large number of potentially active agents involved, it is evident that generic solutions to health impact assessment will be required to evaluate these energy alternatives

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

    Directory of Open Access Journals (Sweden)

    Lindsay C. McCallum

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Health impact of air pollution to children

    Czech Academy of Sciences Publication Activity Database

    Šrám, Radim; Binková, B.; Dostál, Miroslav; Merkerová-Dostálová, M.; Líbalová, Helena; Milcová, Alena; Rössner ml., Pavel; Rössnerová, Andrea; Schmuczerová, Jana; Švecová, Vlasta; Topinka, Jan; Votavová, H.

    2013-01-01

    Roč. 216, č. 5 (2013), s. 533-540 ISSN 1438-4639 R&D Projects: GA MŽP(CZ) SP/1B3/8/08; GA MŠk 2B08005; GA ČR GAP503/11/0084; GA ČR GAP503/11/0142 Institutional support: RVO:68378041 Keywords : PM2.5 * carcinogenic polycyclic aromatic hydrocarbons * pregnancy outcome Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 3.276, year: 2013

  7. Cardinal Scales for Public Health Evaluation

    DEFF Research Database (Denmark)

    Harvey, Charles M.; Østerdal, Lars Peter

    Policy studies often evaluate health for a population by summing the individuals' health as measured by a scale that is ordinal or that depends on risk attitudes. We develop a method using a different type of preferences, called preference intensity or cardinal preferences, to construct scales...... that measure changes in health. The method is based on a social welfare model that relates preferences between changes in an individual's health to preferences between changes in health for a population...

  8. Evaluating the environmental impacts of dietary recommendations.

    Science.gov (United States)

    Behrens, Paul; Kiefte-de Jong, Jessica C; Bosker, Thijs; Rodrigues, João F D; de Koning, Arjan; Tukker, Arnold

    2017-12-19

    Dietary choices drive both health and environmental outcomes. Information on diets come from many sources, with nationally recommended diets (NRDs) by governmental or similar advisory bodies the most authoritative. Little or no attention is placed on the environmental impacts within NRDs. Here we quantify the impact of nation-specific NRDs, compared with an average diet in 37 nations, representing 64% of global population. We focus on greenhouse gases (GHGs), eutrophication, and land use because these have impacts reaching or exceeding planetary boundaries. We show that compared with average diets, NRDs in high-income nations are associated with reductions in GHG, eutrophication, and land use from 13.0 to 24.8%, 9.8 to 21.3%, and 5.7 to 17.6%, respectively. In upper-middle-income nations, NRDs are associated with slight decrease in impacts of 0.8-12.2%, 7.7-19.4%, and 7.2-18.6%. In poorer middle-income nations, impacts increase by 12.4-17.0%, 24.5-31.9%, and 8.8-14.8%. The reduced environmental impact in high-income countries is driven by reductions in calories (∼54% of effect) and a change in composition (∼46%). The increased environmental impacts of NRDs in low- and middle-income nations are associated with increased intake in animal products. Uniform adoption of NRDs across these nations would result in reductions of 0.19-0.53 Gt CO 2 eq⋅a -1 , 4.32-10.6 Gt [Formula: see text] eq⋅a -1 , and 1.5-2.8 million km 2 , while providing the health cobenefits of adopting an NRD. As a small number of dietary guidelines are beginning to incorporate more general environmental concerns, we anticipate that this work will provide a standardized baseline for future work to optimize recommended diets further. Copyright © 2017 the Author(s). Published by PNAS.

  9. Evaluation of the environmental impact in Mexico

    International Nuclear Information System (INIS)

    Mendoza, O.

    2004-01-01

    The present work, shows the origin and development of the evaluation of the environmental impact in Mexico, like juridical-environmental instrument, it is the environmental politics' s instrument that is relatively new, with the time it has suffered modifications of technical, administrative, law and conceptual nature. It has changed in substantial form, its importance inside the general outline of protection of the natural resources of Mexico, which is reflected in the structure of the organisms that are responsible for applying it. The objectives of the work embrace describing the antecedents of the evaluation of the environmental impact, to provide a reference mark, and to observe the evolution of this juridical instrument, as well as to summarize more outstanding aspects of the evaluation of the environmental impact; making emphasis in the form like it has been related with the environmental politics' s instruments; and to point out the changes that the procedure of evaluation of the environmental impact has fomented in the development outlines, in the technology and even in the human thought. The results of the evaluation and dictamination of the projects that entered to the procedure of environmental impact in the period 1995-2000 are observed that of the 6,100 entered projects, 5,533 were resolved, which means that answer was given to 91% of the total of projects that entered; of the work it can be concluded that this juridical-environmental instrument, it has evolved with the step of the time and it has left adapting according to the juridical, administrative procedures, technicians and of sustainable development of Mexico

  10. Evaluation Tools of nanomaterials environmental impact

    International Nuclear Information System (INIS)

    Barberio, Grazia; Scalbi, Simona; Buttol, Patrizia; Masoni, Paolo; Righi, Serena

    2015-01-01

    Nanotechnology show an increasing spread thanks to the special properties of nanomaterials (NM). Knowledge of the NM behavior and interactions with the environment and human health is still insufficient to assess the impact of the NM. A multidisciplinary, multidimensional and systemic such as that of the life cycle (Life Cycle Thinking - LCT), applied through the tool Life Cycle Assessment (LCA), is essential in environmental sustainability assessment of technologies, with some limitations that can be overcome through integration with other instruments such as, for example, non-linear models, analysis of flows of material, Risk Assessment (RA). This article offers a detailed analysis of the state and the main problems related to the application of LCA and RA to NM both separately and in combined use; They will then discuss the strategies and integrations needed to overcome the limitations of both methods and obtain robust assessments of the impacts on health and the environment [it

  11. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

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

  12. Impact of Information Technologies on Adolescents’ Health

    Directory of Open Access Journals (Sweden)

    A.V. Yeshchenko

    2013-04-01

    Full Text Available The paper presents recent data concerning the impact of computer technologies, long Internet surfing, mobile phone use on adolescents’ health. The development of addictive behaviors in adolescents — personal computer users is described. The recommendations concerning rational computer and mobile phone use by adolescents have been offered. A necessity of special doctors’ training in medical and social assistance to adolescents has been accentuated.

  13. Health impacts of different energy sources

    International Nuclear Information System (INIS)

    1982-01-01

    Energy is needed to sustain the economy, health and welfare of nations. As a consequence of this, energy consumption figures are frequently used as an index of a nation's advancement. As a result of the global energy crisis, almost every nation has had to develop all its available energy resources and plan its future use of energy. The planners of national and international energy policies are however often faced with a problem of 'public acceptance' arising from the potential health and environmental impacts of developing energy resources. The public's desire to preserve the quality of man's health and his environment frequently results in opposition to many industrial innovations, including the generation and use of energy. Reliable, quantitative data and information are needed on the risks to health and the environment of different contemporary energy systems, to improve public understanding, and to serve as the basis from which national planners can choose between different energy supply options. With the exception of nuclear energy, even in technologically advanced countries little systematic research and development has been done on the quantitative assessment of the effects on health and the environment of the conventional energy sources. The need for this information has only been realized over the past decade as the climate and environment in many regions of the world has deteriorated with the unabated release of pollutants from factories and energy generating plants in particular. A number of countries have started national environmental health research programmes to monitor and regulate toxic emissions from industry and energy plants. Energy-related environmental health research has been supported and co-ordinated by various international organizations such as the International Atomic Energy Agency (IAEA), World Health Organization (WHO) and United Nations Environment Programme (UNEP). WHO has supported expert reviews on the potential health risks posed

  14. Evaluating Realized Impacts of DOE/EERE R&D Programs. Standard impact evaluation method

    Energy Technology Data Exchange (ETDEWEB)

    Ruegg, Rosalie [TIA Consulting, Inc. (United States); O' Connor, Alan C. [RTI International, Research Triangle Park, NC (United States); Loomis, Ross J. [RTI International, Research Triangle Park, NC (United States)

    2014-08-01

    This document provides guidance for evaluators who conduct impact assessments of research and development (R&D) programs for the U.S. Department of Energy’s (DOE) Office of Energy Efficiency and Renewable Energy (EERE). It is also targeted at EERE program staff responsible for initiating and managing commissioned impact studies. The guide specifies how to estimate economic benefits and costs, energy saved and installed or generated, environmental impacts, energy security impacts, and knowledge impacts of R&D investments in advanced energy technologies.

  15. 40 CFR 227.4 - Criteria for evaluating environmental impact.

    Science.gov (United States)

    2010-07-01

    ... impact. 227.4 Section 227.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN... Impact § 227.4 Criteria for evaluating environmental impact. This subpart B sets specific environmental... of direct environmental impact. ...

  16. Office-based narrow band imaging-guided flexible laryngoscopy tissue sampling: A cost-effectiveness analysis evaluating its impact on Taiwanese health insurance program

    Directory of Open Access Journals (Sweden)

    Tuan-Jen Fang

    2015-07-01

    Conclusion: Office-based NBI flexible laryngoscopy tissue sampling is a cost-saving procedure for patients and the Taiwanese National Health Insurance program. It also saves the procedure time. However, the net financial loss for the institution and physician would limit its popularization unless reimbursement patterns are changed.

  17. Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study

    NARCIS (Netherlands)

    Elsey, H.; Bragg, R.; Elings, M.; Cade, J.E.; Brennan, C.; Farragher, T.; Tubeuf, S.; Gold, R.; Shickle, D.; Wickramasekera, N.; Richardson, Z.; Murray, J.

    2014-01-01

    Introduction: Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of

  18. How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses

    NARCIS (Netherlands)

    Ammenwerth, Elske; de Keizer, Nicolet; Brender McNair, Jytte; Craven, Catherine K.; Eisenstein, Eric; Georgiou, Andrew; Khairat, Saif; Magrabi, Farah; Nykänen, Pirkko; Otero, Paula; Rigby, Michael; Scott, Philip; Weir, Charlene

    2017-01-01

    Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust

  19. Environmental impacts evaluation associated to renewable sources of energy

    International Nuclear Information System (INIS)

    Ferreira, Vinicius Verna M.; Aronne, Ivan D.; Santos, Rosana A.M.

    2009-01-01

    As time goes by, the need for electricity increases and creates several problems to mankind. Health and environmental problems happens wherever a power plant arises. For many people the best option for these problems is to invest in energy alternative sources, such as solar and wind. But unfortunately this sources also generates some environmental and health damages. The objective of this work is to analyze the impacts of these energy sources, to review their utilization all over the world and to discuss its relevance in the global energy market. To make a comparative evaluation, the nuclear option will also be analyzed. (author)

  20. The Mass Media Influence on the Impact of Health Policy

    Directory of Open Access Journals (Sweden)

    Cătălin BABA

    2007-02-01

    Full Text Available The theme of this study is a distinct examination of the issues regarding health policy, social representations and mass media. The analysis of the mass media influence on the impact of health policy leads to a portrayal of the related programs and the way they are received by citizens through mass media. Owing to the mass media quality to be an indicator of democracy it is very important to study its role in setting people daily agenda considering how it is able to maintain and create trends merely through recurrent messages. The issues frequently conveyed by media industry influences citizens’ interest with regard to community, producing effects on public policy. We must bear in mind that the more persistent in media they are, the more relevant for community this issues will be. The authors of the study put forward a method through which diverse programmes can be analysed. A comparative analysis of mass media and citizens’ social representations and its findings provide information about the influence between them. According to agenda setting theory and many international studies on health policy the authors conclude that mass media institution highly influence the impact of the health policy in health. Moreover, it is important to mention that the impact refers to all the stages of a policy-making: beginning with the problem identification and ending with the evaluation of the implementation process.

  1. The effect of an affordable daycare program on health and economic well-being in Rajasthan, India: protocol for a cluster-randomized impact evaluation study

    Directory of Open Access Journals (Sweden)

    Arijit Nandi

    2016-06-01

    Full Text Available Abstract Background The provision of affordable and reliable daycare services is a potentially important policy lever for empowering Indian women. Access to daycare might reduce barriers to labor force entry and generate economic opportunities for women, improve education for girls caring for younger siblings, and promote nutrition and learning among children. However, empirical evidence concerning the effects of daycare programs in low-and-middle-income countries is scarce. This cluster-randomized trial will estimate the effect of a community-based daycare program on health and economic well-being over the life-course among women and children living in rural Rajasthan, India. Methods This three-year study takes place in rural communities from five blocks in the Udaipur District of rural Rajasthan. The intervention is the introduction of a full-time, affordable, community-based daycare program. At baseline, 3177 mothers with age eligible children living in 160 village hamlets were surveyed. After the baseline, these hamlets were randomized to the intervention or control groups and respondents will be interviewed on two more occasions. Primary social and economic outcomes include women’s economic status and economic opportunity, women’s empowerment, and children’s educational attainment. Primary health outcomes include women’s mental health, as well as children’s nutritional status. Discussion This interdisciplinary research initiative will provide rigorous evidence concerning the effects of daycare in lower-income settings. In doing so it will address an important research gap and has the potential to inform policies for improving the daycare system in India in ways that promote health and economic well-being. Trial registration (1 The ISRCTN clinical trial registry (ISRCTN45369145, http://www.isrctn.com/ISRCTN45369145 , registered on May 16, 2016 and (2 The American Economic Association’s registry for randomized controlled trials

  2. Dental Electronic Health Record Evaluation

    Czech Academy of Sciences Publication Activity Database

    Chleborád, K.; Zvára Jr., Karel; Dostálová, T.; Zvára, Karel; Ivančáková, R.; Zvárová, Jana; Smidl, L.; Trmal, J.; Psutka, J.

    2013-01-01

    Roč. 1, č. 1 (2013), s. 50-50 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : dentistry * medical documentation * electronic health record Subject RIV: IN - Informatics, Computer Science

  3. Interviewing: Methodological Briefs - Impact Evaluation No. 12

    OpenAIRE

    Bronwen McDonald; Patricia Rogers

    2014-01-01

    Interviews are easy to do badly and hard to do well - good planning, adequate time and appropriate skills are required. The type of interview should be carefully chosen to suit the situation rather than choosing a type of interview (such as focus groups) simply because it is commonly used. Interviews with children raise particular ethical issues that need to be carefully considered and fully addressed. This brief outlines key issues to consider in planning interviews for impact evaluation, ta...

  4. The communities first (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities.

    Science.gov (United States)

    White, James; Greene, Giles; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Palmer, Stephen; Elliott, Eva; Phillips, Ceri J; Fone, David

    2014-10-14

    Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. 'Communities First' is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents' mental health and social cohesion. A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18-74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains. This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in local and national government, and updates on our study website

  5. Development of key indicators to quantify the health impacts of climate change on Canadians

    OpenAIRE

    Cheng, June J.; Berry, Peter

    2013-01-01

    Objectives This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. Methods A literature review was conducted in OVID Medline to identify health morbidity and mortality indicators currently used to quantify climate change impacts. Public health frameworks and other studies of climate change indicators were reviewed to identify criteria with which to evaluate the list of proposed key indicators and a rating scale was d...

  6. Multidisciplinary eHealth Survey Evaluation Methods

    Science.gov (United States)

    Karras, Bryant T.; Tufano, James T.

    2006-01-01

    This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the…

  7. Impact of air pollution on health in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Kruzyzanowski, M [WHO European Centre for Environment and Health, Bilthoven (Netherlands)

    1996-12-31

    Assessment of health risks due to air pollution should be an important indicator for setting the priorities for the environmental policies and for the abatement of the pollution. The scale of such assessment depends on the level, and scope, of the policy decisions relying on the evaluation. The analysis may range from an estimate of the health impact of a single pollution source, through the risk assessment in a community or a region of a country, to an international, or pan-continental approach. Such assessment, addressing population of all Europe, was one of the aims of the project `Concern for Europe`s Tomorrow` (CET). The WHO European Centre for Environment and Health completed this project, and the corresponding report, as a contribution to the Second European Conference on Environment and Health which gathered ministries of health and of environment from all European countries in Helsinki in June 1994. Using the report as the background information, the ministries have endorsed the `Environmental Health Action Plan for Europe`, the document formulating common environmental health policy of the Region. In this article, the summary of the evaluation will be presented and the main constraints of the pan-European approach will be addressed. (author)

  8. Impact of air pollution on health in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Kruzyzanowski, M. [WHO European Centre for Environment and Health, Bilthoven (Netherlands)

    1995-12-31

    Assessment of health risks due to air pollution should be an important indicator for setting the priorities for the environmental policies and for the abatement of the pollution. The scale of such assessment depends on the level, and scope, of the policy decisions relying on the evaluation. The analysis may range from an estimate of the health impact of a single pollution source, through the risk assessment in a community or a region of a country, to an international, or pan-continental approach. Such assessment, addressing population of all Europe, was one of the aims of the project `Concern for Europe`s Tomorrow` (CET). The WHO European Centre for Environment and Health completed this project, and the corresponding report, as a contribution to the Second European Conference on Environment and Health which gathered ministries of health and of environment from all European countries in Helsinki in June 1994. Using the report as the background information, the ministries have endorsed the `Environmental Health Action Plan for Europe`, the document formulating common environmental health policy of the Region. In this article, the summary of the evaluation will be presented and the main constraints of the pan-European approach will be addressed. (author)

  9. Evaluation of the Impact of Mandating Health Care Providers to Offer Hepatitis C Virus Screening to All Persons Born During 1945-1965 - New York, 2014.

    Science.gov (United States)

    Flanigan, Colleen A; Leung, Shu-Yin J; Rowe, Kirsten A; Levey, Wendy K; King, Andrea; Sommer, Jamie N; Morne, Johanne E; Zucker, Howard A

    2017-09-29

    Approximately 75% of all hepatitis C virus (HCV) infections in the United States and 73% of HCV-associated mortality occur in persons born during 1945-1965, placing this birth cohort at increased risk for liver cancer and other HCV-related liver disease (1). In the United States, an estimated 2.7 million persons are living with HCV infection, and it is estimated that up to 75% of these persons do not know their status. Since 2012, CDC has recommended that persons born during 1945-1965 receive one-time HCV testing. To increase the number of persons tested for HCV and to ensure timely diagnosis and linkage to care, in 2014, New York enacted a hepatitis C testing law that requires health care providers to offer HCV antibody screening to all persons born during 1945-1965 who are receiving services in primary care settings or as hospital inpatients, and to refer persons with positive HCV antibody tests for follow-up health care, including an HCV diagnostic test (i.e., HCV RNA).* The New York State Department of Health (NYSDOH) used survey data from clinical laboratories and Medicaid claims and encounter data, and state and New York City (NYC) HCV surveillance data to assess the number of persons tested for HCV and number of persons with newly diagnosed HCV infections who were linked to care. During the first year of the HCV law implementation, there was a 51% increase in specimens submitted for HCV testing to surveyed clinical laboratories; testing rates among active Medicaid clients increased 52%, and linkage to care among persons with newly diagnosed HCV infection increased approximately 40% in New York and 11% in NYC. These findings highlight the potential for state laws to promote HCV testing and the utility of HCV surveillance and Medicaid claims data to monitor the quality of HCV testing and linkage to care for HCV-infected persons.

  10. Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology.

    Science.gov (United States)

    Schwerner, Henry; Mellody, Timothy; Goldstein, Allan B; Wansink, Daryl; Sullivan, Virginia; Yelenik, Stephan N; Charlton, Warwick; Lloyd, Kelley; Courtemanche, Ted

    2006-02-01

    The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  12. Mobile health technology evaluation: the mHealth evidence workshop.

    Science.gov (United States)

    Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

    2013-08-01

    Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

  13. The impact of public employment on health and health inequalities: evidence from China.

    Science.gov (United States)

    Zhang, Wei

    2011-01-01

    Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.

  14. Uranium mining: Environmental and health impacts

    International Nuclear Information System (INIS)

    Vance, Robert

    2014-01-01

    Producing uranium in a safe and environmentally responsible manner is important not only to the producers and consumers of the product, but also to society at large. Given expectations of growth in nuclear generating capacity in the coming decades - particularly in the developing world - enhancing awareness of leading practice in uranium mining is important. This was the objective of a recent NEA report entitled Managing Environmental and Health Impacts of Uranium Mining, providing a non-technical overview of the significant evolution of uranium mining practices from the time that it was first mined for military purposes until today. (author)

  15. The impact of weather on human health.

    Science.gov (United States)

    Sulman, F G

    1984-01-01

    The impact of weather on human health is a well-known fact, yet, alas, neglected in the past. Bioclimatology, a vast field of medical knowledge, has only been developed in the past few years. It shows that the air we breathe has a profound influence on our well-being. Electrical charges of the air, such as ions, spherics and electrofields can affect our endocrine, vegetative and autonomous nerve system. It may even be responsible for post-operative thromboembolism. The present article describes weather reactions, electric radiations, climate rhythm, medical aspects of weather changes, and their effect on health and disease. Special devotion is also given to the manifestations of evil winds.

  16. Health Impacts of Active Transportation in Europe.

    Directory of Open Access Journals (Sweden)

    David Rojas-Rueda

    Full Text Available Policies that stimulate active transportation (walking and bicycling have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16-64 in six European cities. We conducted a health impact assessment using two scenarios: increased cycling and increased walking. The primary outcome measure was all-cause mortality related to changes in physical activity level, exposure to fine particulate matter air pollution with a diameter <2.5 μm, as well as traffic fatalities in the cities of Barcelona, Basel, Copenhagen, Paris, Prague, and Warsaw. All scenarios produced health benefits in the six cities. An increase in bicycle trips to 35% of all trips (as in Copenhagen produced the highest benefits among the different scenarios analysed in Warsaw 113 (76-163 annual deaths avoided, Prague 61 (29-104, Barcelona 37 (24-56, Paris 37 (18-64 and Basel 5 (3-9. An increase in walking trips to 50% of all trips (as in Paris resulted in 19 (3-42 deaths avoided annually in Warsaw, 11(3-21 in Prague, 6 (4-9 in Basel, 3 (2-6 in Copenhagen and 3 (2-4 in Barcelona. The scenarios would also reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year. Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists and urban planners will help to introduce the health perspective in transport policies and promote active transportation.

  17. Health Impacts of Active Transportation in Europe.

    Science.gov (United States)

    Rojas-Rueda, David; de Nazelle, Audrey; Andersen, Zorana J; Braun-Fahrländer, Charlotte; Bruha, Jan; Bruhova-Foltynova, Hana; Desqueyroux, Hélène; Praznoczy, Corinne; Ragettli, Martina S; Tainio, Marko; Nieuwenhuijsen, Mark J

    2016-01-01

    Policies that stimulate active transportation (walking and bicycling) have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16-64) in six European cities. We conducted a health impact assessment using two scenarios: increased cycling and increased walking. The primary outcome measure was all-cause mortality related to changes in physical activity level, exposure to fine particulate matter air pollution with a diameter Paris, Prague, and Warsaw. All scenarios produced health benefits in the six cities. An increase in bicycle trips to 35% of all trips (as in Copenhagen) produced the highest benefits among the different scenarios analysed in Warsaw 113 (76-163) annual deaths avoided, Prague 61 (29-104), Barcelona 37 (24-56), Paris 37 (18-64) and Basel 5 (3-9). An increase in walking trips to 50% of all trips (as in Paris) resulted in 19 (3-42) deaths avoided annually in Warsaw, 11(3-21) in Prague, 6 (4-9) in Basel, 3 (2-6) in Copenhagen and 3 (2-4) in Barcelona. The scenarios would also reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year). Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists and urban planners will help to introduce the health perspective in transport policies and promote active transportation.

  18. Determining the impact of smoking point of sale legislation among youth (Display) study: a protocol for an evaluation of public health policy.

    Science.gov (United States)

    Haw, Sally; Amos, Amanda; Eadie, Douglas; Frank, John; MacDonald, Laura; MacKintosh, Anne Marie; MacGregor, Andy; Miller, Martine; Pearce, Jamie; Sharp, Clare; Stead, Martine; Tisch, Catherine; van der Sluijs, Winfried

    2014-03-14

    Tobacco advertising and product promotions have been largely banned in the UK but point of sale (POS) tobacco advertising is one of the few places where tobacco products may be legitimately advertised. POS displays have been shown to increase susceptibility to smoking, experimentation and initiation into smoking. These displays may also influence perceived prevalence of smoking and the perception that tobacco products are easily obtained and are a 'normal' product. A ban of POS tobacco advertising was introduced in Scotland in large tobacco retail outlets of over 280 m2 internal sales floor areas (mainly supermarkets) in April 2013 and will be extended to include smaller tobacco retail outlets in April 2015. However, the impact of POS bans on smoking attitudes, behaviours and prevalence has yet to be determined. This study has a multi-modal before and after design and uses mixed methods to collect data, at baseline and then with longitudinal follow-up for 4 years, in four purposively selected communities. For the purposes of the study, community is defined as the catchment areas of the secondary schools selected for study. There are four main components to the on-going study. In each of the four communities, at baseline and in follow-up years, there will be: mapping and spatial analyses of tobacco retail outlets; tobacco advertising and marketing audits of tobacco retail outlets most used by young people; cross-sectional school surveys of secondary school pupils; and focus group interviews with purposive samples of secondary school pupils. The tobacco audit is supplemented by interviews and observations conducted with a panel of tobacco retailers recruited from four matched communities. This study examines the impact of the implementation of both a partial and comprehensive ban on point of sale (POS) tobacco advertising on attitudes to smoking, brand awareness, perceived ease of access to tobacco products and youth smoking prevalence. The results will be of

  19. Determining the impact of smoking point of sale legislation among youth (Display) study: a protocol for an evaluation of public health policy

    Science.gov (United States)

    2014-01-01

    Background Tobacco advertising and product promotions have been largely banned in the UK but point of sale (POS) tobacco advertising is one of the few places where tobacco products may be legitimately advertised. POS displays have been shown to increase susceptibility to smoking, experimentation and initiation into smoking. These displays may also influence perceived prevalence of smoking and the perception that tobacco products are easily obtained and are a ‘normal’ product. A ban of POS tobacco advertising was introduced in Scotland in large tobacco retail outlets of over 280m2 internal sales floor areas (mainly supermarkets) in April 2013 and will be extended to include smaller tobacco retail outlets in April 2015. However, the impact of POS bans on smoking attitudes, behaviours and prevalence has yet to be determined. Methods/design This study has a multi-modal before and after design and uses mixed methods to collect data, at baseline and then with longitudinal follow-up for 4 years, in four purposively selected communities. For the purposes of the study, community is defined as the catchment areas of the secondary schools selected for study. There are four main components to the on-going study. In each of the four communities, at baseline and in follow-up years, there will be: mapping and spatial analyses of tobacco retail outlets; tobacco advertising and marketing audits of tobacco retail outlets most used by young people; cross-sectional school surveys of secondary school pupils; and focus group interviews with purposive samples of secondary school pupils. The tobacco audit is supplemented by interviews and observations conducted with a panel of tobacco retailers recruited from four matched communities. Discussion This study examines the impact of the implementation of both a partial and comprehensive ban on point of sale (POS) tobacco advertising on attitudes to smoking, brand awareness, perceived ease of access to tobacco products and youth smoking

  20. Quality dimensions in health evaluation: manager's conceptions.

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães; Pontes, Ricardo José Soares; Vasconcelos, Suziana Martins de

    2010-04-01

    To understand manager's perceptions and experiences in regards to qualitative evaluations in basic health care. A qualitative study, based on the critical interpretive approach, was performed in 2006, in the city of Fortaleza, Northeastern Brazil. The sample consisted of the group responsible for planning basic health care at the state level. In order to obtain the empirical data, the focus group technique was utilized. Two central themes emerged concerning the perceptions about quality and the dimensions of quality employed in health evaluations, which were revealed in distinct ways. The concepts of quality evaluation and qualitative evaluation did not appear clearly understood, confusing qualitative evaluation with formal quality evaluations. Likewise, the inherent multidimensionality of quality was not recognized. Despite the criticism expressed by the participants regarding the improper quantification of certain dimensions, the necessary technical skills and understanding were not observed for the approach to include the distinct dimensions of quality in the evaluation process. The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.

  1. Parking taxes : evaluating options and impacts

    International Nuclear Information System (INIS)

    Litman, T.A.

    2006-01-01

    In addition to encouraging the use of alternative modes of transport, parking taxes can help to reduce congestion, air pollution, and urban sprawl. Various types of parking taxes were evaluated in this paper, as well as their impacts on parking supply, prices and travel patterns. Examples of various parking tax programs in major cities in Canada, Europe, the United States and Australia were presented. Parking tax programs were divided into 2 main categories: (1) per-space parking levies which distribute cost burdens and encourage property owners to manage parking supply more efficiently and (2) commercial parking taxes on parking rental transactions which discourage the pricing of parking and concentrate impacts in limited areas. Worksite parking levies were discussed, as well stormwater fees and employee parking as a taxable benefit. Typical parking facility financial costs were reviewed and best practices for structuring and implementing parking taxes to increase public acceptability were outlined. It was suggested that the tax base should be broad and well-defined. Local governments should increase parking prices to market rates before imposing special parking taxes, and taxes and fees should be structured to avoid undesirable land use. Parking tax reforms should be part of an overall parking and mobility management program. Stakeholders should be consulted to insure that regulations, administrative procedures and enforcement policies are efficient and fair. The establishment of an evaluation program to determine tax impacts on parking supply and pricing, economic activity, traffic and spillover problems was also recommended. 42 refs., 4 tabs., 1 fig

  2. Evaluating Broader Impacts: Issues and Opportunities (Invited)

    Science.gov (United States)

    Elthon, D.

    2010-12-01

    The NSF expects that funded projects will include activities that have intrinsic Intellectual Merit and that promote the Broader Impacts (BI) of this work to those outside the immediate research community. These BI activities take many forms, but often involve collaborations with schools, informal science centers, and media developers in efforts to promote the public understanding of science, encourage a talented and diverse pool of students to pursue careers in science, and illustrate the benefits society derives from scientific discoveries. A critical question is how to evaluate individual BI activities and the overall portfolio of BI activities. What are the metrics for success? How can evaluation results be used to improve the BI portfolio? Evaluation of BI activities is complicated by several factors, including: [1] The scope of BI activities is highly variable across different types of NSF-funded projects. Individual research projects typically have limited BI activities, with only modest funding (facilities typically have dedicated BI/education specialists and formal evaluation expertise. An additional complication is that many BI activities are unique or have novel aspects that reflect the local circumstances and opportunities, but make it difficult to develop broadly-applicable evaluation instruments;[2] There is not consensus on the perspective from which the evaluation should be conducted. Scientists, participants (teachers, students, museum/aquarium personnel), and the funding agencies typically have differing objectives and metrics for BI projects. [3] The timeframe for conducting any evaluation is frequently limited to a few years, placing limitations on the scope of the evaluation effort. Long-term learning, career impacts, and changes in cultural attitudes or perceptions are difficult to assess under this circumstance; [4] Limited financial resources sharply constrain the depth of inquiry for many studies, and, consequently, most BI efforts have not

  3. Evaluating impact of clinical guidelines using a realist evaluation framework.

    Science.gov (United States)

    Reddy, Sandeep; Wakerman, John; Westhorp, Gill; Herring, Sally

    2015-12-01

    The Remote Primary Health Care Manuals (RPHCM) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote Australia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20-year history. These evaluations did not consider a theory-based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence-based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM. The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence-based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community-controlled clinics, in three regions of Australia. Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation. © 2015 John Wiley & Sons, Ltd.

  4. Full-mouth rehabilitation with immediate loading of implants inserted with computer-guided flap-less surgery: a 3-year multicenter clinical evaluation with oral health impact profile.

    Science.gov (United States)

    Marra, Roberto; Acocella, Alessandro; Rispoli, Alessandra; Sacco, Roberto; Ganz, Scott D; Blasi, Andrea

    2013-10-01

    The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis. The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction. The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures. The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.

  5. [The role of ecological studies to evaluate the impact of an enviromental factor on health: a case study on the results of the SENTIERI project].

    Science.gov (United States)

    Donato, Francesco; Raffetti, Elena

    2014-01-01

    A case-study regarding the results of the SENTIERI project on the Brescia-Caffaro NPCS (National Priority Contaminated Site) is reported. This area has been polluted mainly by polychlorinated biphenyls (PCBs), which have been classified recently by the International Agency for Research on Cancer as human carcinogens (group 1), with sufficient evidence for melanoma and limited for non-Hodgkin lymphoma (NHL) and breast cancer. The 3rd report of the SENTIERI project (2014) has shown an excess of cancer incidence with respect to the expected, on the basis of the incidence rates from the pool of Centre-North Italy cancer registries, but a mortality similar to that expected according to the regional rates, for melanoma, NHL and breast cancer. Furthermore, a higher than expected incidence has been found for various cancers which are not associated a priori with PCB exposure. The Brescia Local Health Authority has also carried out an analysis of cancer incidence, which has shown an incidence in the area similar to other ones in North Italy and a cluster of cases centered on Brescia town for melanoma only. A possible explanation of these discrepancies is the use of different reference populations for the comparisons (Region and pool of Centre-North Italy cancer registries), besides possible confounding bias. We discuss here the most critical aspects of modern ecological studies, their potential information content and interpretation limits.

  6. Potential impact of fireworks on respiratory health

    Science.gov (United States)

    Gouder, Caroline; Montefort, Stephen

    2014-01-01

    The world-wide use of fireworks with their consequent detrimental effect on the air quality is widely recognized with elevated ambient air levels of particulate matter and its several metallic components and gases identified in several studies carried out during such events. Exposed individuals may be at risk following inhalation of such produced pollutants. This review focuses on the impact of fireworks on air quality and the potential effect of fireworks on the respiratory system of healthy individuals as well as those suffering from underlying respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). This applies not only to spectators including children but also to pyrotechnicians themselves. An extensive Medline search revealed that a strong evidence of the impact of fireworks on respiratory health is lacking in susceptible as well as healthy individuals with no formal studies on COPD or asthma, other than a few case reports in the latter. The implementation of global strategies to control the use of fireworks and hence improve air quality could possibly reduce their likely detrimental effect on human respiratory health in exposed individuals, but clearly a more targeted research is needed. PMID:25378846

  7. Photochemical model evaluation of the ground-level ozone impacts on ambient air quality and vegetation health in the Alberta oil sands region: Using present and future emission scenarios

    Science.gov (United States)

    Vijayaraghavan, Krish; Cho, Sunny; Morris, Ralph; Spink, David; Jung, Jaegun; Pauls, Ron; Duffett, Katherine

    2016-09-01

    One of the potential environmental issues associated with oil sands development is increased ozone formation resulting from NOX and volatile organic compound emissions from bitumen extraction, processing and upgrading. To manage this issue in the Athabasca Oil Sands Region (AOSR) in northeast Alberta, a regional multi-stakeholder group, the Cumulative Environmental Management Association (CEMA), developed an Ozone Management Framework that includes a modelling based assessment component. In this paper, we describe how the Community Multi-scale Air Quality (CMAQ) model was applied to assess potential ground-level ozone formation and impacts on ambient air quality and vegetation health for three different ozone precursor cases in the AOSR. Statistical analysis methods were applied, and the CMAQ performance results met the U.S. EPA model performance goal at all sites. The modelled 4th highest daily maximum 8-h average ozone concentrations in the base and two future year scenarios did not exceed the Canada-wide standard of 65 ppb or the newer Canadian Ambient Air Quality Standards of 63 ppb in 2015 and 62 ppb in 2020. Modelled maximum 1-h ozone concentrations in the study were well below the Alberta Ambient Air Quality Objective of 82 ppb in all three cases. Several ozone vegetation exposure metrics were also evaluated to investigate the potential impact of ground-level ozone on vegetation. The chronic 3-months SUM60 exposure metric is within the CEMA baseline range (0-2000 ppb-hr) everywhere in the AOSR. The AOT40 ozone exposure metric predicted by CMAQ did not exceed the United Nations Economic Commission for Europe (UN/ECE) threshold of concern of 3000 ppb-hr in any of the cases but is just below the threshold in high-end future emissions scenario. In all three emission scenarios, the CMAQ predicted W126 ozone exposure metric is within the CEMA baseline threshold of 4000 ppb-hr. This study outlines the use of photochemical modelling of the impact of an industry (oil

  8. Impact of a health promotion program on employee health risks and work productivity.

    Science.gov (United States)

    Mills, Peter R; Kessler, Ronald C; Cooper, John; Sullivan, Sean

    2007-01-01

    Evaluate the impact of a multicomponent workplace health promotion program on employee health risks and work productivity. Quasi-experimental 12-month before-after intervention-control study. A multinational corporation headquartered in the United Kingdom. Of 618 employees offered the program, 266 (43%) completed questionnaires before and after the program. A total of 1242 of 2500 (49.7%) of a control population also completed questionnaires 12 months apart. A multicomponent health promotion program incorporating a health risk appraisal questionnaire, access to a tailored health improvement web portal, wellness literature, and seminars and workshops focused upon identified wellness issues. Outcomes were (1) cumulative count of health risk factors and the World Health Organization health and work performance questionnaire measures of (2) workplace absenteeism and (3) work performance. After adjusting for baseline differences, improvements in all three outcomes were significantly greater in the intervention group compared with the control group. Mean excess reductions of 0.45 health risk factors and 0.36 monthly absenteeism days and a mean increase of 0.79 on the work performance scale were observed in the intervention group compared with the control group. The intervention yielded a positive return on investment, even using conservative assumptions about effect size estimation. The results suggest that a well-implemented multicomponent workplace health promotion program can produce sizeable changes in health risks and productivity.

  9. Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities.

    Science.gov (United States)

    Kelaher, Margaret A; Ferdinand, Angeline S; Paradies, Yin

    2014-07-07

    To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians. A cross-sectional survey of experiences of racism and mental health was conducted in two metropolitan and two rural Victorian local government areas (LGAs) between 1 December 2010 and 31 October 2011. Participants included 755 Aboriginal Australians aged over 18 years who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%. Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale. 221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (OR, 4.49; 95% CI, 2.28-8.86) and non-health settings (OR, 2.66; 95% CI, 1.39-5.08) were more likely than people who did not experience racism to be above the threshold for high or very high psychological distress. Experiencing interpersonal racism in health settings is associated with increased psychological distress over and above what would be expected in other settings. This finding supports the rationale for improving cultural competency and reducing racism as a means of closing the health gap between Aboriginal and other Australians. Capitalising on this investment will require explicitly evaluating the impact of these initiatives on reducing patient experiences of racism.

  10. Simulation studies for the evaluation of health information technologies

    DEFF Research Database (Denmark)

    Ammenwerth, Elske; Hackl, Werner; Binzer, Kristine

    2012-01-01

    It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated...... is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management...... system on the appropriateness of prescriptions and drugrelated activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences...

  11. Evaluation of urban air pollution impact. Brest and Nantes impact at long term; Evaluation de l'impact sanitaire de la pollution atmospherique urbaine. Brest et Nantes impact a long terme

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    The assessment for Brest and Nantes of the health impact in 1999 of chronic exposure to air pollution relies on four stages: health outcome identification, the selection of exposure-response functions, exposure assessment and risk characterization. The study characterizes: - the health gain due to a 25% decrease in air pollution levels; - the expected health impact of a 15% rise in air pollution levels. The results give the number of deaths attributable to air pollution. As for the health gain, the gain in days of life expectancy is also calculated. The study for Brest relies on one single exposure-response function. Concerning Nantes, the air control network is more complete and allows to use four exposure-response functions. The health gain due to a 25% decrease in air pollution levels is interpreted as a prudent evaluation of the health impact of air pollution. The estimated number of deaths due to the impact is around 38 (23 - 53) for Brest and around 40 (14 - 65) for Nantes. It means a decrease in the lifespan of 48 (29 - 68) days for Brest and 51 (17 - 84) days for Nantes. The uncertainty about exposure evaluation, the use of American exposure-response functions and of strong hypotheses to calculate the lifespan reduction generate more errors and uncertainty than for short term health impact assessment. (author)

  12. The Impact of Long-Term Dental Health Education on Oral Hygiene Behavior.

    Science.gov (United States)

    Houle, Bonnie A.

    1982-01-01

    A study evaluated the impact of five years' exposure to a dental health curriculum on the oral hygiene of fifth-grade students. Findings of the study indicate that a well-designed dental health curriculum based on cognitive and behavioral objectives can result in a greater accumulation of dental health knowledge. (JN)

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

    International Nuclear Information System (INIS)

    Pennock, Michael; Ura, Karma

    2011-01-01

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

  14. The impact of the minimum wage on health.

    Science.gov (United States)

    Andreyeva, Elena; Ukert, Benjamin

    2018-03-07

    This study evaluates the effect of minimum wage on risky health behaviors, healthcare access, and self-reported health. We use data from the 1993-2015 Behavioral Risk Factor Surveillance System, and employ a difference-in-differences strategy that utilizes time variation in new minimum wage laws across U.S. states. Results suggest that the minimum wage increases the probability of being obese and decreases daily fruit and vegetable intake, but also decreases days with functional limitations while having no impact on healthcare access. Subsample analyses reveal that the increase in weight and decrease in fruit and vegetable intake are driven by the older population, married, and whites. The improvement in self-reported health is especially strong among non-whites, females, and married.

  15. Does supplier evaluation impact process improvement?

    Directory of Open Access Journals (Sweden)

    Shiva Prasad h c

    2016-09-01

    Full Text Available Purpose: The research explores and examines factors for supplier evaluation and its impact on process improvement particularly aiming on a steel pipe manufacturing firm in Gujarat, India. Design/Methodology/approach: The conceptual research framework was developed and hypotheses were stated considering the analysis of literature and discussions with the managers and engineers of a steel pipe manufacturing company in Gujarat, India. Data was collected using in-depth interview. The questionnaire primarily involves the perception of evaluation of supplier. Factors influencing supplier evaluation and its influence on process improvement is also examined in this study. The model testing and validation was done using partial least square method. Outcomes signified that the factors that influence evaluation of the supplier are quality, cost, delivery and supplier relationship management. Findings: The study depicted that quality and cost factors for supplier evaluation are insignificant. The delivery and supplier relationship management have significant influence on evaluation of the supplier. The research also depicted that supplier evaluation has significant influence on process improvement. Research limitations/implications: The study has been made specifically for ABC steel pipe manufacturing industry in Gujarat, India and may not be appropriate to the other industries or any parts of the world. There is a possibility of response bias as the conclusions of this research was interpreted on survey responses taken from the employees of case study company, so it is suggested that future research can overcome this problem by employing various methodologies in addition to surveys like carrying out focus group and in-depth interviews, brainstorming sessions with the experts etc. Originality/value: Many researchers have considered quality, cost and delivery as the factors for evaluating the suppliers. But for a company it is quintessential to have good

  16. Qualitative Assessment: Evaluating the Impacts of Climate ...

    Science.gov (United States)

    The South Fork Nooksack River (South Fork) is located in northwest Washington State and is home to nine species of Pacific salmon, including Nooksack early Chinook (aka, spring Chinook salmon), an iconic species for the Nooksack Indian Tribe. The quantity of salmon in the South Fork, especially spring Chinook salmon, has dramatically declined from historic levels, due primarily to habitat degradation from the legacy impacts of various land uses such as commercial forestry, agriculture, flood control, and transportation infrastructure. Segments of the South Fork and some of its tributaries exceed temperature criteria established for the protection of cold-water salmonid populations, and were listed on Washington State’s Clean Water Act (CWA) 303(d) list of impaired waterbodies. High water temperatures in the South Fork are detrimental to fish and other native species that depend on cool, clean, well-oxygenated water. Of the nine salmon species, three have been listed as threatened under the federal Endangered Species Act (ESA) and are of high priority to restoration efforts in the South Fork—spring Chinook salmon, summer steelhead trout, and bull trout. Growing evidence shows that climate change will exacerbate legacy impacts. This qualitative assessment is a comprehensive analysis of climate change impacts on freshwater habitat and Pacific salmon in the South Fork. It also evaluates the effectiveness of restoration tools that address Pacific salmon recovery.

  17. Health impacts of power-exporting plants in northern Mexico

    International Nuclear Information System (INIS)

    Blackman, Allen; Chandru, Santosh; Mendoza-Domínguez, Alberto; Russell, A.G.

    2012-01-01

    In the past two decades, rapid population and economic growth on the U.S.–Mexico border has spurred a dramatic increase in electricity demand. In response, American energy multinationals have built power plants just south of the border that export most of their electricity to the U.S. This development has stirred considerable controversy because these plants effectively skirt U.S. air pollution regulations in a severely degraded international airshed. Yet to our knowledge, this concern has not been subjected to rigorous scrutiny. This paper uses a suite of air dispersion, health impacts, and valuation models to assess the human health damages in the U.S. and Mexico caused by air emissions from two power-exporting plants in Mexicali, Baja California. We find that these emissions have limited but nontrivial health impacts, mostly by exacerbating particulate pollution in the U.S., and we value these damages at more than half a million dollars per year. These findings demonstrate that power-exporting plants can have cross-border health effects and bolster the case for systematically evaluating their environmental impacts. - Highlights: ► We estimate the health effects of emissions from Mexican electric power plants exporting to the U.S. ► The plants have limited but nontrivial effects, mostly from particulate pollution in the U.S. ► We value these damages at more than half a million dollars per year. ► Hence, power-exporting plants can have significant cross-border health effects.

  18. Conceptual framework for development of comprehensive e-health evaluation tool.

    Science.gov (United States)

    Khoja, Shariq; Durrani, Hammad; Scott, Richard E; Sajwani, Afroz; Piryani, Usha

    2013-01-01

    The main objective of this study was to develop an e-health evaluation tool based on a conceptual framework including relevant theories for evaluating use of technology in health programs. This article presents the development of an evaluation framework for e-health programs. The study was divided into three stages: Stage 1 involved a detailed literature search of different theories and concepts on evaluation of e-health, Stage 2 plotted e-health theories to identify relevant themes, and Stage 3 developed a matrix of evaluation themes and stages of e-health programs. The framework identifies and defines different stages of e-health programs and then applies evaluation theories to each of these stages for development of the evaluation tool. This framework builds on existing theories of health and technology evaluation and presents a conceptual framework for developing an e-health evaluation tool to examine and measure different factors that play a definite role in the success of e-health programs. The framework on the horizontal axis divides e-health into different stages of program implementation, while the vertical axis identifies different themes and areas of consideration for e-health evaluation. The framework helps understand various aspects of e-health programs and their impact that require evaluation at different stages of the life cycle. The study led to the development of a new and comprehensive e-health evaluation tool, named the Khoja-Durrani-Scott Framework for e-Health Evaluation.

  19. Embedding Mental Health Support in Schools: Learning from the Targeted Mental Health in Schools (TaMHS) National Evaluation

    Science.gov (United States)

    Wolpert, Miranda; Humphrey, Neil; Belsky, Jay; Deighton, Jessica

    2013-01-01

    The Targeted Mental Health in Schools (TaMHS) programme was a nationwide initiative that funded mental health provision in schools for pupils at risk of or already experiencing mental health problems. The implementation, impact and experience of this programme was evaluated using quantitative and qualitative methodology involving three main…

  20. Theorising interprofessional pedagogic evaluation: framework for evaluating the impact of interprofessional CPD on practice change

    OpenAIRE

    Payler, Jane; Meyer, Edgar; Humphris, Debra

    2007-01-01

    This study outlines the development of a conceptual framework to guide the evaluation of the impact of the pedagogy employed in continuing professional development for professionals in education, health and social care. The work is developed as part of the Centre for Excellence in Teaching and Learning: Interprofessional Learning across the Public Sector (CETL: IPPS) at the University of Southampton. The study briefly outlines the field for pedagogic research and comments on the underpinning ...

  1. Importance of Economic Evaluation in Health Care: An Indian Perspective.

    Science.gov (United States)

    Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

    2016-05-01

    Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. 23 CFR 777.7 - Evaluation of impacts.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Evaluation of impacts. 777.7 Section 777.7 Highways... IMPACTS TO WETLANDS AND NATURAL HABITAT § 777.7 Evaluation of impacts. (a) The reasonableness of the... related to: (1) The importance of the impacted wetlands and natural habitats; (2) The extent of highway...

  3. Towards validating use of self reported health (SRH) for community-based studies: Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition

    Science.gov (United States)

    Environmental health impact assessment (HIA) studies, should consider social, behavioral, nutritional, dietary, environmental exposure and health risk factors at both the individual and community levels. Chemicals measured in blood or urine are often evaluated in relation to one ...

  4. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

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

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

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

  5. The Practice of Health Program Evaluation.

    Science.gov (United States)

    Lewis, Sarah R

    2017-11-01

    The Practice of Health Program Evaluation provides an overview of the evaluation process for public health programs while diving deeper to address select advanced concepts and techniques. The book unfolds evaluation as a three-phased process consisting of identification of evaluation questions, data collection and analysis, and dissemination of results and recommendations. The text covers research design, sampling methods, as well as quantitative and qualitative approaches. Types of evaluation are also discussed, including economic assessment and systems research as relative newcomers. Aspects critical to conducting a successful evaluation regardless of type or research design are emphasized, such as stakeholder engagement, validity and reliability, and adoption of sound recommendations. The book encourages evaluators to document their approach by developing an evaluation plan, a data analysis plan, and a dissemination plan, in order to help build consensus throughout the process. The evaluative text offers a good bird's-eye view of the evaluation process, while offering guidance for evaluation experts on how to navigate political waters and advocate for their findings to help affect change.

  6. A Blueprint to Evaluate One Health

    DEFF Research Database (Denmark)

    Rüegg, Simon R; McMahon, Barry J; Häsler, Barbara

    2017-01-01

    , and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone......One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation...... and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring...

  7. The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand.

    Science.gov (United States)

    Ghislandi, Simone; Manachotphong, Wanwiphang; Perego, Viviana M E

    2015-07-01

    Thailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand's UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals' likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence of ex ante moral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC.

  8. Impact of an Oral Health Education Workshop on Parents’ Oral Health Knowledge, Attitude, and Perceived Behavioral Control among African Immigrants

    OpenAIRE

    Maryam Amin; Pawan Nyachhyon; Maryam Elyasi; Muhammed Al-Nuaimi

    2014-01-01

    Purpose. To evaluate the impact of an educational workshop on parental knowledge, attitude, and perceived behavioral control regarding their child’s oral health. Materials and Methods. A one-time oral health education workshop including audio/visual and hands-on components was conducted by a trained dentist and bilingual community workers in community locations. Participants were African parents of children who had lived in Canada for less than ten years. The impact of the workshop was evalua...

  9. Evaluating the Fraser Health Balanced Scorecard--a formative evaluation.

    Science.gov (United States)

    Barnardo, Catherine; Jivanni, Amin

    2009-01-01

    Fraser Health (FH), a large, Canadian, integrated health care network, adopted the Balanced Scorecard (BSC) approach to monitor organizational performance in 2006. This paper reports on the results of a formative evaluation, conducted in April, 2008, to assess the usefulness of the BSC as a performance-reporting system and a performance management tool. Results indicated that the BSC has proven to be useful for reporting performance but is not currently used for performance management in a substantial way.

  10. how do district health managers experience the impact of family ...

    African Journals Online (AJOL)

    KB Von Pressentin

    impact of family physicians within the South African district health system? ... paper (2015) described six aspirational roles of family physicians (FPs) working within the district health system. ... composition and deployment of the primary care workforce.5 ... mental health.30,31 In addition, FPs appear to have some impact.

  11. Electric vehicles in China: emissions and health impacts.

    Science.gov (United States)

    Ji, Shuguang; Cherry, Christopher R; J Bechle, Matthew; Wu, Ye; Marshall, Julian D

    2012-02-21

    E-bikes in China are the single largest adoption of alternative fuel vehicles in history, with more than 100 million e-bikes purchased in the past decade and vehicle ownership about 2× larger for e-bikes as for conventional cars; e-car sales, too, are rapidly growing. We compare emissions (CO(2), PM(2.5), NO(X), HC) and environmental health impacts (primary PM(2.5)) from the use of conventional vehicles (CVs) and electric vehicles (EVs) in 34 major cities in China. CO(2) emissions (g km(-1)) vary and are an order of magnitude greater for e-cars (135-274) and CVs (150-180) than for e-bikes (14-27). PM(2.5) emission factors generally are lower for CVs (gasoline or diesel) than comparable EVs. However, intake fraction is often greater for CVs than for EVs because combustion emissions are generally closer to population centers for CVs (tailpipe emissions) than for EVs (power plant emissions). For most cities, the net result is that primary PM(2.5) environmental health impacts per passenger-km are greater for e-cars than for gasoline cars (3.6× on average), lower than for diesel cars (2.5× on average), and equal to diesel buses. In contrast, e-bikes yield lower environmental health impacts per passenger-km than the three CVs investigated: gasoline cars (2×), diesel cars (10×), and diesel buses (5×). Our findings highlight the importance of considering exposures, and especially the proximity of emissions to people, when evaluating environmental health impacts for EVs.

  12. The impact and effectiveness of health impact assessment: A conceptual framework

    International Nuclear Information System (INIS)

    Harris-Roxas, Ben; Harris, Elizabeth

    2013-01-01

    The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project and (iii) an in-depth study of seven completed HIAs. The framework emphasises context, process and impacts as key domains in understanding and evaluating the effectiveness of an HIA. This new framework builds upon the existing approaches to evaluating HIA and extends them to reflect the broad range of factors that comprise and influence the effectiveness of HIAs. It may be of use in evaluating completed HIAs and in planning HIAs that are yet to be undertaken. -- Highlights: ► The first empirically-derived conceptual framework for evaluating HIA ► It may also be useful for planning and reporting on HIAs. ► The framework emphasises context, process and impacts as key domains. ► A broad range of factors influence the effectiveness of HIAs

  13. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Exploring available options in characterising the health impact of industrially contaminated sites.

    Science.gov (United States)

    Pasetto, Roberto; Martin-Olmedo, Piedad; Martuzzi, Marco; Iavarone, Ivano

    2016-01-01

    Industrially contaminated sites (ICS) are of high concern from an environmental public health perspective, since industrial plants may produce a widespread contamination that can result in several health impacts on the populations living in their neighbourhood. The objective of this contribution is to briefly explore available options in studying the health impact of ICS, mainly referring to information provided by documents and activities developed by the WHO and the WHO Collaborating Center for Environmental Health in Contaminated Sites. In current practice the health impact of ICS is evaluated using studies and assessments falling in two broad types of strategies: one based on epidemiology and the other on risk assessment methods. In recent years, traditional approaches to assess relationships between environmental risks and health has been evolved considering the intricate nature between them and other factors. New developments should be explored in the context of ICS to find common strategies and tools to assess their impacts and to guide public health interventions.

  15. Global Warming and Its Health Impact.

    Science.gov (United States)

    Rossati, Antonella

    2017-01-01

    Since the mid-19th century, human activities have increased greenhouse gases such as carbon dioxide, methane, and nitrous oxide in the Earth's atmosphere that resulted in increased average temperature. The effects of rising temperature include soil degradation, loss of productivity of agricultural land, desertification, loss of biodiversity, degradation of ecosystems, reduced fresh-water resources, acidification of the oceans, and the disruption and depletion of stratospheric ozone. All these have an impact on human health, causing non-communicable diseases such as injuries during natural disasters, malnutrition during famine, and increased mortality during heat waves due to complications in chronically ill patients. Direct exposure to natural disasters has also an impact on mental health and, although too complex to be quantified, a link has even been established between climate and civil violence. Over time, climate change can reduce agricultural resources through reduced availability of water, alterations and shrinking arable land, increased pollution, accumulation of toxic substances in the food chain, and creation of habitats suitable to the transmission of human and animal pathogens. People living in low-income countries are particularly vulnerable. Climate change scenarios include a change in distribution of infectious diseases with warming and changes in outbreaks associated with weather extreme events. After floods, increased cases of leptospirosis, campylobacter infections and cryptosporidiosis are reported. Global warming affects water heating, rising the transmission of water-borne pathogens. Pathogens transmitted by vectors are particularly sensitive to climate change because they spend a good part of their life cycle in a cold-blooded host invertebrate whose temperature is similar to the environment. A warmer climate presents more favorable conditions for the survival and the completion of the life cycle of the vector, going as far as to speed it up

  16. Global Warming and Its Health Impact

    Directory of Open Access Journals (Sweden)

    Antonella Rossati

    2017-01-01

    Full Text Available Since the mid-19th century, human activities have increased greenhouse gases such as carbon dioxide, methane, and nitrous oxide in the Earth's atmosphere that resulted in increased average temperature. The effects of rising temperature include soil degradation, loss of productivity of agricultural land, desertification, loss of biodiversity, degradation of ecosystems, reduced fresh-water resources, acidification of the oceans, and the disruption and depletion of stratospheric ozone. All these have an impact on human health, causing non-communicable diseases such as injuries during natural disasters, malnutrition during famine, and increased mortality during heat waves due to complications in chronically ill patients. Direct exposure to natural disasters has also an impact on mental health and, although too complex to be quantified, a link has even been established between climate and civil violence. Over time, climate change can reduce agricultural resources through reduced availability of water, alterations and shrinking arable land, increased pollution, accumulation of toxic substances in the food chain, and creation of habitats suitable to the transmission of human and animal pathogens. People living in low-income countries are particularly vulnerable. Climate change scenarios include a change in distribution of infectious diseases with warming and changes in outbreaks associated with weather extreme events. After floods, increased cases of leptospirosis, campylobacter infections and cryptosporidiosis are reported. Global warming affects water heating, rising the transmission of water-borne pathogens. Pathogens transmitted by vectors are particularly sensitive to climate change because they spend a good part of their life cycle in a cold-blooded host invertebrate whose temperature is similar to the environment. A warmer climate presents more favorable conditions for the survival and the completion of the life cycle of the vector, going as far

  17. A Logic Model for Evaluating the Academic Health Department.

    Science.gov (United States)

    Erwin, Paul Campbell; McNeely, Clea S; Grubaugh, Julie H; Valentine, Jennifer; Miller, Mark D; Buchanan, Martha

    2016-01-01

    Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.

  18. Unpaid work in health economic evaluations.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Health care evaluation, utilitarianism and distortionary taxes.

    Science.gov (United States)

    Calcott, P

    2000-09-01

    Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.

  20. Health evaluation of energy-generating sources

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The American Medical Association's House of Delegates, at its December 1976 Clinical Convention, requested that an evaluation be made of the health hazards of nuclear, fossil, and alternative energy-generating sources, for employees of energy-producing facilities as well as for the general population. This report is a summary evaluation of such hazards prepared in response to that request. This report, which was adopted by the House of Delegates on June 21, 1978, appears here in a revised and corrected version

  1. Employees' perceptions of the impact of work on health behaviours.

    Science.gov (United States)

    Payne, Nicola; Jones, Fiona; Harris, Peter R

    2013-07-01

    Research examining the impact of work on health behaviours has rarely provided a complete picture of the impact across health behaviours. Twenty-four employees were interviewed about their smoking, drinking, exercise and eating. Themes included the impact of the work environment, including policy, convenience and workplace cultural norms; business events effecting one's routine and again convenience and workplace cultural norms; being busy at work effecting time and energy for healthy behaviour; and work stress leading to health behaviours being used as coping responses on bad and good days. The impact of work is similar across health behaviours and is primarily detrimental.

  2. The impact of gender roles on health.

    Science.gov (United States)

    Sánchez-López, María del Pilar; Cuellar-Flores, Isabel; Dresch, Virginia

    2012-01-01

    The present research focused on a sample of Spanish undergraduate women and men to evaluate whether gender was related to substance use and chronic illness. This research examined the associations of conformity to masculine norms for men and conformity to feminine norms for women with substance use in chronic illnesses. Spanish male (n = 226) and female (n = 234) college undergraduates completed measures of chronic diseases, alcohol and tobacco consumption, and conformity to gender norms. Multivariable regression analyses demonstrated that being female was related to lower alcohol and cigarette consumption but a greater rate of chronic illnesses. Although masculinity did not explain the rate of chronic illnesses, specific feminine and masculine gender norms were related to alcohol and tobacco use and prevalence of chronic diseases. The present study provides insights for further cross-cultural psychological studies on the mediating effect of self-reported conformity to gender norms (rather than only sex) on health. Limitations and implications are discussed.

  3. Health Impacts of the Great Recession: A Critical Review.

    Science.gov (United States)

    Margerison-Zilko, Claire; Goldman-Mellor, Sidra; Falconi, April; Downing, Janelle

    2016-03-01

    The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession's full health impact. We conclude with suggestions for future work in this field.

  4. Binge drinking: Health impact, prevalence, correlates and interventions

    NARCIS (Netherlands)

    Kuntsche, E.N.; Kuntsche, S.; Thrul, J.; Gmel, G.

    2017-01-01

    Objective: Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and

  5. The training for health equity network evaluation framework: a pilot study at five health professional schools.

    Science.gov (United States)

    Ross, Simone J; Preston, Robyn; Lindemann, Iris C; Matte, Marie C; Samson, Rex; Tandinco, Filedito D; Larkins, Sarah L; Palsdottir, Bjorg; Neusy, Andre-Jacques

    2014-01-01

    The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection comprising of workshops, qualitative interviews and focus group discussions, document review and collation and analysis of existing quantitative data. The evaluation framework allowed each school to contextually gather evidence on how it was meeting the aspirational goals of social accountability across a range of school activities, and to identify strengths and areas for improvement and development. The evaluation framework pilot study demonstrated how social accountability can be assessed through a critically reflective and comprehensive process. As social accountability focuses on the relationship between health professions schools and health system and health population outcomes, each school was able to demonstrate to students, health professionals, governments, accrediting bodies, communities and other stakeholders how current and future health care needs of populations are addressed in terms of education, research, and service learning.

  6. Program Development and Evaluation - Nutrition / Health

    OpenAIRE

    2004-01-01

    Martha Archuleta: Kitchen Creations - A Cooking School for People with Diabetes. Darlene Christensen: University of Wyoming Food & Nutrition Extension Website. Judith L. Corbus: Hawaii Five-A-Day A Taste of the Tropics with Fruits and Vegetables. Luanne J. Hughes: Reaching Key Audiences with Food Safety Messages. Darlene Liesch: Pregnancy Prevention for Latino Teens. Karen Richey: Food Irradiation - Insuring your Food’s Safety. Carole Rison: Farmers Markets – Impacting Health through Economic...

  7. Abortion and Mental Health: Evaluating the Evidence

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-01-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…

  8. Evaluation of health care system reform in Hubei Province, China.

    Science.gov (United States)

    Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

    2014-02-21

    This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

  9. Building-related health impacts in European and Chinese cities

    DEFF Research Database (Denmark)

    Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki

    2015-01-01

    consumption of buildings. In addition, the model should be usable for policy comparisons by non-health experts on city level with city-specific data, it should give guidance on the particular climate mitigation questions but at the same time increase understanding on the related health impacts and the model......BACKGROUND: Public health is often affected by societal decisions that are not primarily about health. Climate change mitigation requires intensive actions to minimise greenhouse gas emissions in the future. Many of these actions take place in cities due to their traffic, buildings, and energy...... consumption. Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health. Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power...

  10. Health services research evaluation principles. Broadening a general framework for evaluating health information technology.

    Science.gov (United States)

    Sockolow, P S; Crawford, P R; Lehmann, H P

    2012-01-01

    Our forthcoming national experiment in increased health information technology (HIT) adoption funded by the American Recovery and Reinvestment Act of 2009 will require a comprehensive approach to evaluating HIT. The quality of evaluation studies of HIT to date reveals a need for broader evaluation frameworks that limits the generalizability of findings and the depth of lessons learned. Develop an informatics evaluation framework for health information technology (HIT) integrating components of health services research (HSR) evaluation and informatics evaluation to address identified shortcomings in available HIT evaluation frameworks. A systematic literature review updated and expanded the exhaustive review by Ammenwerth and deKeizer (AdK). From retained studies, criteria were elicited and organized into classes within a framework. The resulting Health Information Technology Research-based Evaluation Framework (HITREF) was used to guide clinician satisfaction survey construction, multi-dimensional analysis of data, and interpretation of findings in an evaluation of a vanguard community health care EHR. The updated review identified 128 electronic health record (EHR) evaluation studies and seven evaluation criteria not in AdK: EHR Selection/Development/Training; Patient Privacy Concerns; Unintended Consequences/ Benefits; Functionality; Patient Satisfaction with EHR; Barriers/Facilitators to Adoption; and Patient Satisfaction with Care. HITREF was used productively and was a complete evaluation framework which included all themes that emerged. We can recommend to future EHR evaluators that they consider adding a complete, research-based HIT evaluation framework, such as HITREF, to their evaluation tools suite to monitor HIT challenges as the federal government strives to increase HIT adoption.

  11. Health Literacy Training for Public Health Nurses in Fukushima: A Multi-site Program Evaluation.

    Science.gov (United States)

    Goto, Aya; Lai, Alden Yuanhong; Rudd, Rima E

    2015-09-01

    Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information. This paper presents an evaluation of an identical training program using data combined from multiple sites, and further included proximal and distal evaluations to document the impact of health literacy training in a post-disaster setting. A total of 64 participants, primarily experienced PHNs, attended one of three multi-session health literacy workshops conducted in multiple sites across Fukushima. Quantitative and qualitative data on PHNs' training satisfaction, self-evaluation of achievements regarding training goals, and application of learned skills were collected and analyzed. Each workshop consisted of two 2-hour sessions introducing health literacy and assessment tools and developing skills to improve written materials, followed by a one-month follow-up assessment on PHNs' application of the gained skills in the field. Post-training evaluations on the appropriateness and usefulness of the workshop were highly positive. At the end of the one-month follow-up, 45% of participants had gained confidence in assessing and revising written materials and had applied the skills they had gained to develop and communicate health information in various settings and modes. This increase in confidence was associated with further application of the learned skills at the municipal level. However, participants reported difficulties in explaining risks, and the need to learn more about plain language to be able to paraphrase professional terms. This paper highlighs the positive outcomes of health literacy training among PHNs. Practical

  12. Environmental and health impact by dairy cattle livestock and manure management in the Czech Republic

    NARCIS (Netherlands)

    Havlikova, M.; Kroeze, C.; Huijbregts, M.A.J.

    2008-01-01

    In this study we evaluate the potential environmental and health impact of dairy cattle livestock and manure management in the Czech Republic. We present a new approach for national assessments of the environmental impact of an agricultural sector. Emission estimates are combined with a

  13. Impact of global health governance on country health systems: the case of HIV initiatives in Nigeria.

    Science.gov (United States)

    Chima, Charles Chikodili; Homedes, Nuria

    2015-06-01

    , strategic planning and coordination, and regulation of externally-financed HIV programs by the government and this poses a great limitation to the optimal use of HIV-specific foreign aid in Nigeria. A few reforms are necessary to improve the strengthening effect of GHIs and to minimize their negative and unintended consequences. This will require stronger leadership from the Nigerian government with regards to better coordination of externally-financed health programs. Also, donors need to play a greater role in addressing the negative consequences of foreign aid. The findings highlight important unintended consequences and system-wide impacts that get little attention in traditional program evaluation.

  14. Adaptation strategies for health impacts of climate change in Western Australia: Application of a Health Impact Assessment framework

    International Nuclear Information System (INIS)

    Spickett, Jeffery T.; Brown, Helen L.; Katscherian, Dianne

    2011-01-01

    Climate change is one of the greatest challenges facing the globe and there is substantial evidence that this will result in a number of health impacts, regardless of the level of greenhouse gas mitigation. It is therefore apparent that a combined approach of mitigation and adaptation will be required to protect public health. While the importance of mitigation is recognised, this project focused on the role of adaptation strategies in addressing the potential health impacts of climate change. The nature and magnitude of these health impacts will be determined by a number of parameters that are dependent upon the location. Firstly, climate change will vary between regions. Secondly, the characteristics of each region in terms of population and the ability to adapt to changes will greatly influence the extent of the health impacts that are experienced now and into the future. Effective adaptation measures therefore need to be developed with these differences in mind. A Health Impact Assessment (HIA) framework was used to consider the implications of climate change on the health of the population of Western Australia (WA) and to develop a range of adaptive responses suited to WA. A broad range of stakeholders participated in the HIA process, providing informed input into developing an understanding of the potential health impacts and potential adaptation strategies from a diverse sector perspective. Potential health impacts were identified in relation to climate change predictions in WA in the year 2030. The risk associated with each of these impacts was assessed using a qualitative process that considered the consequences and the likelihood of the health impact occurring. Adaptations were then developed which could be used to mitigate the identified health impacts and provide responses which could be used by Government for future decision making. The periodic application of a HIA framework is seen as an ideal tool to develop appropriate adaptation strategies to

  15. Impact of public health research in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine

    2004-01-01

    research. Two health surveys have been carried out in Greenland by the National Institute of Public Health, and a follow-up is being planned together with the Directorate of Health. The results have been widely used by politicians, administrators, and health care professionals.......In 1992, the Greenland Home Rule Government took over the responsibility for health care. There has since been a growing cooperation between the Directorate of Health and researchers in Denmark and Greenland, for instance by the Directorate supporting workshops and funding a chair in health...

  16. Health Literacy Impact on National Healthcare Utilization and Expenditure.

    Science.gov (United States)

    Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley

    2015-08-17

    Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA® 11.0 statistical software. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare

  17. Evaluating interventions in health: a reconciliatory approach.

    Science.gov (United States)

    Wolff, Jonathan; Edwards, Sarah; Richmond, Sarah; Orr, Shepley; Rees, Geraint

    2012-11-01

    Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that 'experience' is a better basis for evaluation. The other, inspired by Amartya Sen, argues that 'capability' should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing 'instruments' designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. © 2011 Blackwell Publishing Ltd.

  18. Gender and Health Impacts of Genetically Engineered Crops in ...

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

    Gender and Health Impacts of Genetically Engineered Crops in Developing Countries ... exists, the gender and health impacts have so far received only cursory attention. ... New funding opportunity for gender equality and climate change ... social inequality, promote greater gender parity, and empower women and girls.

  19. Essays on Impact evaluation: new empirical evidence from Vietnam

    NARCIS (Netherlands)

    Nguyen Viet Cuong, N.

    2009-01-01

    Keywords: Credit, cash transfers, remittances, migration, poverty, inequality, impact evaluation, Vietnam, Asia

    This study estimates the impact of various economic flows including government-subsidized micro-credit, informal credit, public and private transfers, international

  20. Systematic review of community health impacts of mountaintop removal mining.

    Science.gov (United States)

    Boyles, Abee L; Blain, Robyn B; Rochester, Johanna R; Avanasi, Raghavendhran; Goldhaber, Susan B; McComb, Sofie; Holmgren, Stephanie D; Masten, Scott A; Thayer, Kristina A

    2017-10-01

    The objective of this evaluation is to understand the human health impacts of mountaintop removal (MTR) mining, the major method of coal mining in and around Central Appalachia. MTR mining impacts the air, water, and soil and raises concerns about potential adverse health effects in neighboring communities; exposures associated with MTR mining include particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), metals, hydrogen sulfide, and other recognized harmful substances. A systematic review was conducted of published studies of MTR mining and community health, occupational studies of MTR mining, and any available animal and in vitro experimental studies investigating the effects of exposures to MTR-mining-related chemical mixtures. Six databases (Embase, PsycINFO, PubMed, Scopus, Toxline, and Web of Science) were searched with customized terms, and no restrictions on publication year or language, through October 27, 2016. The eligibility criteria included all human population studies and animal models of human health, direct and indirect measures of MTR-mining exposure, any health-related effect or change in physiological response, and any study design type. Risk of bias was assessed for observational and experimental studies using an approach developed by the National Toxicology Program (NTP) Office of Health Assessment and Translation (OHAT). To provide context for these health effects, a summary of the exposure literature is included that focuses on describing findings for outdoor air, indoor air, and drinking water. From a literature search capturing 3088 studies, 33 human studies (29 community, four occupational), four experimental studies (two in rat, one in vitro and in mice, one in C. elegans), and 58 MTR mining exposure studies were identified. A number of health findings were reported in observational human studies, including cardiopulmonary effects, mortality, and birth defects. However, concerns for risk of bias were identified, especially

  1. Operational Contract Support: Economic Impact Evaluation and Measures of Effectiveness

    Science.gov (United States)

    2017-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES...DATES COVERED MBA professional report 4. TITLE AND SUBTITLE OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES OF EFFECTIVENESS 5...evaluation, expeditionary economics , operational contract support, measure of effectiveness 15. NUMBER OF PAGES 89 16. PRICE CODE 17. SECURITY

  2. Impact of marital status on health

    Science.gov (United States)

    Richmond, Peter; Roehner, Bertrand M.

    2017-11-01

    The Farr-Bertillon law states that the mortality rate of single and widowed persons is about three times the rate of married people of same age. This excess mortality can be measured with good accuracy for all ages except for young widowers. The reason is that, at least nowadays, very few people become widowed under the age of 30. Here we show that disability data from census records can also be used as a reliable substitute for mortality rates. In fact excess-disability and excess-mortality go hand in hand. Moreover, as there are about ten times more cases of disability than deaths, the disability variable is able to offer more accurate measurements in all cases where the number of deaths is small. This allows a more accurate investigation of the young widower effect; it confirms that, as already suspected from death rate data, there is a huge spike between the ages of 20 and 30. By using disability rates we can also study additional features not accessible using death rate data. For example we can examine the health impact of a change in living place. The observed temporary inflated disability rate confirms what could be expected by invoking the ;Transient Shock; conjecture formuladted by the authors in a previous paper. Finally, in another observation it is shown that the disability rate of newly married persons is higher than for those who have been married for more than one year, a result which comes in confirmation of the ;newly married couple; effect reported in an earlier paper.

  3. Evaluation of the Physical Activity and Public Health Course for Practitioners

    Science.gov (United States)

    Evenson, Kelly R.; Brown, David R.; Pearce, Emily; Camplain, Ricky; Jernigan, Jan; Epping, Jacqueline; Shepard, Dennis M.; Dorn, Joan M.

    2016-01-01

    Purpose: From 1996 to 2013, a 6-day Physical Activity and Public Health Course for Practitioners has been offered yearly in the United States. An evaluation was conducted to assess the impact of the course on building public health capacity for physical activity and on shaping the physical activity and public health careers of fellows since taking…

  4. Evaluating community-based public health leadership training.

    Science.gov (United States)

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  5. Working Health Services Scotland: a 4-year evaluation

    Science.gov (United States)

    Hanson, M; Bakhshi, A; Kennedy, M; Macdonald, E B

    2018-01-01

    Abstract Background Working Health Service Scotland (WHSS) supports the self-employed and employees of small and medium-sized enterprises (SMEs) in Scotland with a health condition affecting their ability to work, who are either absent or at risk of becoming absent due to it. Aims To evaluate the impact on health and work outcomes of WHSS clients over a 4-year period. Methods Data were collected at enrolment, entry, discharge and follow-up at 3 and 6 months after discharge. Clients completed up to three validated health questionnaires at entry and discharge—EuroQol five dimensions (EQ-5D) and visual analogue scale (VAS); Hospital Anxiety and Depression Scale (HADS); and Canadian Occupational Performance Measure (COPM). Results A total of 13463 referrals occurred in the 4-year period; 11748 (87%) were eligible and completed entry assessment and 60% of the latter completed discharge paperwork. The majority of referrals were due to musculoskeletal conditions (84%) while 12% were referred with mental health conditions. Almost a fifth (18%) of cases were absent at entry and back at work at discharge. Work days lost while in WHSS was associated with age, length of absence prior to entering WHSS, primary health condition and time in programme. All health measures showed significant improvements from entry to discharge. Improvement in general health was sustained at 3- and 6-month follow-up. Conclusions The WHSS evaluation findings indicate that participation was associated with positive changes to health and return-to-work. The extent of the positive change in health measures and work ability can be highly important economically for employees and employers. PMID:29390161

  6. Energy interventions that facilitate sustainable development and impact health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-04-01

    Objective To inform policy by providing an overview of systematic reviews on interventions that facilitate sustainable energy use and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 13 databases and nine websites based on a pre-defined protocol, including clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese during the 17 years from January 1997 - January 2014 was included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Five systematic reviews and one economic evaluation met the inclusion criteria. The most promising interventions that impacted health were electricity for lighting and other uses (developing countries); improved stoves for cooking and health and/or cleaner fuels for cooking (developing countries); and household energy efficiency measures (developed countries). These interventions also had potential environmental and economic impacts. Their cost-effectiveness is not known, nor is their impact on health inequalities. Conclusions What is needed now is careful implementation of interventions where the impacts are likely to be positive but their implementation needs to be rigorously evaluated, including possible adverse impacts. Care needs to be taken not to exacerbate health inequalities and to consider context, human behavior and cultural factors so that the potential health benefits are realized in real-life implementation. Possible impact on health inequalities needs to be considered and measured in future primary studies and systematic reviews.

  7. Employees’ perceptions of the impact of work on health behaviours

    OpenAIRE

    Payne, Nicola; Jones, Fiona; Harris, Peter R.

    2013-01-01

    Research examining the impact of work on health behaviours has rarely provided a complete picture of the impact across health behaviours. Twenty-four employees were interviewed about their smoking, drinking, exercise and eating. Themes included the impact of the work environment, including policy, convenience and workplace cultural norms; business events effecting one’s routine, and again convenience and workplace cultural norms; being busy at work effecting time and energy for healthy behavi...

  8. Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-08-01

    Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as "sustainable," interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development), all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

  9. Agriculture, food, and nutrition interventions that facilitate sustainable food production and impact health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Michelle M. Haby

    Full Text Available ABSTRACT Objectives To identify the agriculture, food, and nutrition security interventions that facilitate sustainable food production and have a positive impact on health. Methods Systematic review methods were used to synthesize evidence from multiple systematic reviews and economic evaluations through a comprehensive search of 17 databases and 10 websites. The search employed a pre-defined protocol with clear inclusion criteria. Both grey and peer-reviewed literature published in English, Spanish, and Portuguese between 1 January 1997 and November 2013 were included. To classify as “sustainable,” interventions needed to aim to positively impact at least two dimensions of the integrated framework for sustainable development and include measures of health impact. Results Fifteen systematic reviews and seven economic evaluations met the inclusion criteria. All interventions had some impact on health or on risk factors for health outcomes, except those related to genetically modified foods. Impact on health inequalities was rarely measured. All interventions with economic evaluations were very cost-effective, had cost savings, or net benefits. In addition to impacting health (inclusive social development, all interventions had the potential to impact on inclusive economic development, and some, on environmental sustainability, though these effects were rarely assessed. Conclusions What is needed now is careful implementation of interventions with expected positive health impacts but with concurrent, rigorous evaluation. Possible impact on health inequalities needs to be considered and measured by future primary studies and systematic reviews, as does impact of interventions on all dimensions of sustainable development.

  10. [Community health course--student's evaluation].

    Science.gov (United States)

    Juresa, Vesna; Musil, Vera; Sosić, Zvonko; Majer, Marjeta; Pavleković, Gordana

    2010-12-01

    Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar

  11. Training evaluation: a case study of training Iranian health managers.

    Science.gov (United States)

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

    2009-03-05

    The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and

  12. Training evaluation: a case study of training Iranian health managers

    Directory of Open Access Journals (Sweden)

    Butcher Christopher

    2009-03-01

    Full Text Available Abstract Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least

  13. Impact of public health research in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine

    2004-01-01

    In 1992, the Greenland Home Rule Government took over the responsibility for health care. There has since been a growing cooperation between the Directorate of Health and researchers in Denmark and Greenland, for instance by the Directorate supporting workshops and funding a chair in health resea...

  14. Health Impacts of Active Transportation in Europe

    DEFF Research Database (Denmark)

    Rojas-Rueda, David; de Nazelle, Audrey; Andersen, Zorana J

    2016-01-01

    Policies that stimulate active transportation (walking and bicycling) have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16-64) in six European cities. We conducted a health...... reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year). Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists...... and urban planners will help to introduce the health perspective in transport policies and promote active transportation....

  15. Process evaluation of a multifaceted health program aiming to improve physical activity levels and dietary patterns among construction workers

    NARCIS (Netherlands)

    Viester, L.; Verhagen, E.A.L.M.; Bongers, P.M.; Beek, A.J. van der

    2014-01-01

    Objective: To evaluate the process of a health promotion program, aiming to improve physical activity levels and diet among construction workers. Methods: The process evaluation was conducted after the RE-AIM framework for the evaluation of the public health impact of health promotion interventions.

  16. Royal Society of Canada expert panel report : environmental and health impacts of Canada's oil sands industry

    International Nuclear Information System (INIS)

    Gosselin, P.; Hrudey, S.E.; Naeth, M.A.; Plourde, A.; Therrien, R.; Laval Univ., Quebec City, PQ; Van Der Kraak, G.; Guelph Univ., ON; Xu, Z.

    2010-12-01

    This expert panel report was commissioned by the Royal Society of Canada to provide a comprehensive evidence-based assessment of the environmental and health impacts of Canada's oil sands industry. The report evaluated the feasibility of land reclamation and the impacts of oil sands contaminants on downstream residents. Health impacts on residents living in the Regional Municipality of Wood Buffalo were assessed, and the impacts on regional water supplies were evaluated. Regional water and ground water quantities were examined, and issues related to tailing pond operations and reclamation were examined. Ambient air quality impacts were assessed, as well as potential impacts of the oil sands industry on greenhouse gas (GHG) emissions. The environmental regulatory performance of operators in the industry was also evaluated. A summary of economic and policy issues related to the industry was also provided. The study identified major gaps in the process of assessment, prevention, and mitigation of the health impacts of oil sands exploitation, as as major indirect health impacts linked to past exploitation activities. 672 refs., 11 tabs., 11 figs. 10 appendices.

  17. Health Impacts of Tobacco Cultivation in Bangladesh | IDRC ...

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

    ... health problems among men, women, and children in Bangladesh will examine the health and socio-economic impact of tobacco cultivation. To date, the health hazards of growing tobacco have not been documented or well researched, particularly in low-and middle-income countries with high rates of tobacco cultivation.

  18. Can the impact of public involvement on research be evaluated? A mixed methods study.

    Science.gov (United States)

    Barber, Rosemary; Boote, Jonathan D; Parry, Glenys D; Cooper, Cindy L; Yeeles, Philippa; Cook, Sarah

    2012-09-01

      Public involvement is central to health and social research policies, yet few systematic evaluations of its impact have been carried out, raising questions about the feasibility of evaluating the impact of public involvement.   To investigate whether it is feasible to evaluate the impact of public involvement on health and social research.   Mixed methods including a two-round Delphi study with pre-specified 80% consensus criterion, with follow-up interviews. UK and international panellists came from different settings, including universities, health and social care institutions and charitable organizations. They comprised researchers, members of the public, research managers, commissioners and policy makers, self-selected as having knowledge and/or experience of public involvement in health and/or social research; 124 completed both rounds of the Delphi process. A purposive sample of 14 panellists was interviewed.   Consensus was reached that it is feasible to evaluate the impact of public involvement on 5 of 16 impact issues: identifying and prioritizing research topics, disseminating research findings and on key stakeholders. Qualitative analysis revealed the complexities of evaluating a process that is subjective and socially constructed. While many panellists believed that it is morally right to involve the public in research, they also considered that it is appropriate to evaluate the impact of public involvement.   This study found consensus among panellists that it is feasible to evaluate the impact of public involvement on some research processes, outcomes and on key stakeholders. The value of public involvement and the importance of evaluating its impact were endorsed. © 2011 Blackwell Publishing Ltd.

  19. Can the impact of public involvement on research be evaluated? A mixed methods study

    Science.gov (United States)

    Barber, Rosemary; Boote, Jonathan D; Parry, Glenys D; Cooper, Cindy L; Yeeles, Philippa; Cook, Sarah

    2011-01-01

    Abstract Background  Public involvement is central to health and social research policies, yet few systematic evaluations of its impact have been carried out, raising questions about the feasibility of evaluating the impact of public involvement. Objective  To investigate whether it is feasible to evaluate the impact of public involvement on health and social research. Methods  Mixed methods including a two‐round Delphi study with pre‐specified 80% consensus criterion, with follow‐up interviews. UK and international panellists came from different settings, including universities, health and social care institutions and charitable organizations. They comprised researchers, members of the public, research managers, commissioners and policy makers, self‐selected as having knowledge and/or experience of public involvement in health and/or social research; 124 completed both rounds of the Delphi process. A purposive sample of 14 panellists was interviewed. Results  Consensus was reached that it is feasible to evaluate the impact of public involvement on 5 of 16 impact issues: identifying and prioritizing research topics, disseminating research findings and on key stakeholders. Qualitative analysis revealed the complexities of evaluating a process that is subjective and socially constructed. While many panellists believed that it is morally right to involve the public in research, they also considered that it is appropriate to evaluate the impact of public involvement. Conclusions  This study found consensus among panellists that it is feasible to evaluate the impact of public involvement on some research processes, outcomes and on key stakeholders. The value of public involvement and the importance of evaluating its impact were endorsed. PMID:21324054

  20. The public health impact of obesity

    NARCIS (Netherlands)

    Visscher, Tommy L S; Seidell, Jacob C.

    2001-01-01

    The increase in obesity worldwide will have an important impact on the global incidence of cardiovascular disease, type 2 diabetes mellitus, cancer, osteoarthritis, work disability, and sleep apnea. Obesity has a more pronounced impact on morbidity than on mortality. Disability due to

  1. Mixed method approaches to evaluate conservation impact

    DEFF Research Database (Denmark)

    Lund, Jens Friis; Burgess, Neil D.; Chamshama, Shabani A.O.

    2015-01-01

    Nearly 10% of the world's total forest area is formally owned by communities and indigenous groups, yet knowledge of the effects of decentralized forest management approaches on conservation (and livelihood) impacts remains elusive. In this paper, the conservation impact of decentralized forest m...

  2. Abortion and mental health: Evaluating the evidence.

    Science.gov (United States)

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-12-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women's varied experiences of abortion be recognized, validated, and understood. 2009 APA.

  3. Measuring and Analyzing the Scholarly Impact of Experimental Evaluation Initiatives

    DEFF Research Database (Denmark)

    Angelini, Marco; Ferro, Nicola; Larsen, Birger

    2014-01-01

    Evaluation initiatives have been widely credited with contributing highly to the development and advancement of information access systems, by providing a sustainable platform for conducting the very demanding activity of comparable experimental evaluation in a large scale. Measuring the impact...

  4. An evaluation of rural health care research.

    Science.gov (United States)

    Kane, R; Dean, M; Solomon, M

    1979-05-01

    Reviews the state of the art of rural health research and evaluation in the U.S. with particular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer a promising source of primary care for rural areas: recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-sufficiency requirement may mean those who need services most will be least likely to receive them.

  5. A common evaluation framework for the African Health Initiative

    Science.gov (United States)

    2013-01-01

    Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

  6. Radiation pathways and potential health impacts from inactive uranium mill tailings

    International Nuclear Information System (INIS)

    1978-07-01

    Radiation exposure pathways and potential health impacts were estimated as part of the evaluation of radioactive uranium mill tailings at the sites of inactive mills in eight western states. The purpose of this report is to describe in detail the methodology used in performing the pathway analysis and health effects estimations. In addition, specific parameters are presented for each of the 22 uranium mill sites that were evaluated. A computer program, RADAD, developed as part of this program, is described and listed

  7. Social impact bonds and their application to preventive health.

    Science.gov (United States)

    Fitzgerald, John L

    2013-05-01

    Although preventive health in Australia has been acknowledged as central to national health and wellbeing, efforts to reform the delivery of preventive health have to date produced limited results. The financing of preventive health at a national level is based on outcome- or performance-based funding mechanisms; however, delivery of interventions and activities at a state level have not been subjected to outcome-based funding processes. A new financing tool being applied in the area of social services (social impact bonds) has emerged as a possible model for application in the prevention arena. This paper explores key issues in the consideration of this funding model in the prevention arena. When preventive health is conceptualised as a merit good, the role of government is clarified and outcome measures fully articulated, social impact bonds may be a viable funding option to supplement core public health activities. WHAT IS KNOWN ABOUT THE TOPIC? The complexities of outcome monitoring in preventive health are well understood.Likewise, the problem of linking funding to outcomes from preventive health practice has also been debated at length in health policy. However, not much is known about the application of social impact bonds into the preventive health arena.WHAT DOES THIS PAPER ADD? This paper discusses the limitations and opportunities facing the application of the social impact bond financing model in the preventive health arena. This has not been undertaken previously.WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Social impact bonds have received significant recent attention from federal and state government treasury departments as potential financing tools for government. Health policy practitioners are watching this space very closely to see the outcomes of a New South Wales trial. Health promotion practitioners and primary care practitioners who deliver preventive services will need to keep abreast of this issue as it will have significant impact on their

  8. [Self-rating of oral health according to the Oral Health Impact Profile and associated factors: a systematic review].

    Science.gov (United States)

    Gabardo, Marilisa Carneiro Leão; Moysés, Simone Tetu; Moysés, Samuel Jorge

    2013-06-01

    To systematically evaluate the literature to investigate associations between social, demographic, economic, psychosocial, and behavioral factors and the self-perception of oral health measured using the Oral Health Impact Profile (OHIP). In this systematic review of the literature, the Preferred Reporting Items for Systematic Reviews (PRISMA) were adapted for the performance of a qualitative metasummary, without meta-analysis. Articles about oral health and associated factors with implications for quality of life were selected, with a focus on the tool for self-rating of the oral health-disease process, the OHIP. Pubmed/National Library of Medicine (NLM) and the Virtual Health Library (Biblioteca Virtual em Saúde - BVS/BIREME) were searched. Articles published between 2001 and 2011 were included. The following Medical Subject Headings (MeSH) were employed: oral health, quality of life, sickness impact profile, and socioeconomic factors. Of 57 articles identified, 20 met the inclusion criteria. The metasummary revealed that a poor self-perception of oral health was associated with unfavorable social, economic, demographic, and psychosocial factors, as well as with undesirable habits and poor clinical oral conditions. There is consensus in the literature about the influence of the investigated factors on the self-perception of oral health and on quality of life. The OHIP is an important aid for determining oral health needs and for developing strategies to control/reduce disease and promote oral health, with a consequent positive impact on quality of life.

  9. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M L; van Royen, L; Krabbe, P; Bonsel, G J; Rutten, F F

    PROBLEMS: What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  10. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M. L.; van Royen, L.; Krabbe, P.; Bonsel, G. J.; Rutten, F. F.

    1995-01-01

    PROBLEMS--What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  11. Impact of instrument response variations on health physics measurements

    International Nuclear Information System (INIS)

    Armantrout, G.A.

    1984-10-01

    Uncertainties in estimating the potential health impact of a given radiation exposure include instrument measurement error in determining exposure and difficulty in relating this exposure to an effective dose value. Instrument error can be due to design or manufacturing deficiencies, limitations of the sensing element used, and calibration and maintenance of the instrument. This paper evaluates the errors which can be introduced by design deficiencies and limitations of the sensing element for a wide variety of commonly used survey instruments. The results indicate little difference among sensing element choice for general survey work, with variations among specific instrument designs being the major factor. Ion chamber instruments tend to be the best for all around use, while scintillator-based units should not be used where accurate measurements are required. The need to properly calibrate and maintain an instrument appears to be the most important factor in instrument accuracy. 8 references, 6 tables

  12. Wilderness educators' evaluation of the Impact Monster Program

    Science.gov (United States)

    William W. Hendricks; Alan E. Watson

    1999-01-01

    Since its development by Jim Bradley in the late 1970s, the Impact Monster, a wilderness education skit designed to teach minimum impact techniques, has been used as a wilderness education tool by federal land management agencies. This paper reports on an evaluation of the perceived effectiveness of the Impact Monster program and its content. Results indicate that the...

  13. Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

    Science.gov (United States)

    Mittelmark, M B

    2001-09-01

    The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

  14. Impact of telepharmacy in a multihospital health system.

    Science.gov (United States)

    Garrelts, James C; Gagnon, Mark; Eisenberg, Charlese; Moerer, Janell; Carrithers, Joe

    2010-09-01

    The impact of telepharmacy in a multihospital health system was evaluated. Telepharmacy services were implemented at five hospitals within a Catholic, nonprofit, integrated delivery network health system. Telepharmacy services were provided by seven pharmacists employed by the health system. Using a virtual private network or terminal server, pharmacists directly accessed hospital servers and information systems to conduct their work. Telephone calls were automatically routed to the telepharmacist so that handling of nursing and other calls would be transparent to staff. Hours of telepharmacy service were 5 p.m. to 2 a.m. Monday through Friday evenings at four of the hospitals and 8 p.m. to 10 p.m. at the rural hospital. Order-processing time for routine orders was reduced from 26.8 to 14 minutes (p order processing was shortened from 11.6 to 8.8 minutes (p = 0.007). For routine orders, turnaround times greater than 60 minutes became almost nonexistent after telepharmacy services were implemented. The number of clinical interventions documented increased by 42%, from 619 to 881, equivalent to a net annualized saving of $1,132,144. A significant improvement in nurses' global satisfaction with pharmacist availability for unit consultations was reported (3.0 versus 4.0 on a 5.0 Likert scale; p = 0.028). The implementation of telepharmacy services in a multihospital health system expanded hours of service, improved the speed of processing of physician medication orders, and increased clinical pharmacy services and cost avoidance. Surveys of health care staff found that telepharmacy services were well received.

  15. Which Features of Spanish Learners' Pronunciation Most Impact Listener Evaluations?

    Science.gov (United States)

    McBride, Kara

    2015-01-01

    This study explores which features of Spanish as a foreign language (SFL) pronunciation most impact raters' evaluations. Native Spanish speakers (NSSs) from regions with different pronunciation norms were polled: 147 evaluators from northern Mexico and 99 evaluators from central Argentina. These evaluations were contrasted with ratings from…

  16. Critical evaluation of international health programs: Reframing global health and evaluation.

    Science.gov (United States)

    Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

    2018-01-05

    Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

  17. Evaluating Public Health Interventions: 1. Examples, Definitions, and a Personal Note.

    Science.gov (United States)

    Spiegelman, Donna

    2016-01-01

    In the first contribution to a new section in AJPH that will address critical methodological issues in evaluations of public health interventions, I will discuss topics in study design and analysis, covering the most innovative emerging methodologies and providing an overview of best practices. The methods considered are motivated by public health evaluations, both domestic and global. In this first contribution, I also define implementation science, program evaluation, impact evaluation, and cost-effectiveness research, disciplines that have tremendous methodological and substantive overlap with evaluation of public health interventions--the focus of this section.

  18. Oral Health Promotion in Schools: Rationale and Evaluation

    Science.gov (United States)

    Kizito, Alex; Caitlin, Meredith; Wang, Yili; Kasangaki, Arabat; Macnab, Andrew J.

    2014-01-01

    Purpose: The purpose of this paper is to explain the rationale and potential for the WHO health promoting schools (HPS) to improve children's oral health, and describe validated quantitative methodologies and qualitative approaches to measure program impact. Design/Methodology/Approach: Critical discussion of the impact of poor oral health and…

  19. A multi-method approach to evaluate health information systems.

    Science.gov (United States)

    Yu, Ping

    2010-01-01

    Systematic evaluation of the introduction and impact of health information systems (HIS) is a challenging task. As the implementation is a dynamic process, with diverse issues emerge at various stages of system introduction, it is challenge to weigh the contribution of various factors and differentiate the critical ones. A conceptual framework will be helpful in guiding the evaluation effort; otherwise data collection may not be comprehensive and accurate. This may again lead to inadequate interpretation of the phenomena under study. Based on comprehensive literature research and own practice of evaluating health information systems, the author proposes a multimethod approach that incorporates both quantitative and qualitative measurement and centered around DeLone and McLean Information System Success Model. This approach aims to quantify the performance of HIS and its impact, and provide comprehensive and accurate explanations about the casual relationships of the different factors. This approach will provide decision makers with accurate and actionable information for improving the performance of the introduced HIS.

  20. [Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

    Science.gov (United States)

    Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

    2011-04-01

    The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

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

    2016-09-01

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

  2. Governance structures impact on eHealth

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2015-01-01

    Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

  3. Evaluating the Impact of Educational Interventions on Patients and Communities: A Conceptual Framework.

    Science.gov (United States)

    Bzowyckyj, Andrew S; Dow, Alan; Knab, Mary S

    2017-11-01

    Health professions education programs can have direct effects on patients and communities as well as on learners. However, few studies have examined the patient and community outcomes of educational interventions. To better integrate education and health care delivery, educators and researchers would benefit from a unifying framework to guide the planning of educational interventions and evaluation of their impact on patients.The authors of this Perspective mirrored approaches from Miller's pyramid of educational assessment and Moore and colleagues' framework for evaluating continuing professional development to propose a conceptual framework for evaluating the impact of educational interventions on patients and communities. This proposed framework, which complements these existing frameworks for evaluating the impact of educational interventions on learners, includes four levels: (1) interaction; (2) acceptability; (3) individual outcomes (i.e., knowledge, skills, activation, behaviors, and individual health indicators); and (4) population outcomes (i.e., community health indicators, capacity, and disparities). The authors describe measures and outcomes at each level and provide an example of the application of their new conceptual framework.The authors encourage educators and researchers to use this conceptual framework to evaluate the impact of educational interventions on patients and to more clearly identify and define which educational interventions strengthen communities and enhance overall health outcomes.

  4. Identification and Prioritization of Relationships between Environmental Stressors and Adverse Human Health Impacts.

    Science.gov (United States)

    Bell, Shannon M; Edwards, Stephen W

    2015-11-01

    There are > 80,000 chemicals in commerce with few data available describing their impacts on human health. Biomonitoring surveys, such as the NHANES (National Health and Nutrition Examination Survey), offer one route to identifying possible relationships between environmental chemicals and health impacts, but sparse data and the complexity of traditional models make it difficult to leverage effectively. We describe a workflow to efficiently and comprehensively evaluate and prioritize chemical-health impact relationships from the NHANES biomonitoring survey studies. Using a frequent itemset mining (FIM) approach, we identified relationships between chemicals and health biomarkers and diseases. The FIM method identified 7,848 relationships between 219 chemicals and 93 health outcomes/biomarkers. Two case studies used to evaluate the FIM rankings demonstrate that the FIM approach is able to identify published relationships. Because the relationships are derived from the vast majority of the chemicals monitored by NHANES, the resulting list of associations is appropriate for evaluating results from targeted data mining or identifying novel candidate relationships for more detailed investigation. Because of the computational efficiency of the FIM method, all chemicals and health effects can be considered in a single analysis. The resulting list provides a comprehensive summary of the chemical/health co-occurrences from NHANES that are higher than expected by chance. This information enables ranking and prioritization on chemicals or health effects of interest for evaluation of published results and design of future studies. Bell SM, Edwards SW. 2015. Identification and prioritization of relationships between environmental stressors and adverse human health impacts. Environ Health Perspect 123:1193-1199; http://dx.doi.org/10.1289/ehp.1409138.

  5. The impact of agriculture on environmental health in Nigeria ...

    African Journals Online (AJOL)

    The impact of agriculture on environmental health in Nigeria. ... Journal of Environmental Extension ... use of antibiotics in animal farming and insecticides accounts for high incidences of food poisoning and deaths of unsuspecting consumers ...

  6. A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

    Science.gov (United States)

    Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

    2017-12-13

    Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

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

    Science.gov (United States)

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

    2014-01-01

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

  8. What is the perceived impact of Alexander technique lessons on health status, costs and pain management in the real life setting of an English hospital? The results of a mixed methods evaluation of an Alexander technique service for those with chronic back pain

    OpenAIRE

    McClean, Stuart; Brilleman, Sam; Wye, Lesley

    2015-01-01

    Background: Randomised controlled trial evidence indicates that Alexander Technique is clinically and cost effective for chronic back pain. The aim of this mixed methods evaluation was to explore the role and perceived impact of Alexander Technique lessons in the naturalistic setting of an acute hospital Pain Management Clinic in England.\\ud \\ud Methods: To capture changes in health status and resource use amongst service users, 43 service users were administered three widely used questionnai...

  9. The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management.

    Science.gov (United States)

    Househ, Mowafa S; Shubair, Mamdouh M; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

    2015-10-01

    The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers' ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Overall, the consumers' ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients.

  10. The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management

    Science.gov (United States)

    Househ, Mowafa S.; Shubair, Mamdouh M.; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

    2015-01-01

    Background: The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). Methods: A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers’ ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Results: Overall, the consumers’ ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Conclusions: Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients. PMID:26635437

  11. The Impact of Bariatric Surgery on Psychological Health

    OpenAIRE

    Kubik, Jeremy F.; Gill, Richdeep S.; Laffin, Michael; Karmali, Shahzeer

    2013-01-01

    Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental ...

  12. The Impact of Gatekeepers on Evaluation Use

    Science.gov (United States)

    Avila, Minerva

    2012-01-01

    By examining the development of a local school reform that was meant to be teacher-driven, this multiple case study explored the limits on evaluation use in a hierarchical setting in which multiple audiences exist. This study was a comparative analysis of the actions and evaluation philosophies of two district administrators responsible for…

  13. Current issues in the impacts of transport on health.

    Science.gov (United States)

    van Schalkwyk, M C I; Mindell, J S

    2018-03-01

    Transport affects health in many ways. Benefits include access to education, employment, goods, services and leisure, and opportunities for incorporating physical activity into daily living. There are major inequalities: benefits generally accrue to wealthier people and harms to the more deprived, nationally and globally. Health on the Move 2; Journal of Transport and Health. Benefits of travel for access and physical activity. Harms include health impacts of air and noise pollution; injuries and fatalities from falls or collisions; sedentary behaviour with motorized transport; community severance (barrier effect of busy roads and transport infrastructure); global climate change; impacts on inequalities; transport's role in facilitating spread of communicable diseases. Biofuels; cycle safety; driving by older people. Effects of default 20 mph speed limits; impacts of autonomous vehicles on health and inequalities.

  14. Perspective for Future Research Direction About Health Impact of Ambient Air Pollution in China.

    Science.gov (United States)

    Dong, Guang-Hui

    2017-01-01

    Air pollution has become one of the major risks to human health because of the progressive increase in the use of vehicles powered by fossil fuels. Although lots of works on the health impact of ambient air pollution have been done in China, the following recommendations for future research were identified in this chapter: (1) the synergistic effect of indoor air pollution with climate change; (2) develop new technologies to improve accurate assessment of air pollution exposure; (3) well-designed cohort study of sensitive populations including children, older people, and people with chronic health problems; (4) multi-omics technologies in the underlying mechanisms study; and (5) benefits evaluation of improvement of air quality. In conclusion, China is becoming a suitable study site, providing an ideal opportunity to evaluate the effects of environmental pollution, including air pollution, on human health, which might serve as an example for developing countries where health impacts of air pollution are as serious as in China.

  15. The Impact of Coffee on Health.

    Science.gov (United States)

    Nieber, Karen

    2017-11-01

    Coffee is one of the most popular and widely consumed beverages worldwide due to its stimulating effects on the central nervous system as well as its taste and aroma. Coffee is a complex mixture of more than 800 volatile compounds whereas caffeine and chlorogenic acids are the most common compounds. During the last years, coffee has progressively moved to a less negative position on health due to its better-known pharmacology. Caffeine, e.g., in a cup of coffee, appears to exert most of its effects through an antagonism of the adenosine receptors. Novel approaches in epidemiological studies and experimental researches suggest that coffee consumption may help to prevent several chronic diseases, including type 2 diabetes mellitus and liver disease. Most prospective cohort studies have not found coffee consumption to be associated with a significantly increased cardiovascular disease risk. There is also evidence that decaffeinated coffee may, in some respect, have similar benefits as regular coffee, indicating that besides caffeine other components contribute to the health protecting effects. For adults consuming moderate amounts of coffee (3 - 4 cups/d providing 300 - 400 mg/d of caffeine), there is little evidence of health risks and some evidence of health benefits. This review provides up-to-date information about coffee on health. Topics addressed include the cardiovascular system, liver diseases, and diabetes as well as gastrointestinal disorders. Georg Thieme Verlag KG Stuttgart · New York.

  16. Gallon Model for the evaluation of environmental impacts

    International Nuclear Information System (INIS)

    Gallon Martinez, Juan Carlos

    2003-01-01

    When it is necessary to know the impact grade that will have the environment for the introduction of a project or handling plan, it is appealed to a study of environmental impact that quantifies variables of qualitative type to obtain results of quantitative type. The evaluation of environmental impacts is necessary to know which phases or actions of the different projects have negative or positive repercussions or far-reaching about the different susceptible environmental factors to receive impacts, and to determine previously, the most important aspects to determine the level of impact of the projects or handling plans. The evaluation measures the repercussions and consequences of the different activities of the industry on the environment, allowing to evaluate the future conditions of the habitat, being an excellent tool for making decisions regarding the possible future impact that can have an industrial process or project to diminish the nature

  17. Evaluating the effectiveness of health care teams.

    Science.gov (United States)

    Mickan, Sharon M

    2005-05-01

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

  18. Impact of actinide recycle on nuclear fuel cycle health risks

    International Nuclear Information System (INIS)

    Michaels, G.E.

    1992-06-01

    The purpose of this background paper is to summarize what is presently known about potential impacts on the impacts on the health risk of the nuclear fuel cycle form deployment of the Advanced Liquid Metal Reactor (ALMR) 1 and Integral Fast Reactor (IF) 2 technology as an actinide burning system. In a companion paper the impact on waste repository risk is addressed in some detail. Therefore, this paper focuses on the remainder of the fuel cycle

  19. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

    Directory of Open Access Journals (Sweden)

    Wight Daniel

    2012-09-01

    Full Text Available Abstract Background Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief, economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  20. Evaluating health care interventions in the European Union.

    Science.gov (United States)

    McDaid, David; Cookson, Richard

    2003-02-01

    This paper examines the current state of evaluations of health care interventions in the European Union, from the identification and commissioning of research through to its impact on policy and practice. Material is drawn from a survey conducted for the ASTEC project as well as a review of literature. Although the use of evaluative research has increased substantially in the last decade, both the pace of change and preferred research methodologies employed differ markedly. Much research still concentrates on issues of safety, efficacy and effectiveness, although there is evidence of an increasing emphasis on cost-effectiveness. Many countries are beginning to introduce systems linking economic evaluation to the decision-making process, while networks for the exchange of information continue to evolve. Research capacity in the public sector, although improving, is uneven, in part due to the uncertainty over long term career prospects and competition from industry. Capacity building measures should in particular ensure that dissemination expertise is strengthened, and that more emphasis is placed on developing receptor capacity within different stakeholder groups. Linking knowledge production to changes in practice remains a key challenge. Further research on implementation and impact assessment is required, to help demonstrate the value of evaluations on both policy and practice.

  1. Impact of Construction Health & Safety Regulations on Project ...

    African Journals Online (AJOL)

    Impact of Construction Health & Safety Regulations on Project Parameters in Nigeria: Consultants and Contractors View. ... The study recommends that better attention is given to health and safety should as a project parameter and that related practice notes and guidelines should be evolved for all project stakeholders.

  2. Impact of secondary cardiovascular events on health status

    NARCIS (Netherlands)

    van Stel, Henk F.; Busschbach, Jan J. V.; Hunink, M. G. Myriam; Buskens, Erik

    2012-01-01

    Objectives: Estimates regarding the impact of secondary cardiovascular events on health status in patients treated for cardiovascular disease are scarce and of limited accuracy. Methods: We obtained individual patient data on health status (EuroQol five-dimensional questionnaire) and secondary

  3. Revenue and Health Impacts of Restructuring Tobacco Excise Tax ...

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

    Revenue and Health Impacts of Restructuring Tobacco Excise Tax in the Philippines. A proposed law in the Philippines to increase the excise tax on tobacco by 215% will likely have implications for tobacco control and consumption, and public health, not just for that country but for the region. Although half of deaths due to ...

  4. The Economic and Health Impacts of Legislative Fiscal Policies to ...

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

    Journal articles. Empowering healthy food and beverage choices in the workplace. Download PDF. Journal articles. Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa. Download PDF. Journal articles. Sugar and health in South Africa ...

  5. Assessing the impact of aflatoxin consumption on animal health and ...

    African Journals Online (AJOL)

    They are toxic to humans, fish and many other animals, even in low concentrations. Susceptibility to aflatoxins varies by age, health status, species and other factors. Most research has focused on aflatoxins in maize or groundnuts and their impacts on human health. However, aflatoxins are found in other foods and can also ...

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  7. Health Impacts Of Radiofrequency Exposure From Mobile Phone ...

    African Journals Online (AJOL)

    Background: The widespread use of mobile phones and indiscriminate siting of transmitter base stations near residential buildings in our environment may have serious health impacts. Objective: To investigate the possible health risks associated with radiofrequency (RF) exposure from mobile phones and other transmitter ...

  8. Climate change impacts health in Tunisia | IDRC - International ...

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

    2012-03-26

    Mar 26, 2012 ... Research is showing that climate change is having major impacts on human health. Weather-related disasters are on the rise and water- and vector-borne diseases are spreading. Strategies to adapt to the effects of climate change may also pose unforeseen health risks. Read more about a project in ...

  9. Impact of environmental radiation on human health

    International Nuclear Information System (INIS)

    Shekhawat, Jyotsna

    2012-01-01

    A clean environment is essential for human health because the interaction between the environment and human health shows the complexity. Air pollution, less water quality, noise etc directly affects the health. Climate change, depletion of ozone layer, loss of biodiversity and degradation of land can also affect human health. Most of the modern technologies produce radiations in the environment having both beneficial and harmful effects through radioactive material. Natural radioactive sources include Cosmic radiation comes from the sun and outer space is absorbed by the atmosphere, a small amount reaches the earth's surface to which we are exposed. The exposure to this type of radiation is higher for people living above sea level. Radon is produced through the decay of uranium and thorium that are found naturally in the earth's crust. Primordial and terrestrial radiation are present in rocks and soils and occur when naturally radioactive isotopes of uranium, thorium and potassium decay within the earth's crust. Artificial (or man-made) radioactive sources include Fallout radiation, which results from past atmospheric nuclear bomb tests (1950s and 1960s many test explosions). Each environmental change, whether occurring as a natural phenomenon or through human intervention, changes the ecological balance and context within which disease hosts or vectors and parasites breed, develop, transmit disease. Today, radiation is a common used in medicine to diagnose illnesses, research to treat diseases and industry to generate electricity in nuclear power reactors. Radiation is energy that moves through space or matter at a very high speed. This energy can be in the form of particles, such as alpha or beta particles, which are emitted from radioisotopes. Radioactive Material is material that contains an unstable atomic nucleus releases radiation in the process of changing to a stable form. There are two types of health effects from radiation - threshold and non threshold

  10. An evaluation of school health services in Sagamu, Nigeria

    African Journals Online (AJOL)

    2013-07-01

    Jul 1, 2013 ... scores (63.6%), while 96.2% of the private primary schools had poor health service evaluation scores. Conclusions: SHS are ... Key words: School Health Services, School Health Services Evaluation scale, Health knowledge, Nigeria ..... Since food and nutrition is an aspect of home economics, teaching.

  11. Health impact assessment of air pollution using a dynamic exposure profile: Implications for exposure and health impact estimates

    International Nuclear Information System (INIS)

    Dhondt, Stijn; Beckx, Carolien; Degraeuwe, Bart; Lefebvre, Wouter; Kochan, Bruno; Bellemans, Tom; Int Panis, Luc; Macharis, Cathy; Putman, Koen

    2012-01-01

    In both ambient air pollution epidemiology and health impact assessment an accurate assessment of the population exposure is crucial. Although considerable advances have been made in assessing human exposure outdoors, the assessments often do not consider the impact of individual travel behavior on such exposures. Population-based exposures to NO 2 and O 3 using only home addresses were compared with models that integrate all time-activity patterns—including time in commute—for Flanders and Brussels. The exposure estimates were used to estimate the air pollution impact on years of life lost due to respiratory mortality. Health impact of NO 2 using an exposure that integrates time-activity information was on average 1.2% higher than when assuming that people are always at their home address. For ozone the overall estimated health impact was 0.8% lower. Local differences could be much larger, with estimates that differ up to 12% from the exposure using residential addresses only. Depending on age and gender, deviations from the population average were seen. Our results showed modest differences on a regional level. At the local level, however, time-activity patterns indicated larger differences in exposure and health impact estimates, mainly for people living in more rural areas. These results suggest that for local analyses the dynamic approach can contribute to an improved assessment of the health impact of various types of pollution and to the understanding of exposure differences between population groups. - Highlights: ► Exposure to ambient air pollution was assessed integrating population mobility. ► This dynamic exposure was integrated into a health impact assessment. ► Differences between the dynamic and residential exposure were quantified. ► Modest differences in health impact were found at a regional level. ► At municipal level larger differences were found, influenced by gender and age.

  12. Health impact assessment of air pollution using a dynamic exposure profile: Implications for exposure and health impact estimates

    Energy Technology Data Exchange (ETDEWEB)

    Dhondt, Stijn, E-mail: stijn.dhondt@vub.ac.be [Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090, Brussels (Belgium); Beckx, Carolien, E-mail: Carolien.Beckx@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Degraeuwe, Bart, E-mail: Bart.Degraeuwe@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Lefebvre, Wouter, E-mail: Wouter.Lefebvre@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Kochan, Bruno, E-mail: Bruno.Kochan@uhasselt.be [Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Bellemans, Tom, E-mail: Tom.Bellemans@uhasselt.be [Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Int Panis, Luc, E-mail: Luc.intpanis@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Macharis, Cathy, E-mail: cjmachar@vub.ac.be [Department MOSI-Transport and Logistics, Vrije Universiteit Brussel, Pleinlaan 2, B-1050, Brussels (Belgium); Putman, Koen, E-mail: kputman@vub.ac.be [Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090, Brussels (Belgium); Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel, Brussels (Belgium)

    2012-09-15

    In both ambient air pollution epidemiology and health impact assessment an accurate assessment of the population exposure is crucial. Although considerable advances have been made in assessing human exposure outdoors, the assessments often do not consider the impact of individual travel behavior on such exposures. Population-based exposures to NO{sub 2} and O{sub 3} using only home addresses were compared with models that integrate all time-activity patterns-including time in commute-for Flanders and Brussels. The exposure estimates were used to estimate the air pollution impact on years of life lost due to respiratory mortality. Health impact of NO{sub 2} using an exposure that integrates time-activity information was on average 1.2% higher than when assuming that people are always at their home address. For ozone the overall estimated health impact was 0.8% lower. Local differences could be much larger, with estimates that differ up to 12% from the exposure using residential addresses only. Depending on age and gender, deviations from the population average were seen. Our results showed modest differences on a regional level. At the local level, however, time-activity patterns indicated larger differences in exposure and health impact estimates, mainly for people living in more rural areas. These results suggest that for local analyses the dynamic approach can contribute to an improved assessment of the health impact of various types of pollution and to the understanding of exposure differences between population groups. - Highlights: Black-Right-Pointing-Pointer Exposure to ambient air pollution was assessed integrating population mobility. Black-Right-Pointing-Pointer This dynamic exposure was integrated into a health impact assessment. Black-Right-Pointing-Pointer Differences between the dynamic and residential exposure were quantified. Black-Right-Pointing-Pointer Modest differences in health impact were found at a regional level. Black

  13. The impact of mHealth interventions on health systems: a systematic review protocol.

    Science.gov (United States)

    Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

    2016-11-25

    Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

  14. Burning Fossil Fuels: Impact of Climate Change on Health.

    Science.gov (United States)

    Sommer, Alfred

    2016-01-01

    A recent, sophisticated granular analysis of climate change in the United States related to burning fossil fuels indicates a high likelihood of dramatic increases in temperature, wet-bulb temperature, and precipitation, which will dramatically impact the health and well-being of many Americans, particularly the young, the elderly, and the poor and marginalized. Other areas of the world, where they lack the resources to remediate these weather impacts, will be even more greatly affected. Too little attention is being paid to the impending health impact of accumulating greenhouse gases. © The Author(s) 2015.

  15. Electromagnetic fields and health impact: measurements, monitoring and environmental indicators

    International Nuclear Information System (INIS)

    Lubritto, C.; Vetromile, C.; Petraglia, A.; Racioppoli, M.; D'Onofrio, A.

    2008-01-01

    Full text: During the last 10 years there has been a remarkable growth of the attention for problems related to the electromagnetic pollution, motivated by the alert connected to potential risk for the health of persons and due to the increasing diffusion of Bats for mobile telecommunication as EMF sources. Many projects are being realized about the environmental and health impact of electromagnetic field and an important social role is played by specific actions to minimize the risk perception of the population. This study aims to find an innovative approach to these problems through the use of a system of continuous time monitoring of the electromagnetic fields and the individuation of appropriate environmental indicators. The proposed system monitors the electromagnetic fields continuously over time, and is already operating in many southern Italian cities. It works in a very efficient way as a mean for: a) Info to the citizens, thanks to diffusion of daily collected data on Internet Web; b) Control for local administrations and Authorities, due to capability of the system itself to alert when measured values exceed the limits reported by the Italian laws; c) Planning, for the implementation of : 1) New procedures agreed among local environmental control agency, local administrations and mobile Companies for network planning and management of alarm situations; 2) New local guidelines documents concerning the installation and operation of telecommunications apparatus. Moreover, starting from the general principles of the Strategic Environmental Evaluation (VAS), the environmental impacts of EMS field is studied. Based on the model DPSIR (Drivers, Pressure, State, Impacts, Responses), 12 environmental indicators have been chosen providing an immediate and understandable tool to obtain very important information on electromagnetic pollution generated by radio-telecommunication systems. The selected environmental indicators have been applied to 11 cities of the

  16. Environmental and health impacts of successive mineral fertilization in Egypt

    Energy Technology Data Exchange (ETDEWEB)

    Abdelhafez, Ahmed A. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Abbas, Hassan H.; Abd-El-Aal, Rafat S. [Faculty of Agriculture, Benha University (Egypt); Kandil, Nabil F. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Li, Jianhua [Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Mahmoud, Wahballah [Center of Excellence of Biotechnology Research, King Saud University, Riyadh (Saudi Arabia)

    2012-04-15

    Excessive amounts of mineral fertilizers are unnecessarily applied to agricultural soils in Egypt to increase crop yield. The current study aims at assessing the impacts of fertilization with different mineral fertilizers for different cultivation periods on the accumulation of heavy metals in soils and plants grown thereon. In addition, human risks resulted due to the exposure to these metal ions through ingestion, and dermal routes were evaluated. Soil and plant samples were collected from several locations in El-Behira Governorate, Egypt and their heavy metal contents were measured. The result indicated that there is a continuous accumulation of heavy metals in the soils and the plants grown thereon. Calculation of the hazard index (HI) revealed that humans, especially children, have a potential health risk for both Pb and Cd, which have levels greater than the safe level (1). Finally, the obtained results showed that the continuous application of mineral fertilizers containing high levels of heavy metals pose a potential health threat. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  17. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    Science.gov (United States)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

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

    OpenAIRE

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

    2013-01-01

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

  19. Impacts of “metals” on human health

    DEFF Research Database (Denmark)

    Pizzol, Massimo; Christensen, Per; Schmidt, Jannick Højrup

    2011-01-01

    This paper looks into the differences and uncertainties in determining the impact of “metals” emissions on human health, in Life Cycle Impact Assessment (LCIA). Metals are diverse substances, with different properties and characteristics, considered important in LCIA because of their toxicity...... to humans and ecosystems. First, we defined a list of the most significant metals in terms of impacts on human health. This was done according to precise criteria accounting for both physical and toxic properties of the metals. Second, we performed a LCIA on different key processes using various existing...... to the total impact on human health changes greatly according to the LCIA method used. These differences are due mainly to the number of metals included in each method and to the technique used to calculate the characterization factors. Results obtained with USEtox show no apparent correlation with results...

  20. Noise Pollution and Impact on Children Health.

    Science.gov (United States)

    Gupta, Alok; Gupta, Anant; Jain, Khushbu; Gupta, Sweta

    2018-04-01

    With rapid urbanization and life style changes, loud noise is omnipresent and has become a part of life. Indoor and outdoor environmental noise pollution have been documented as a serious health hazard with increasing adverse effects on fetus, infants, children, adolescents and adults. Noise induced hearing loss and non-auditory adverse effects due to noise pollution, are being increasingly diagnosed in all age groups including the fetus. Outdated motorized vehicles, machinery, increasing traffic, congested residential areas, crowded educational institutions and workplaces, unregulated commercial and industrial noise have become a source of noise pollution with long-term disability. Areas of noise pollution must be identified and corrective measures be taken. Toys, personal, domestic, commercial, industrial equipment should be within the safe sound intensity. Loudspeakers and vehicular horns should be banned except in emergencies. Nocturnal noise pollution must be avoided near residential areas as sleep disturbances have serious long-term health consequences. Pregnant women, fetus, newborns, infants and children are most susceptible to noise induced health hazards and should be given utmost protection. Educational institutions, workplaces, commercial and industrial areas should be regularly monitored for noise levels and protective ear muffs and plugs be used. Public be educated repeatedly regarding health hazards of noise. Traffic noise should be regulated to be within safe limits. Bus-stands, railway stations and airports should be moved away from residential areas. Houses should be sound proofed suitably. Long term studies should be conducted in pregnant women, newborn children and adults to have more data on hazards of noise pollution.

  1. Climate change and health: temperature and health impacts

    CSIR Research Space (South Africa)

    Matooane, M

    2009-03-01

    Full Text Available /heat waves are anticipated to increase in frequency and magnitude in the 21st century. excessive temperatures lead to excess morbidity and mortality (all cause, respiratory, cardiovascular system mortality). Figure 1 depicts the impact of summer 2003... mortality temperature threshold below or above which every 1?C change increases mortality by ~4% and ~0.5%, respectively (mcmichael, et al., 2008). temperature-related mortality rates (all cause, cardiovascular and respiratory) are modified by many...

  2. Evaluation of Multidisciplinary Tobacco Cessation Training Program in a Large Health Care System

    Science.gov (United States)

    Chen, Timothy C.; Hamlett-Berry, Kim W.; Watanabe, Jonathan H.; Bounthavong, Mark; Zillich, Alan J.; Christofferson, Dana E.; Myers, Mark G.; Himstreet, Julianne E.; Belperio, Pamela S.; Hudmon, Karen Suchanek

    2015-01-01

    Background: Health care professionals can have a dramatic impact by assisting patients with tobacco cessation but most have limited training. Purpose: To evaluate the effectiveness of a 4-hour tobacco cessation training program. Methods: A team of multidisciplinary health care professionals created a veteran-specific tailored version of the Rx for…

  3. Impact of leishmaniasis on public health

    Directory of Open Access Journals (Sweden)

    L. B Camargo

    2006-01-01

    Full Text Available Leishmaniasis is a parasitic zoonosis caused by protozoans of the genus Leishmania transmitted by insects known as phlebotomines, which are found in wild or urban environments. It affects domestic and wild animals and transmission to man happens by accident. The disease occurs in tropical and sub-tropical areas, mainly in Asia, Europe, Africa, and the Americas. There are two forms that affect man: American cutaneous leishmaniasis (ACL and American visceral leishmaniasis (AVL. The latter is caused by three species of Leishmania: Leishmania (Leishmania donovani, Leishmania (Leishmania infantum, and Leishmania (Leishmania chagasi, which are grouped in the Leishmania (Leishmania donovani complex. Wild reservoir hosts of L. chagasi known so far are foxes and marsupials. In domestic environment, dogs are the most important reservoir hosts and sources of infection to the vectors Lutzomyia longipalpis. Leishmaniasis is difficult to control, causing epidemic outbreaks, thus being an important public health problem. Due to lesions caused by the mucocutaneous type and the severity of those caused by the visceral type in humans, visceral leishmaniasis is one of the main public health concerns. This paper is part of the monograph presented at the end of the residency program in the field of Zoonosis and Public Health at the School of Veterinary Sciences and Animal Husbandry, São Paulo State University, UNESP, Botucatu, São Paulo State, Brazil, in 2005.

  4. Impacts of Climate Change on Human Health in the United ...

    Science.gov (United States)

    Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

  5. The Impact of Bariatric Surgery on Psychological Health

    Directory of Open Access Journals (Sweden)

    Jeremy F. Kubik

    2013-01-01

    Full Text Available Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient’s sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery.

  6. The impact of bariatric surgery on psychological health.

    Science.gov (United States)

    Kubik, Jeremy F; Gill, Richdeep S; Laffin, Michael; Karmali, Shahzeer

    2013-01-01

    Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient's sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery.

  7. A comprehensive health service evaluation and monitoring framework.

    Science.gov (United States)

    Reeve, Carole; Humphreys, John; Wakerman, John

    2015-12-01

    To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    Science.gov (United States)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  9. Evolution of a multilevel framework for health program evaluation.

    Science.gov (United States)

    Masso, Malcolm; Quinsey, Karen; Fildes, Dave

    2017-07-01

    A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination. These components of the evaluation framework fit into a matrix structure, and cells within the matrix are supported by relevant evaluation tools. The development of the framework has been influenced by feedback from various stakeholders, existing knowledge of the evaluators and the literature on health promotion and implementation science. Over the years, the framework has matured and is generic enough to be useful in a wide variety of circumstances, yet specific enough to focus data collection, data analysis and the presentation of findings.

  10. Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

    Science.gov (United States)

    Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

    2016-09-01

    In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

  11. Evaluation process of global environmental impact: assessment guidelines

    International Nuclear Information System (INIS)

    Memon, A.R.; Mahar, R.B.

    2001-01-01

    In developed and developing countries, the EIA (Environmental Impact Assessment) is becoming mandatory for the approval of Industrial projects and projects of Environmental hazards. The approving authority of each country has its own guidelines to get projects approved and make project proponents responsible to submit Environmental Impact Statement for the its detailed assessment. In this paper authors have studied an existing EIA Global guidelines and its evaluation process of altogether 40 countries from four continents, Asia, Pacific/Middle East, Europe, Australia and America/Canada. This evaluation process is recorded in the tabulation form and it has been formulated stage wise in which stage one highlights the inception of EIA guidelines of each country and stage two and three gives implementation process. The inception stage of guidelines gives an idea that when EIA was started and an implementation stages provide all information that when EIA become a part of legislation that provide an opportunity to the reader to understand the decision making process for project approvals. The main objective of writing EIA guidelines is to monitor the sustain ability of various types of the projects under different sectoral guidelines, therefore Projects related with different Sectors have been chosen and a detailed record in tabulation form gives an idea to understand the interaction of these guidelines. To make this paper more comprehensive, authors have gone thorough the sectoral guidelines of altogether 64 countries and studied 21 sector oriented project fields. These are of Agriculture/Irrigation, Biodiversity, Coastal/Marine, Community Participation, Extractive industries, Fisheries, Forestry, Hazard Risk, Health, Human settlement, Industry, Multi sectorial, Ports and Harbors, Power, refugees/resettlement, Social, Strategies/Planning, Tourism/Recreational, transportation, Waste Pollution and Wetlands/Water resources. (author)

  12. Impact of Health Literacy on Senior Citizen Engagement in Health Care IT Usage

    Directory of Open Access Journals (Sweden)

    Alice M. Noblin PhD, RHIA, CCS

    2017-04-01

    Full Text Available Objective: Patient engagement in health care information technology (IT is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS and eHealth Literacy Scale (eHEALS tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group. Results: Although most participants have adequate literacy, they are not more likely to use health care IT than those with limited literacy scores. Knowledge of how to use the Internet to answer questions about health was statistically associated with IT usage. Discussion: Health care IT usage is important for healthy aging. The ability of older adults to understand information provided to them can impact population health including medication usage and other important factors.

  13. Impact of Health Literacy on Senior Citizen Engagement in Health Care IT Usage.

    Science.gov (United States)

    Noblin, Alice M; Rutherford, Ashley

    2017-01-01

    Objective: Patient engagement in health care information technology (IT) is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS) and eHealth Literacy Scale (eHEALS) tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group. Results: Although most participants have adequate literacy, they are not more likely to use health care IT than those with limited literacy scores. Knowledge of how to use the Internet to answer questions about health was statistically associated with IT usage. Discussion: Health care IT usage is important for healthy aging. The ability of older adults to understand information provided to them can impact population health including medication usage and other important factors.

  14. [Exploring models for the assessment of the economic, social, political, and scientific impact of health research].

    Science.gov (United States)

    Macías-Angel, Beatriz; Agudelo-Calderón, Carlos A

    2015-05-01

    Health research produces effects on the health of populations. This document approaches the frameworks and the models used by developed countries to assess the impact of health research through documentary analysis of research with the highest impact. With this, it was possible to identify two guiding axes of analysis: one having to do with focus, and the other having to do with emphasis. With these, the published models, their uses, their reach, and their origins are related. Our study brings awareness to the features they have and the areas in which Colombia could implement them. We found that the framework for evaluating health research known as the "payback model" is a model for monitoring research that tracks the process and research results with multidimensional categorization of the impacts of research.

  15. Evaluating impacts of gender integration on agriculture and food ...

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

    Evaluating impacts of gender integration on agriculture and food security outcomes ... to and control over land, agricultural technologies, extension services, markets, ... IDRC “unpacks women's empowerment” at McGill University Conference.

  16. Impact of Diffusion and Variability on Vendor Performance Evaluation

    National Research Council Canada - National Science Library

    Doerr, Kenneth; Lewis, Ira

    2005-01-01

    In this paper we develop a theory of the impact of behavioral decision making factors on the evaluation of logistic service providers under performance-based logistics and provide an analysis of pilot...

  17. Welfare Evaluation and the Economic Impacts of Climate Change on ...

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

    Welfare Evaluation and the Economic Impacts of Climate Change on Water Supply ... In a context of positive economic growth, demand for water is expected to ... Socially equitable climate action is essential to strengthen the resilience of all ...

  18. Impact of working hours on sleep and mental health.

    Science.gov (United States)

    Afonso, P; Fonseca, M; Pires, J F

    2017-07-01

    The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  19. Avaliação do impacto na qualidade de vida causado por problemas bucais na população adulta e idosa em município da Região Sudeste Evaluation of the impact on quality of life caused by oral health problems in adults and the elderly in a southeastern Brazilian city

    Directory of Open Access Journals (Sweden)

    Maria Helena Monteiro de Barros Miotto

    2012-02-01

    Full Text Available OBJETIVO: Avaliar a prevalência de impactos dos problemas bucais na qualidade de vida e associação com variáveis sociodemográficas, clínicas e utilização de serviços por adultos e idosos de Marechal Floriano, ES. MÉTODOS: Este estudo transversal utilizou uma amostra aleatória de 237 indivíduos. Foram utilizados roteiros para a coleta de dados incluindo o perfil do impacto de saúde bucal (OHIP-14. Os testes qui-quadrado e exato de Fischer (pThe scope of this paper was to evaluate the prevalence of the impact of oral health problems on quality of life, and its association with socio-demographic and clinical variables and the use of dental services by adults and the elderly in Marechal Floriano. A cross-sectional study was conducted on a random sample of 237 participants. Data was collected by Municipal Community Health Agents using four questionnaires with items about the socio-demographic and oral health status of the participants, dental practice structure and oral health impact profile (OHIP-14. The greatest impact perception related to oral health problems was found in individuals over 40 years of age (OR= 2.37 IC 95%=1.375;4.098, those with a perceived need for removable partial dentures (OR= 2.771 IC 95%=1.488;5.162, and full removable dentures (OR= 2.292 IC 95%=1.305;4.026. The impact prevalence was of 35% and revealed an association with age and the perceived need for partial and full dentures. Subjective indicators must be used in conjunction with objective indicators to determine the population's treatment needs, thereby improving oral health and quality of life of the population.

  20. Industrial Assessment Center Program Impact Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Martin, M.A.

    2000-01-26

    This report presents the results of an evaluation of the U.S. Department of Energy's Industrial Assessment Center (IAC) Program. The purpose of this program is to conduct energy, waste, and productivity assessments for small to medium-sized industrial firms. Assessments are conducted by 30 university-based industrial assessment centers. The purpose of this project was to evaluate energy and cost savings attributable to the assessments, the trained alumni, and the Websites sponsored by this program. How IAC assessments, alumni, and Web-based information may influence industrial energy efficiency decision making was also studied. It is concluded that appreciable energy and cost savings may be attributed to the IAC Program and that the IAC Program has resulted in more active and improved energy-efficiency decision making by industrial firms.

  1. [The evaluation of morbidity, physical health of students and the formation of self-protecting behavior].

    Science.gov (United States)

    2012-01-01

    The article presents the graded analysis of morbidity of students in comparison with adolescents and adults with consideration for gender age and trends in physical health. With maturation, the number of students with good physical health conditions decreases almost twice. The process of education in university can be considered as one of the factors negatively impacting the youth's health. The information indicators of students' health (weight/height indicator; test of Genchi and Ruffier) and organization of health information data bank considered as evaluation criteria in the development of complex target program of students' health promotion during education process.

  2. Impacts of Climate Change on Inequities in Child Health

    Directory of Open Access Journals (Sweden)

    Charmian M. Bennett

    2014-12-01

    Full Text Available This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

  3. The impact of health information technology on patient safety.

    Science.gov (United States)

    Alotaibi, Yasser K; Federico, Frank

    2017-12-01

    Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

  4. The impact of health information technology on patient safety

    Directory of Open Access Journals (Sweden)

    Yasser K. Alotaibi

    2017-12-01

    Full Text Available Since the original Institute of Medicine (IOM report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

  5. The Energy Burden and Environmental Impact of Health Services

    Science.gov (United States)

    Buettner, Petra G.; Canyon, Deon V.

    2012-01-01

    Objectives. We reviewed the English-language literature on the energy burden and environmental impact of health services. Methods. We searched all years of the PubMed, CINAHL, and ScienceDirect databases for publications reporting energy consumption, greenhouse gas emissions, or the environmental impact of health-related activities. We extracted and tabulated data to enable cross-comparisons among different activities and services; where possible, we calculated per patient or per event emissions. Results. We identified 38 relevant publications. Per patient or per event, health-related energy consumption and greenhouse gas emissions are quite modest; in the aggregate, however, they are considerable. In England and the United States, health-related emissions account for 3% and 8% of total national emissions, respectively. Conclusions. Although reducing health-related energy consumption and emissions alone will not resolve all of the problems of energy scarcity and climate change, it could make a meaningful contribution. PMID:23078475

  6. Evaluating the impacts of packaging policy in The Netherlands

    NARCIS (Netherlands)

    Rouw, M.; Worrell, E.

    2011-01-01

    Packaging materials are one of the largest contributors to municipal solid waste production. This paper evaluates the material impacts packaging policy in The Netherlands in the period 1986–2007. Five different voluntary agreements were implemented over this period to reduce the environmental impact

  7. Assessing Impact Submissions for REF 2014: An Evaluation

    Science.gov (United States)

    Manville, Catriona; Guthrie, Susan; Henham, Marie-Louise; Garrod, Bryn; Sousa, Sonia; Kirtley, Anne; Castle-Clarke, Sophie; Ling, Tom

    2015-01-01

    The Research Excellence Framework (REF) is a new system for assessing the quality of research in UK higher education institutions (HEIs). For the first time, part of the assessment included the wider impact of research. RAND Europe was commissioned to evaluate the assessment process of the impact element of REF submissions, and to explore the…

  8. An evaluation on environment radiation impact of pulsed reactor

    International Nuclear Information System (INIS)

    Gao Yingwei; Pu Gongxu; Li Jian

    1991-01-01

    The dose regulation, assessment scope and assessment method adopted by the environment impact evaluation for the pulsed reactor are discussed. The compute model, the compute programme and the compute result of the dose adopted for the model pulsed reactor are introduced. The probable environment radiation impact under normal status and accident status are also appraised

  9. Evaluation of Harmonics Impact on Digital Relays

    Directory of Open Access Journals (Sweden)

    Kinan Wannous

    2018-04-01

    Full Text Available This paper presents the concept of the impact of harmonic distortion on a digital protection relay. The aim is to verify and determine the reasons of a mal-trip or failure to trip the protection relays; the suggested solution of the harmonic distortion is explained by a mathematical model in the Matlab Simulink programming environment. The digital relays have been tested under harmonic distortions in order to verify the function of the relays algorithm under abnormal conditions. The comparison between the protection relay algorithm under abnormal conditions and a mathematical model in the Matlab Simulink programming environment based on injected harmonics of high values is provided. The test is separated into different levels; the first level is based on the harmonic effect of an individual harmonic and mixed harmonics. The test includes the effect of the harmonics in the location of the fault point into distance protection zones. This paper is a new proposal in the signal processing of power quality disturbances using Matlab Simulink and the power quality impact on the measurements of the power system quantities; the test simulates the function of protection in power systems in terms of calculating the current and voltage values of short circuits and their faults. The paper includes several tests: frequency variations and decomposition of voltage waveforms with Fourier transforms (model and commercial relay, the effect of the power factor on the location of fault points, the relation between the tripping time and the total harmonic distortion (THD levels in a commercial relay, and a comparison of the THD capture between the commercial relay and the model.

  10. Extended impacts of climate change on health and wellbeing

    International Nuclear Information System (INIS)

    Thomas, Felicity; Sabel, Clive E.; Morton, Katherine; Hiscock, Rosemary; Depledge, Michael H.

    2014-01-01

    Highlights: • Incorporates wellbeing into understandings of climate change impacts on health. • Considers a range of secondary impacts of climate change on health and wellbeing. • Examines co-benefits and dis-benefits of climate change adaptation and mitigation strategies for health and wellbeing. • Emphasises the spatially and socially differentiated repercussions of adaptation and mitigation measures. - Abstract: Anthropogenic climate change is progressively transforming the environment despite political and technological attempts to reduce greenhouse gas emissions to tackle global warming. Here we propose that greater insight and understanding of the health-related impacts of climate change can be gained by integrating the positivist approaches used in public health and epidemiology, with holistic social science perspectives on health in which the concept of ‘wellbeing’ is more explicitly recognised. Such an approach enables us to acknowledge and explore a wide range of more subtle, yet important health-related outcomes of climate change. At the same time, incorporating notions of wellbeing enables recognition of both the health co-benefits and dis-benefits of climate change adaptation and mitigation strategies across different population groups and geographical contexts. The paper recommends that future adaptation and mitigation policies seek to ensure that benefits are available for all since current evidence suggests that they are spatially and socially differentiated, and their accessibility is dependent on a range of contextually specific socio-cultural factors

  11. The practical impact of differential item functioning analyses in a health-related quality of life instrument

    DEFF Research Database (Denmark)

    Scott, Neil W; Fayers, Peter M; Aaronson, Neil K

    2009-01-01

    Differential item functioning (DIF) analyses are commonly used to evaluate health-related quality of life (HRQoL) instruments. There is, however, a lack of consensus as to how to assess the practical impact of statistically significant DIF results.......Differential item functioning (DIF) analyses are commonly used to evaluate health-related quality of life (HRQoL) instruments. There is, however, a lack of consensus as to how to assess the practical impact of statistically significant DIF results....

  12. CAPACITY BUILDING PROCESS IN ENVIRONMENTAL AND HEALTH IMPACT ASSESSMENT FOR A THAI COMMUNITY.

    Science.gov (United States)

    Chaithui, Suthat; Sithisarankul, Pornchai; Hengpraprom, Sarunya

    2017-03-01

    This research aimed at exploring the development of the capacitybuilding process in environmental and health impact assessment, including the consideration of subsequent, capacity-building achievements. Data were gathered through questionnaires, participatory observations, in-depth interviews, focus group discussions, and capacity building checklist forms. These data were analyzed using content analysis, descriptive statistics, and inferential statistics. Our study used the components of the final draft for capacity-building processes consisting of ten steps that were formulated by synthesis from each respective process. Additionally, the evaluation of capacity building levels was performed using 10-item evaluation criteria for nine communities. The results indicated that the communities performed well under these criteria. Finally, exploration of the factors influencing capacity building in environmental and health impact assessment indicated that the learning of community members by knowledge exchange via activities and study visits were the most influential factors of the capacity building processes in environmental and health impact assessment. The final revised version of capacitybuilding process in environmental and health impact assessment could serve as a basis for the consideration of interventions in similar areas, so that they increased capacity in environmental and health impact assessments.

  13. Concept of waste and its impact on human health.

    Science.gov (United States)

    Pashkov, Vitalii M; Batyhina, Olena M; Trotska, Maryna V

    Impact of the environment on human health is increasingly being paid attention both at the international level and at the level of individual countries. Among the factors that anyhow can affect it negatively, various objects are distinguished and waste is not of the last consequence. It has different nature of origin, ways of further utilization and a degree of impact on human health and the environment. Its generation, utilization and neutralization are determined by the relevant processes; their research allows continuous improvement and reduction of their negative impact on human health and the environment. To analyze provisions of the international legislation concerning the concept of waste and its classification, as well as its potential impacts on human health and the environment. The study analyzes and uses international legal documents, data of international organizations and scientists' deductions. Furthermore, the study integrates information from scientific journals with scientific methods from the medical and legal point of view. Within the framework of the system approach, as well as analysis and synthesis, the concept of waste, its classification and impact on human health and the environment have been researched. In consequence of the conducted study, it has been found that at the European level, considerable attention is paid to waste in the context of its possible negative impact on human health and the environment. Solution of this problem is carried out with the integrated approach, which is expressed both in enacting statutory acts and amending existing ones, as well as elucidating various aspects at the scientific, methodological, statistical and other levels. Waste in itself has different nature of origin, negative impact, ways of its further utilization. Some kinds of it can be used further in order to achieve other goals and needs that are not related to their generation, others can no longer be used for human benefits taking into account

  14. Hunger: its impact on children's health and mental health.

    Science.gov (United States)

    Weinreb, Linda; Wehler, Cheryl; Perloff, Jennifer; Scott, Richard; Hosmer, David; Sagor, Linda; Gundersen, Craig

    2002-10-01

    Hunger, with its adverse consequences for children, continues to be an important national problem. Previous studies that document the deleterious effects of hunger among children cannot distinguish child from family hunger and do not take into account some critical environmental, maternal, and child variables that may influence child outcomes. This study examines the independent contribution of child hunger on children's physical and mental health and academic functioning, when controlling for a range of environmental, maternal, and child factors that have also been associated with poor outcomes among children. With the use of standardized tools, comprehensive demographic, psychosocial, and health data were collected in Worcester, Massachusetts, from homeless and low-income housed mothers and their children (180 preschool-aged children and 228 school-aged children). Mothers and children were part of a larger unmatched case-control study of homelessness among female-headed households. Hunger was measured by a set of 7 dichotomous items, each asking the mother whether she has or her children have experienced a particular aspect of hunger during the past year--1 concerns food insecurity for the entire family, 2 concern adult hunger, and 4 involve child hunger. The items, taken from the Childhood Hunger Identification Project measure, are summed to classify the family and divided into 3 categories: no hunger, adult or moderate child hunger, or severe child hunger (indicating multiple signs of child hunger). Outcome measures included children's chronic health condition count using questions adapted from the National Health Interview Survey, Child Health Supplement, and internalizing behavior problems and anxiety/depression, measured by the Child Behavior Checklist. Additional covariates included demographic variables (ie, age, gender, ethnicity, housing status, number of moves, family size, income), low birth weight, child life events (ie, care and protection order, out

  15. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management.

    Science.gov (United States)

    Reed, Karla S; Meade, Michelle A; Krause, James S

    2016-01-01

    Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

  16. Public health evaluation of waste management plan of urban areas of Florence

    International Nuclear Information System (INIS)

    Corti, Andrea; Lombardi, Lidia; Carpentieri, Matteo; Buiatti, Eva; Bartolacci, Simone; Bianchi, Fabrizio; Linzalone, Nunzia; Minichilli, Fabrizio; Mancuso, Stefano

    2005-01-01

    Public health evaluation impact for solid municipal waste management of Florence urban areas is considered. In this case study the evaluation step of screening show the environmental analysis of pollutants in the urban areas and epidemiologic study of exposed population in the area

  17. Health care needs of children with Down syndrome and impact of health system performance on children and their families.

    Science.gov (United States)

    Phelps, Randall A; Pinter, Joseph D; Lollar, Donald J; Medlen, Joan Guthrie; Bethell, Christina D

    2012-04-01

    The functional, financial, and social impact on families of children with Down syndrome (DS) in the United States and the role of the US health care system in ameliorating these impacts have not been well characterized. We sought to describe the demographic characteristics and functional difficulties of these children and to determine whether children with DS, compared with children with "intellectual disability" (ID) generally, and compared with other "children and youth with special health care needs" (CYSHCN), are more or less likely to receive health care that meets quality standards related to care coordination and to have their health care service needs met. This study analyzed data from the 2005-2006 National Survey of Children with Special Health Care Needs (n = 40,723). Children and youth aged 0 to 17 years with special health care need (CYSHCN) who experience DS (n = 395) and/or IDs (n = 4252) were compared with each other and other CYSHCN on a range of functioning, family impact, and health care quality variables using bivariate and multivariate methods. Data were weighted to represent all CYSHCN in the United States. Compared with CYSHCN without DS, children with DS were significantly less likely to receive comprehensive care within a medical home (29.7% vs 47.3%; p work due to their child's health needs (23.5% vs 55.1%; p performance was poorer for children with DS compared with those with ID and no DS after adjustment for family income, prevalence on most aspects of quality of care and family impacts evaluated were similar for these 2 groups. In this study, the families of children with DS, and ID generally, are burdened disproportionately when compared with other CYSHCN, reflecting the combination of impairments intrinsic to DS and ID and impacts of suboptimal medical care coordination and social support.

  18. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  19. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  20. Health Impacts from Acute Radiation Exposure

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.

    2003-09-30

    Absorbed doses above1-2 Gy (100-200 rads) received over a period of a day or less lead to one or another of the acute radiation syndromes. These are the hematopoietic syndrome, the gastrointestinal (GI) syndrome, the cerebrovascular (CV) syndrome, the pulmonary syndrome, or the cutaneous syndrome. The dose that will kill about 50% of the exposed people within 60 days with minimal medical care, LD50-60, is around 4.5 Gy (450 rads) of low-LET radiation measured free in air. The GI syndrome may not be fatal with supportive medical care and growth factors below about 10 Gy (1000 rads), but above this is likely to be fatal. Pulmonary and cutaneous syndromes may or may not be fatal, depending on many factors. The CV syndrome is invariably fatal. Lower acute doses, or protracted doses delivered over days or weeks, may lead to many other health outcomes than death. These include loss of pregnancy, cataract, impaired fertility or temporary or permanent sterility, hair loss, skin ulceration, local tissue necrosis, developmental abnormalities including mental and growth retardation in persons irradiated as children or fetuses, radiation dermatitis, and other symptoms listed in Table 2 on page 12. Children of parents irradiated prior to conception may experience heritable ill-health, that is, genetic changes from their parents. These effects are less strongly expressed than previously thought. Populations irradiated to high doses at high dose rates have increased risk of cancer incidence and mortality, taken as about 10-20% incidence and perhaps 5-10% mortality per sievert of effective dose of any radiation or per gray of whole-body absorbed dose low-LET radiation. Cancer risks for non-uniform irradiation will be less.

  1. The impact of community health workers (CHWs) on Buruli ulcer in ...

    African Journals Online (AJOL)

    Buruli ulcer (BU) is a cutaneous neglected tropical disease caused by Mycobacterium ulcerans. Participation of Community Health Workers (CHWs) is an integral part of the management of BU, yet their impact has not been systematically evaluated in sub-Saharan Africa. Methods: Our objectives were to summarize the ...

  2. Population Dynamics and Air Pollution: The Impact of Demographics on Health Impact Assessment of Air Pollution

    Directory of Open Access Journals (Sweden)

    Esben Meulengracht Flachs

    2013-01-01

    Full Text Available Objective. To explore how three different assumptions on demographics affect the health impact of Danish emitted air pollution in Denmark from 2005 to 2030, with health impact modeled from 2005 to 2050. Methods. Modeled air pollution from Danish sources was used as exposure in a newly developed health impact assessment model, which models four major diseases and mortality causes in addition to all-cause mortality. The modeling was at the municipal level, which divides the approximately 5.5 M residents in Denmark into 99 municipalities. Three sets of demographic assumptions were used: (1 a static year 2005 population, (2 morbidity and mortality fixed at the year 2005 level, or (3 an expected development. Results. The health impact of air pollution was estimated at 672,000, 290,000, and 280,000 lost life years depending on demographic assumptions and the corresponding social costs at 430.4 M€, 317.5 M€, and 261.6 M€ through the modeled years 2005–2050. Conclusion. The modeled health impact of air pollution differed widely with the demographic assumptions, and thus demographics and assumptions on demographics played a key role in making health impact assessments on air pollution.

  3. Health care: economic impact of caring for geriatric patients.

    Science.gov (United States)

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

    Science.gov (United States)

    Lee, K

    2000-09-01

    There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

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

    Science.gov (United States)

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

    2018-06-13

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

  6. The Impact of Health Behaviors and Health Management on Employment After SCI: Physical Health and Functioning.

    Science.gov (United States)

    Meade, Michelle A; Reed, Karla S; Krause, James S

    2016-01-01

    Background : Research has shown that employment following spinal cord injury (SCI) is related to health and functioning, with physical health and functioning after SCI frequently identified as a primary barrier to employment. Objective: To examine the relationship between employment and behaviors associated with the management of physical health and functioning as described by individuals with SCI who have been employed post injury. Methods: A qualitative approach using 6 focus groups at 2 sites included 44 participants with SCI who had worked at some time post injury. Heterogeneous and homogeneous groups were created based on specific characteristics, such as education, gender, or race. A semi-structured interview format asked questions about personal, environmental, and policy-related factors influencing employment after SCI. Groups were recorded, transcribed, and entered into NVivo before coding by 2 reviewers. Results: Within the area of behaviors and management of physical health and functioning, 4 overlapping themes were identified: (1) relearning your own body and what it can do; (2) general health and wellness behaviors; (3) communication, education, and advocacy; and (4) secondary conditions and aging. Specific themes articulate the many types of behaviors individuals must master and their impact on return to work as well as on finding, maintaining, and deciding to leave employment. Conclusions: Individuals with SCI who are successfully employed after injury must learn how to perform necessary behaviors to manage health and function in a work environment. The decision to leave employment often appears to be associated with secondary complications and other conditions that occur as persons with SCI age.

  7. Unmet Need: Improving mHealth Evaluation Rigor to Build the Evidence Base.

    Science.gov (United States)

    Mookherji, Sangeeta; Mehl, Garrett; Kaonga, Nadi; Mechael, Patricia

    2015-01-01

    mHealth-the use of mobile technologies for health-is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4+) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.

  8. Impact of culture on health outcomes.

    Science.gov (United States)

    Kagawa-Singer, Marjorie

    2011-10-01

    The diagnosis of cancer creates anticipatory grief and fear for the patient and the family, and the x cancer care experience is fraught with physical, emotional and spiritual challenges. The palliative care literature in Europe and North American is rapidly growing, but such literature is sparse in other parts of the world. Translating the findings from the W